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Jyoti A, Kumar S, Kumar Srivastava V, Kaushik S, Govind Singh S. Neonatal sepsis at point of care. Clin Chim Acta 2021; 521:45-58. [PMID: 34153274 DOI: 10.1016/j.cca.2021.06.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/14/2021] [Accepted: 06/14/2021] [Indexed: 01/03/2023]
Abstract
Sepsis, which includes infection followed by inflammation, is one of the leading causes of death among neonates worldwide. The major attribute of this disease process is dysregulated host response to infection leading to organ dysfunction and potentially death. A comprehensive understanding of the host response as well as the pathogen itself are important factors contributing to outcome. Early diagnosis is paramount, as it leads to accurate assessment and improved clinical management. Accordingly, a number of diagnostic platforms have been introduced to assess the presence of blood stream pathogens in septic neonates. Unfortunately, current point-of-care (POC) methods rely on a single parameter/biomarker and thus lack a comprehensive evaluation. The emerging field of biosensing has, however, resulted in the development of a wide range of analytical devices that may be useful at POC. This review discusses currently available methods to screen the inflammatory process in neonatal sepsis. We describe POC sensor-based methods for single platform multi-analyte detection and highlight the latest advances in this evolving technology. Finally, we critically evaluate the applicability of these POC devices clinically for early diagnosis of sepsis in neonates.
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Affiliation(s)
- Anupam Jyoti
- Amity Institute of Biotechnology, Amity University, Jaipur, Rajasthan 303002, India; Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Solan, Himachal Pradesh, 173229, India.
| | - Sanni Kumar
- Department of Electrical Engineering, Indian Institute of Technology, Hyderabad, Telangana 502285, India.
| | | | - Sanket Kaushik
- Amity Institute of Biotechnology, Amity University, Jaipur, Rajasthan 303002, India.
| | - Shiv Govind Singh
- Department of Electrical Engineering, Indian Institute of Technology, Hyderabad, Telangana 502285, India.
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2
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Petersen MR, Patel EU, Abraham AG, Quinn TC, Tobian AAR. Changes in Cytomegalovirus Seroprevalence Among U.S. Children Aged 1-5 Years: The National Health and Nutrition Examination Surveys. Clin Infect Dis 2021; 72:e408-e411. [PMID: 32776128 DOI: 10.1093/cid/ciaa1168] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 08/05/2020] [Indexed: 12/12/2022] Open
Abstract
Data from the cross-sectional National Health and Nutrition Examination Surveys (NHANES) indicate that the seroprevalence of cytomegalovirus immunoglobulin G (IgG) antibodies among US children aged 1-5 years was 20.7% (95% confidence interval [CI]: 14.0, 29.0) in 2011-2012 and 28.2% (95% CI: 23.1-34.0) in 2017-2018 (adjusted prevalence difference, +7.6% [95% CI: -.4, +15.6]).
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Affiliation(s)
- Molly R Petersen
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Eshan U Patel
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Alison G Abraham
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Thomas C Quinn
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Laboratory of Immunoregulation, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Baltimore, Maryland, USA
| | - Aaron A R Tobian
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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3
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Schaefer MR, Holttum J, Olson M, Westenberg D, Rubin N, Schleiss MR, Nyholm J. Development and Assessment of a Prenatal Cytomegalovirus (CMV) Educational Survey: Implementation and Impact in a Metropolitan University-Based Clinic. Int J Womens Health 2020; 12:1205-1214. [PMID: 33363413 PMCID: PMC7752651 DOI: 10.2147/ijwh.s276214] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 11/10/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Congenital CMV infection can result in serious sequelae in the newborn. The goal of this study was to assess pregnant women's knowledge and understanding of CMV infection during pregnancy and develop an educational tool about CMV infection to be utilized during prenatal care. Materials and Methods This is a prospective intervention study that assessed pregnant women's knowledge before and after receiving an educational handout about CMV infection in pregnancy and the perceived value of this education. Pre- and post-education questionnaires were utilized to assess knowledge. The pre-education questionnaire and CMV educational handout were given at the same clinic visit. The educational handout was given after the pre-education questionnaire had been completed. The post-education questionnaire was given at the next scheduled prenatal clinic appointment and included questions regarding the level of satisfaction with the education and the perceived value of the information. Pregnant women less than 34 weeks of gestation were eligible. Results A total of 263 women were enrolled, 263 completed the pre-CMV educational questionnaire and 215 women completed both questionnaires. Some women only partially completed the questionnaires and those partial responses have been included. Prior to education, 33% (85/261) of participants had heard of CMV. This increased to 75% (160/214) after education. Participants scored each of the recommended hygiene practices between 1 and 5 (5 is the most acceptable) and each recommended hygiene practice received an average score between 3.8 and 5. 74% (134/180) of participants reported increasing their hygienic practices after education. 96% (180/188) of participants indicated they were satisifed to have received the education. 98% (187/190) thought more women should receive this education during prenatal care. Conclusion Pregnant women viewed education about CMV favorably and increased the frequency of recommended hygiene practices. Introducing an educational handout to routine prenatal care may be beneficial in increasing awareness of CMV infection in pregnancy.
