You are here

Prevalence of Cytomegalovirus in Iraqi Children

Journal Name:

Publication Year:

Abstract (2. Language): 
The majority of children with congenital cytomegalovirus are born to cytomegalovirus seropositive women. However, the likelihood of congenital infection with disability is highest for children whose mothers were cytomegalovirus seronegative acquired infection during pregnancy. Objectives: to provide first nationally estimate of cytomegalovirus seropositivity among Iraqi children under five years of age. Materials and Methods was used total of 1000 hospitalized children under five years of age form different geographical area in Iraq were enrolled in this study. The numbers of children were collected by proportional allocation for each selected governorate according to total number of participant children. Kuppuswamy scale has been used to measure the socioeconomic status for children. Serum samples were obtained from each subject participate in this study, cytomegalovirus infection was defined as IgM antibody positive by electro-chemiluminescence Immunoassay techniques. The results show that the current study revealed a prevalence of cytomegalovirus specific IgM as a serum marker was 5.4% among children under five years of age. Positive cytomegalovirus was associated with low socioeconomic status, maternal bad obstetric history, and lower age of children, while the infection was not associated to geographical distribution and gender. By stratified the children into symptomatic and asymptomatic according to the signs and symptoms of cytomegalovirus congenital and acquired infection at time of sample collection, 15% and 0.9% proved to have positive specific IgM among symptomatic and asymptomatic children, respectively. Jaundice was the most predominant clinical sign 56% among symptomatic infected children, followed by hepatosplenomegaly 41.7%. Conclusion: The data provide in the current study strongly encourage routine testing for cytomegalovirus Antibodies among pregnant women in Iraq. Infants diagnosed to be sub-clinically infected with cytomegalovirus, considered being at a risk for the developmental sequelae and they should be observed closely in order to detect the consequences of congenital infection and to allow treatment to occur as early as possible.
113
124

REFERENCES

References: 

