Okalany Noela Regina Akwi, Engebretsen Ingunn Marie S, Mukunya David, Chebet Martin, Okello Francis, Weeks Andrew D, Mwanda Edrin, Muhindo Rita, Bisso Fred, Tylleskär Thorkild, Olupot-Olupot Peter, Burgoine Kathy
Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Department of Community and Public Health, Busitema University, Mbale, Uganda.
BMC Pediatr. 2025 Mar 11;25(1):179. doi: 10.1186/s12887-025-05518-7.
Cytomegalovirus (CMV) infection poses risks to both maternal and neonatal health, however there are limited comprehensive data on congenital CMV in low-resource settings where the virus is widespread, particularly among women of reproductive age. Our research in eastern Uganda aimed to assess the prevalence of congenital CMV and outcomes among infants to inform public health policies and interventions in similar settings, addressing a significant gap in current knowledge.
We conducted a descriptive study, nested within the BabyGel Trial, across Mbale and Budaka districts in eastern Uganda, between May 2023 and January 2024. Infants underwent saliva sampling within the first week of life, which was validated through urine polymerase chain reaction testing within the first 21 days of life. At three months of age, a cranial ultrasound examination, neurological examination, developmental evaluation, and audiological assessment were conducted for all infants diagnosed with congenital CMV infection. Statistical analyses were performed using Stata 17.0.
Congenital CMV infection was found in 5 out of 1,265 newborns tested, indicating a prevalence of 0.4% (95% CI: 0.16 to 0.96). Of these 5 infected infants, two experienced febrile illness at birth and required hospitalisation within the first week of life, and three had findings on ultrasound examination consistent with congenital cytomegalovirus during the neonatal period. Audiologic follow-up until three months of age revealed that three infants had failed unilateral and bilateral hearing screening. Neurodevelopment assessments using the Malawi Development Assessment Tool fell within optimal ranges for all 5 infants; however, when evaluated using the Hammersmith Infant Neurological Examination, four infants scored below optimal levels.
Our community-based study revealed a low prevalence of congenital CMV infection. Further longitudinal multi-site research is needed to assess the generalisability of these findings. Also, long-term follow-up of children is crucial to understanding the outcomes and sequelae of infected infants to inform prevention strategies, targeted interventions and scalable screening frameworks in resource-limited settings.
巨细胞病毒（CMV）感染对孕产妇和新生儿健康均构成风险，然而，在该病毒广泛传播的资源匮乏地区，尤其是育龄妇女中，关于先天性CMV的综合数据有限。我们在乌干达东部的研究旨在评估先天性CMV的患病率及婴儿的结局，为类似环境中的公共卫生政策和干预措施提供依据，填补当前知识的重大空白。
我们于2023年5月至2024年1月在乌干达东部的姆巴莱和布达卡区进行了一项描述性研究，该研究嵌套于BabyGel试验中。婴儿在出生后第一周内进行唾液采样，并在出生后21天内通过尿液聚合酶链反应检测进行验证。在三个月大时，对所有诊断为先天性CMV感染的婴儿进行了头颅超声检查、神经学检查、发育评估和听力评估。使用Stata 17.0进行统计分析。
在1265名接受检测的新生儿中，发现5例先天性CMV感染，患病率为0.4%（95%CI：0.16至0.96）。在这5名感染婴儿中，2名出生时出现发热疾病，在出生后第一周内需要住院治疗，3名在新生儿期超声检查结果与先天性巨细胞病毒一致。直到三个月大的听力随访显示，3名婴儿单侧和双侧听力筛查未通过。使用马拉维发育评估工具进行的神经发育评估显示，所有5名婴儿的评估结果均在最佳范围内；然而，使用哈默史密斯婴儿神经学检查进行评估时，4名婴儿的得分低于最佳水平。
我们基于社区的研究显示先天性CMV感染的患病率较低。需要进一步开展纵向多地点研究，以评估这些发现的普遍性。此外，对儿童进行长期随访对于了解感染婴儿的结局和后遗症至关重要，可为资源有限环境中的预防策略、针对性干预措施和可扩展的筛查框架提供依据。