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Affiliation(s)
- Malinda R Schaefer
- Department of Obstetrics, Gynecology & Women's Health, University of Minnesota Medical School, Minneapolis, MN 55455, USA
| | - Jessica Holttum
- Department of Obstetrics, Gynecology & Women's Health, University of Minnesota Medical School, Minneapolis, MN 55455, USA
| | - Megan Olson
- Department of Obstetrics, Gynecology & Women's Health, University of Minnesota Medical School, Minneapolis, MN 55455, USA
| | - Danielle Westenberg
- Department of Obstetrics, Gynecology & Women's Health, University of Minnesota Medical School, Minneapolis, MN 55455, USA
| | - Nathan Rubin
- Biostatistics Core, Masonic Cancer Center, University of Minnesota Medical School, Minneapolis, MN 55455, USA
| | - Mark R Schleiss
- Department of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, University of Minnesota Medical School, Minneapolis, MN 55455, USA
| | - Jessica Nyholm
- Department of Obstetrics, Gynecology & Women's Health, University of Minnesota Medical School, Minneapolis, MN 55455, USA
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4
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Pekar-Zlotin M, Alufi Naim A, Eliassi Revivo P, Kugler N, Melcer Y, Wiener Y, Maymon R. Impact of the Israeli Ministry of Health Cytomegalovirus Guidelines on the Local Pregnancy Outcome. Fetal Diagn Ther 2020; 48:28-33. [PMID: 33271537 DOI: 10.1159/000510816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 08/11/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE In 2011, the Israeli Ministry of Health (MOH) published standard guidelines for the follow-up of pregnant women infected by CMV, recommending that amniocentesis be performed in cases of maternal serum viral seroconversion or abnormal sonographic findings suggestive of CMV, in order to prove fetal infection before electing for pregnancy termination. METHODS A retrospective cohort study was performed, describing 448 pregnant women from 2006 to 2017. We collected data from all women that elected to continue their pregnancies after seroconversion and also of those who chose to undergo pregnancy termination. Subsequently, a telephone survey was then conducted to record outcomes of the newborns of women with CMV seroconversion during pregnancy. RESULTS 325 (73%) women chose to continue their pregnancy, while 123 (27%) opted for termination of pregnancy. We found that pregnancy termination due to CMV infection was reduced by 7%, from 72 cases (32%) to 51 cases (25%) after the implementation of the MOH guidelines in 2011. In addition, 182/305 (60%) of women responded to our telephone questionnaire regarding newborn outcomes. Of these women, 45/305 (14%) reported complications, and no correlation was found between the prenatal findings and postnatal outcome among those who have responded to our survey. CONCLUSION Implementation of the new MOH guidelines has reduced the rate of pregnancy termination, without increasing the rate of neonatal complications in Israel with a similar outcome of complication rate as reported in the literature.