[1] Tomtishen III, John Paul. “Human cytomegalovirus tegument proteins (pp65, pp71, pp150, pp28).” Virology
Journal Vol. 9, No. 1, 2012, p. 22.
[2] Slobedman, Barry, and Edward S. Mocarski. “Quantitative analysis of latent human cytomegalovirus.” Journal
of Virology Vol. 73, No. 6, 1999, pp. 4806-12.
[3] Murphy, E., and Thomas E. Shenk. “Human cytomegalovirus genome.” Human Cytomegalovirus 2008, pp. 1-19.
[4] Restrepo-Gualteros, Sonia M., et al. “Characterization of cytomegalovirus lung infection in non-HIV infected
children.” Viruses Vol. 6, No. 5, 2014, pp. 2038-51.
[5] Chin J. “Cytomegalovirus” Control of Communicable Disease Manual, 17th ed., edited by David L. Heymann,
American Public Health Association, 2000, p. 138.
[6] Cunha, Burke A. “Cytomegalovirus pneumonia: Community-acquired pneumonia in immunocompetent
hosts.” Infectious Disease Clinics of North America Vol. 24, No. 1, 2010, pp. 147-58.
[7] Sinclair, John H., and Matthew B. Reeves. “Human cytomegalovirus manipulation of latently infected
cells.” Viruses Vol. 5, No. 11, 2013, pp. 2803-24.
[8] Harrison GJ. “Cytomegalovirus.” Feigin and Cherry’s Textbook of Pediatric Infectious Diseases, edited by
James Donald Cherry. Elsevier/Saunders, 2014.
[9] Radigan, Kathryn A., and Richard G. Wunderink. “Epidemic viral pneumonia and other emerging
pathogens.” Clinics in Chest Medicine Vol. 32, No. 3, 2011, pp. 451-67.
[10] Limaye, Ajit P., and Michael Boeckh. “CMV in critically ill patients: pathogen or bystander?” Reviews in
Medical Virology Vol. 20, No. 6, 2010, pp. 372-79.
[11] Atkinson, Claire, and Vincent C. Emery. “Cytomegalovirus quantification: where to next in optimising patient
management?” Journal of Clinical Virology Vol. 51, No. 4, 2011, pp. 223-28.
[12] El-Sayed, Manal F., et al. “Severe late-onset multisystem cytomegalovirus infection in a premature neonate
previously treated for congenital infection.” BMC Pediatrics Vol. 13, No. 1, 2013, p. 142.
[13] Margioula-Siarkou, Chrysoula, et al. “Cytomegalovirus, Toxoplasma gondii and Rubella vertical transmission
rates according to mid-trimester amniocentesis: A retrospective study.” International Journal of Preventive
Medicine Vol. 6, 2015.
[14] Demmler-Harrison, Gail J. “Congenital cytomegalovirus: Public health action towards awareness, prevention,
and treatment.” Journal of Clinical Virology Vol. 46, 2009, pp. S1-S5.
[15] Crough, Tania, and Rajiv Khanna. “Immunobiology of human cytomegalovirus: From bench to bedside.” Clinical
Microbiology Reviews Vol. 22, No. 1, 2009, pp. 76-98.
[16] Mocarski ES, Jr, Shenk T and Pass RF. “Cytomegaloviruses.” Fields’ Virology, Volume 1, edited by David
Mahan Knipe and Peter M. Howley, Lippincott Williams & Wilkins, 2007, pp. 2702-72.
[17] Kenneson, Aileen, and Michael J. Cannon. “Review and meta-analysis of the epidemiology of congenital
cytomegalovirus (CMV) infection.” Reviews in Medical Virology Vol. 17, No. 4, 2007, pp. 253-76.
Alwan, et al. Int J Med Res Health Sci 2017, 6(11): 113-124
122
[18] Pereira, Lenore, et al. “Intrauterine growth restriction caused by underlying congenital cytomegalovirus
infection.” The Journal of Infectious Diseases Vol. 209, No. 10, 2014, pp. 1573-84.
[19] Griffiths, Paul, et al. “Desirability and feasibility of a vaccine against cytomegalovirus.” Vaccine Vol. 31, 2013,
pp. B197-B203.
[20] Dollard, Sheila C., Scott D. Grosse, and Danielle S. Ross. “New estimates of the prevalence of neurological
and sensory sequelae and mortality associated with congenital cytomegalovirus infection.” Reviews in Medical
Virology Vol. 17, No. 5, 2007, pp. 355-63.
[21] Lombardi, Giuseppina, Francesca Garofoli, and Mauro Stronati. “Congenital cytomegalovirus infection:
treatment, sequelae and follow-up.” The Journal of Maternal-Fetal & Neonatal Medicine Vol. 23. Supp. 3, 2010,
pp. 45-48.
[22] Dasari, Vijayendra, Corey Smith, and Rajiv Khanna. “Recent advances in designing an effective vaccine to
prevent cytomegalovirus-associated clinical diseases.” Expert Review of Vaccines Vol. 12, No. 6, 2013, pp. 661-76.
[23] Shedlock, Devon J., et al. “Vaccination with synthetic constructs expressing cytomegalovirus immunogens is
