Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS H24-5, Atlanta, GA, 30333, USA.
Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
J Immigr Minor Health. 2020 Oct;22(5):1101-1104. doi: 10.1007/s10903-020-01024-3.
To assess prevalence of congenital cytomegalovirus (CMV)-coded diagnosis among American Indian/Alaska Native (AI/AN) infants who received Indian Health Service (IHS)-funded care during 2000-2017. Using data from the Indian Health Service National Data Warehouse, we identified AI/AN infants with congenital CMV-coded diagnosis, defined as presence of a diagnostic code for congenital CMV disease or CMV infection (International Classification of Diseases, Ninth Revision or Tenth Revision, Clinical Modification 771.1, 078.5, P35.1, B25.xx) within 90 days of life. We calculated prevalence of congenital CMV-coded diagnosis overall, by age at first CMV-coded diagnosis, and by geographical region. During 2000-2017, 54 (1.5/10,000) of 354,923 AI/AN infants had a congenital CMV-coded diagnosis; 32 (0.9/10,000) had their first CMV-coded diagnosis within 45 days of life, and 22 (0.6/10,000) between 46 and 90 days of life. Prevalence of congenital CMV-coded diagnosis varied by region (range 0.9/10,000 in Southern Plains to 3.7/10,000 in Alaska, P = 0.0038). Among the 54 infants with a congenital CMV-coded diagnosis, 48% had clinical signs such as jaundice, petechiae, or microcephaly, compared to 25% of 354,869 infants without a CMV-coded diagnosis (P < 0.01); and 1 (2%) vs. 277 (0.1%), respectively, died (P < 0.05). The prevalence of congenital CMV-coded diagnosis among AI/AN infants who received care at IHS facilities was slightly lower than in other studies based on health claims data and varied by geographical region.
评估 2000-2017 年期间接受美国印第安人/阿拉斯加原住民（AI/AN）接受印第安人健康服务（IHS）资助的医疗服务的 AI/AN 婴儿中先天性巨细胞病毒（CMV）编码诊断的流行率。使用印第安人健康服务国家数据库的数据，我们确定了患有先天性 CMV 编码诊断的 AI/AN 婴儿，定义为在生命的 90 天内存在先天性 CMV 疾病或 CMV 感染的诊断代码（国际疾病分类，第九修订版或第十修订版，临床修正 771.1、078.5、P35.1、B25.xx）。我们计算了总体上、按首次 CMV 编码诊断年龄以及按地理区域的先天性 CMV 编码诊断的流行率。在 2000-2017 年期间，354923 名 AI/AN 婴儿中有 54 名（1.5/10000）被诊断为先天性 CMV 编码诊断；32 名（0.9/10000）在生命的 45 天内首次被诊断为 CMV 编码诊断，22 名（0.6/10000）在 46-90 天内被诊断为 CMV 编码诊断。先天性 CMV 编码诊断的流行率因地区而异（南部平原地区为 0.9/10000，阿拉斯加地区为 3.7/10000，P=0.0038）。在 54 名患有先天性 CMV 编码诊断的婴儿中，48%有黄疸、瘀点或小头畸形等临床体征，而在 354869 名无 CMV 编码诊断的婴儿中，有 25%有临床体征（P<0.01）；分别有 1 名（2%）和 277 名（0.1%）死亡（P<0.05）。在接受 IHS 设施医疗服务的 AI/AN 婴儿中，先天性 CMV 编码诊断的流行率略低于基于健康索赔数据的其他研究，并且因地理区域而异。