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Affiliation(s)
- Marina Pekar-Zlotin
- Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (Formerly Assaf Harofeh Medical Center), Zerifin, Israel, .,Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,
| | - Anat Alufi Naim
- Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (Formerly Assaf Harofeh Medical Center), Zerifin, Israel.,Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Perry Eliassi Revivo
- Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (Formerly Assaf Harofeh Medical Center), Zerifin, Israel.,Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nadav Kugler
- Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (Formerly Assaf Harofeh Medical Center), Zerifin, Israel.,Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yaakov Melcer
- Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (Formerly Assaf Harofeh Medical Center), Zerifin, Israel.,Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yifat Wiener
- Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (Formerly Assaf Harofeh Medical Center), Zerifin, Israel.,Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ron Maymon
- Department of Obstetrics and Gynecology, The Yitzhak Shamir Medical Center (Formerly Assaf Harofeh Medical Center), Zerifin, Israel.,Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Pek JH, Gan MY, Yap BJ, Seethor STT, Greenberg RG, Hornik CPV, Tan B, Lee JH, Chong SL. Contemporary trends in global mortality of sepsis among young infants less than 90 days old: protocol for a systematic review and meta-analysis. BMJ Open 2020; 10:e038815. [PMID: 32737098 PMCID: PMC7398098 DOI: 10.1136/bmjopen-2020-038815] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Neonatal sepsis has a high mortality rate that varies across different populations. We aim to perform a contemporary global evidence synthesis to determine the case fatality rates of neonatal sepsis, in order to better delineate this public health urgency and inform strategies to reduce fatality in this high-risk population. METHODS AND ANALYSIS We will search PubMed, Cochrane Central, Embase and Web of Science for articles in English language published between January 2010 and December 2019. All clinical trials and observational studies involving infants less than 90 days old with a clinical diagnosis of sepsis and reported case fatality rate will be included. Two independent reviewers will screen the studies and extract data on study variables chosen a priori. Quality of evidence and risk of bias will be assessed using Cochrane Collaboration's tool and ROBINS-I. Results will be synthesised qualitatively and pooled for meta-analysis. ETHICS AND DISSEMINATION No formal ethical approval is required as there is no collection of primary data. This systematic review and meta-analysis will be disseminated through conference meetings and peer-reviewed publications. PROSPERO REGISTRATION NUMBER CRD42020164321.
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Affiliation(s)
- Jen Heng Pek
- Emergency Medicine, Sengkang General Hospital, Singapore
| | - Ming Ying Gan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Bei Jun Yap
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Rachel G Greenberg
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Christoph Paul Vincent Hornik
- Division of Critical Care Medicine, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Bobby Tan
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | - Jan Hau Lee
- Children's Intensive Care Unit, KK Women's and Children's Hospital, Singapore
| | - Shu-Ling Chong
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore
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6
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Boubker S, Zerrouki N, Sidqi Z, Moussi M, El Mekkaoui A, Khannoussi W, Kharrasse G, Ismaili Z. Prevalence of hepatitis B and C in blood transfusion center, Oujda Morocco (2013-2015). Pan Afr Med J 2019; 33:163. [PMID: 31565125 PMCID: PMC6756816 DOI: 10.11604/pamj.2019.33.163.18688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 06/23/2019] [Indexed: 01/21/2023] Open
Abstract
Viral hepatitis is a serious public health problem. Its epidemiology is not precisely known in Morocco. Our objective was to assess the prevalence of HBV and HCV in a particular population of "blood donors" at the Regional Blood Transfusion Centre in Oujda. A retrospective study was conducted from May 1, 2013 to May 31, 2015. Thirty-one thousand nine hundred and fifty-two blood donors were tested. Antigen detection was made according to ELISA technique (MonolisaTMHBs Ag ULTRA). HCV research was performed by ELISA using the kit « Monolisa HCV Ag-Ab ULTRA ». 177 blood donors included, they are divided into 155 male (87.6%) and 22 female (12.4%) subjects with a ratio of 7. The average age was 37.64 ± 12 years. Six cases were positive for HCV with an overall prevalence of 0.02%. The population study by sex shows a prevalence of 0.004% for 23177 male sera and 0.057% for 8775 female sera. Six donors were HCV positive, of which 05 were female (83.33%) and one was male (16.66%). The average age was 43 ± 14 years. Co-infection with HCV HBV-HCV and HCV-Syphilis and HCV-HIV are absent. Co-infection with HBV and HIV was found in one case. HBV-syphilis co-infection was found in 04 cases. Chronic viral hepatitis is a real global health problem. Its prevalence is currently estimated at 0.55% for HBV and 0.02% for HCV, reclassifying Morocco as a low endemic area. The prevention remains the most effective method to successfully control HBV and HCV infection.