highly T cell immunogenic in mice.” Human Vaccines & Immunotherapeutics Vol. 8, No. 11, 2012, pp. 1668-81.
[24] Manicklal, Sheetal, et al. “The “silent” global burden of congenital cytomegalovirus.” Clinical Microbiology
Reviews Vol. 26, No. 1, 2013, pp. 86-102.
[25] Dollard, Sheila C., et al. “Cytomegalovirus viral and antibody correlates in young children.” BMC Research
Notes Vol. 7, No. 1, 2014, pp. 776.
[26] Cannon, Michael J., D. Scott Schmid, and Terri B. Hyde. “Review of cytomegalovirus seroprevalence and
demographic characteristics associated with infection.” Reviews in Medical Virology Vol. 20, No. 4, 2010, pp.
202-13.
[27] Lanzieri, Tatiana M., et al. “Seroprevalence of cytomegalovirus among children 1 to 5 years of age in the United
States from the National Health and Nutrition Examination Survey of 2011 to 2012.” Clinical and Vaccine
Immunology Vol. 22, No. 2, 2015, pp. 245-47.
[28] Voigt, Sebastian, Angelika Schaffrath Rosario, and Annette Mankertz. “Cytomegalovirus seroprevalence
among children and adolescents in Germany: data from the German Health Interview and Examination Survey
for Children and Adolescents (KiGGS), 2003–2006.” Open Forum Infectious Diseases Vol. 3. No. 1. Oxford
University Press, 2015.
[29] De Vries, Jutte JC, et al. “Congenital cytomegalovirus infection in the Netherlands: Birth prevalence and risk
factors.” Journal of Medical Virology Vol. 83, No. 10, 2011, pp. 1777-82.
[30] Staras, Stephanie AS, et al. “Cytomegalovirus seroprevalence and childhood sources of infection: A populationbased
study among pre-adolescents in the United States.” Journal of Clinical Virology Vol. 43, No. 3, 2008, pp.
266-71.
[31] Alsamarai, Abdulghani Mohamed, Z. Khalil, and M. Aljumaili. “Seroepidemiology of Toxoplasma, Rubella,
Cytomegalovirus and Herpes Simplex Virus-2 in women with bad obstetric history. Part I: Toxoplasma and
Rubella infections.” Our Dermatology Online Vol. 4, 2013, pp. 522-35.
[32] Maidji, Ekaterina, et al. “Antibody treatment promotes compensation for human cytomegalovirus-induced
pathogenesis and a hypoxia-like condition in placentas with congenital infection.” The American Journal of
Pathology Vol. 177, No. 3, 2010, pp. 1298-1310.
[33] Kurath, Stefan, et al. “Transmission of cytomegalovirus via breast milk to the prematurely born infant: a
systematic review.” Clinical Microbiology and Infection Vol. 16, No. 8, 2010, pp. 1172-78.
[34] Swanson, Elizabeth C., and Mark R. Schleiss. “Congenital cytomegalovirus infection: New prospects for
prevention and therapy for pediatric clinics of North America: Advances in evaluation, diagnosis and treatment
of pediatric infectious disease.” Pediatric Clinics of North America Vol. 60, No. 2, 2013.
[35] Bale, James F., et al. “Cytomegalovirus transmission in child care homes.” Archives of Pediatrics & Adolescent
Medicine Vol. 153, No. 1, 1999, pp. 75-79.
[36] Kumar, BP Ravi, Shankar Reddy Dudala, and A. R. Rao. “Kuppuswamy’s socio-economic status scale–a
Alwan, et al. Int J Med Res Health Sci 2017, 6(11): 113-124
123
revision of economic parameter for 2012.” International Journal of Research & Development of Health Vol. 1,
No. 1, 2013, pp. 2-4.
[37] Doocy, Shannon, and Gilbert Burnham. “Assessment of socio-economic status in the context of food insecurity:
Implications for field research.” World Health & Population Vol. 8, No. 3, 2006, pp. 32-42.
[38] Aljumaili, Zainab Khalil Mohamed, Abdulghani Mohamed Alsamarai, and Wesam Suhail Najem.
“Cytomegalovirus seroprevalence in women with bad obstetric history in Kirkuk, Iraq.” Journal of Infection and
Public Health Vol. 7, No. 4, 2014, pp. 277-88.
[39] Vauloup-Fellous, Christelle, et al. “Does hygiene counseling have an impact on the rate of CMV primary
infection during pregnancy? Results of a 3-year prospective study in a French hospital.” Journal of Clinical
Virology Vol. 46, 2009, pp. S49-S53.
[40] Abiola, A. O., et al. “Effect of health education on knowledge, attitude and practices of personal hygiene
among secondary school students in rural Sokoto, North West, Nigeria.” Nigerian Quarterly Journal of Hospital
Medicine Vol. 22, No. 3, 2012, pp. 181-90.
[41] Colugnati, Fernando AB, et al. “Incidence of cytomegalovirus infection among the general population and
pregnant women in the United States.” BMC Infectious Diseases Vol. 7, No. 1, 2007, p. 71.
[42] Kaimollah HT. “Sample size estimation in epidemiologic studies.” Caspian Journal of Internal Medicine Vol.
2, No. 4, 2011, pp. 289-98.
[43] Tuma FL, Fadhil HY, Moayad D, Anor M, Al-Hamdani F. Survey for CMV, HSV-2 Infections and their
Association with Congenital Anomalies, Baghdad. International Journal of Advanced Research. 2013; Vol. 1,
No. 10, pp. 310-16.
[44] Mokhtar SY, Elhag WI. “Serofrequency of cytomegalovirus infection in women with bad obstetric history
attending routine antenatal clinic at Omdurman Military Hospital.” European Academic Research Vol. 3, No. 6,
2015, pp. 6270-82.
[45] Hamprecht, Klaus, et al. “Epidemiology of transmission of cytomegalovirus from mother to preterm infant by
breastfeeding.” The Lancet Vol. 357, No. 9255, 2001, pp. 513-18.
[46] Gaytant, Michael A., et al. “Congenital cytomegalovirus infection: A review of the epidemiology and
outcome.” Obstetrical & Gynecological Survey Vol. 57, No. 4, 2002, pp. 245-56.
[47] Habib MA, Al-Omar LS, Sameh H. Prevalence of HCMV infection among Iraqi infants. Iraqi J Med Sci. 2003;
2: 76-82.
[48] Al Ali, H.Y., S.A. Yasseen, AL-Rawi S. Congenital CMV infection among newborn infants with congenital
malformation in Mosul. Jordan Medical Journal Vol. 26, 1995, pp. 53-58.
[49] Neirukh, Tahani, et al. “Seroprevalence of Cytomegalovirus among pregnant women and hospitalized children
in Palestine.” BMC Infectious Diseases Vol. 13, No. 1, 2013, p. 528.
[50] Golalipour, M.J., B. Khodabakhshi, and E. Ghaemi. “Possible role of TORCH agents in congenital malformations
in Gorgan, northern Islamic Republic of Iran.” Eastern Mediterranean Health Journal Vol. 15, No. 2, 2009, pp.
330-36.
[51] Gandhoke, Inderjeet, et al. “Glycoprotein B genotyping in congenital/perinatal cytomegalovirus infection in
symptomatic infants.” Indian Pediatrics Vol. 50, No. 7, 2013, pp. 663-67.
[52] Salwa El-S. Abdel Hamid, et al. “Comparative Epidemiology of Infection with Human Cytomegalovirus in
Cairo and South London.” International Journal of Virology Vol. 7, No. 3, 2011, pp. 116-22.
[53] Yamazaki, Hiroshi, et al. “Cochlear implantation in children with congenital cytomegalovirus infection
accompanied by psycho-neurological disorders.” Acta Oto-laryngologica Vol. 132, No. 4, 2012, pp. 420-27.
[54] Scheurer, Michael E., et al. “Detection of human cytomegalovirus in different histological types of gliomas.” Acta
Neuropathologica Vol. 116, No. 1, 2008, pp. 79-86.
[55] Kalil, Andre C., and Diana F. Florescu. “Prevalence and mortality associated with cytomegalovirus infection
in nonimmunosuppressed patients in the intensive care unit.” Critical Care Medicine Vol. 37, No. 8, 2009, pp.
2350-58.
Alwan, et al. Int J Med Res Health Sci 2017, 6(11): 113-124
124
[56] Caposio, Patrizia, Susan L. Orloff, and Daniel N. Streblow. “The role of cytomegalovirus in angiogenesis.” Virus
Research Vol. 157, No. 2, 2011, pp. 204-11.
[57] Moghimi, M., et al. “Serological study on cytomegalovirus and Toxoplasma gondii in thalassemia major patients
of Yazd, Iran.” Iranian Journal of Pediatric Hematology and Oncology Vol. 5, No. 3, 2015, p. 149.
[58] Enders, Gisela, et al. “Intrauterine transmission and clinical outcome of 248 pregnancies with primary
cytomegalovirus infection in relation to gestational age.” Journal of Clinical Virology Vol. 52, No. 3, 2011, pp.
244-46.
[59] Sowmya, P., et al. “Comparative efficacy of PCR-based restriction fragment length polymorphism (RFLP)
& multiplex PCR for glycoprotein B (gB) genotyping of human cytomegalovirus.” Indian Journal of Medical
Research Vol. 126, No. 2, 2007, p. 122.
[60] Novak, Zdenek, et al. “Cytomegalovirus strain diversity in seropositive women.” Journal of Clinical
Microbiology Vol. 46, No. 3, 2008, pp. 882-86.
[61] Boppana, Suresh B., et al. “Symptomatic congenital cytomegalovirus infection: neonatal morbidity and
mortality.” The Pediatric Infectious Disease Journal Vol. 11, No. 2, 1992, pp. 93-98.

Thank you for copying data from http://www.arastirmax.com