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Affiliation(s)
- Samira Boubker
- Hepato-Gastro-Enterology Unit Mohammed VI University Hospital Oujda, Oujda, Morocco
| | - Nassiba Zerrouki
- Hepato-Gastro-Enterology Unit Mohammed VI University Hospital Oujda, Oujda, Morocco
| | - Zaina Sidqi
- Blood transfusion center, Oujda, Morocco Samira Boubker, Hepato-Gastro-Enterology Unit Mohammed VI, University Hospital Oujda, Oujda, Morocco
| | - Maria Moussi
- Blood transfusion center, Oujda, Morocco Samira Boubker, Hepato-Gastro-Enterology Unit Mohammed VI, University Hospital Oujda, Oujda, Morocco
| | - Amine El Mekkaoui
- Hepato-Gastro-Enterology Unit Mohammed VI University Hospital Oujda, Oujda, Morocco
| | - Wafaa Khannoussi
- Hepato-Gastro-Enterology Unit Mohammed VI University Hospital Oujda, Oujda, Morocco
| | - Ghizlane Kharrasse
- Hepato-Gastro-Enterology Unit Mohammed VI University Hospital Oujda, Oujda, Morocco
| | - Zahi Ismaili
- Hepato-Gastro-Enterology Unit Mohammed VI University Hospital Oujda, Oujda, Morocco
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7
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Abstract
Neonatal sepsis is the cause of substantial morbidity and mortality. Precise estimates of neonatal sepsis burden vary by setting. Differing estimates of disease burden have been reported from high-income countries compared with reports from low-income and middle-income countries. The clinical manifestations range from subclinical infection to severe manifestations of focal or systemic disease. The source of the pathogen might be attributed to an in-utero infection, acquisition from maternal flora, or postnatal acquisition from the hospital or community. The timing of exposure, inoculum size, immune status of the infant, and virulence of the causative agent influence the clinical expression of neonatal sepsis. Immunological immaturity of the neonate might result in an impaired response to infectious agents. This is especially evident in premature infants whose prolonged stays in hospital and need for invasive procedures place them at increased risk for hospital-acquired infections. Clinically, there is often little difference between sepsis that is caused by an identified pathogen and sepsis that is caused by an unknown pathogen. Culture-independent diagnostics, the use of sepsis prediction scores, judicious antimicrobial use, and the development of preventive measures including maternal vaccines are ongoing efforts designed to reduce the burden of neonatal sepsis.
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Affiliation(s)
- Andi L Shane
- Division of Infectious Disease, Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, USA.
| | - Pablo J Sánchez
- Divisions of Neonatology and Infectious Disease, Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, OH, USA
| | - Barbara J Stoll
- University of Texas, Health McGovern Medical School, Houston, TX, USA
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8
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Peters MD, McArthur A, Munn Z. Safe management of expressed breast milk: A systematic review. Women Birth 2016; 29:473-481. [DOI: 10.1016/j.wombi.2016.05.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 05/26/2016] [Accepted: 05/29/2016] [Indexed: 10/21/2022]
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9
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Abstract
Herpesviruses have evolved exquisite virus-host interactions that co-opt or evade a number of host pathways to enable the viruses to persist. Persistence of human cytomegalovirus (CMV), the prototypical betaherpesvirus, is particularly complex in the host organism. Depending on host physiology and the cell types infected, CMV persistence comprises latent, chronic, and productive states that may occur concurrently. Viral latency is a central strategy by which herpesviruses ensure their lifelong persistence. Although much remains to be defined about the virus-host interactions important to CMV latency, it is clear that checkpoints composed of viral and cellular factors exist to either maintain a latent state or initiate productive replication in response to host cues. CMV offers a rich platform for defining the virus-host interactions and understanding the host biology important to viral latency. This review describes current understanding of the virus-host interactions that contribute to viral latency and reactivation.
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Affiliation(s)
- Felicia Goodrum
- Department of Immunobiology, BIO5 Institute, University of Arizona, Tucson, Arizona 85721;
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10
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Binda S, Pellegrinelli L, Terraneo M, Caserini A, Primache V, Bubba L, Barbi M. What people know about congenital CMV: an analysis of a large heterogeneous population through a web-based survey. BMC Infect Dis 2016; 16:513. [PMID: 27671033 PMCID: PMC5037595 DOI: 10.1186/s12879-016-1861-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 09/21/2016] [Indexed: 11/10/2022] Open
Abstract
Background Congenital CMV (cCMV) infection is a serious public health issue due to both its worldwide prevalence and the severe and permanent impairments it causes. However, awareness of this infection is low in the general population and among pregnant women, and it also seems to be generally disregarded by healthcare providers. The identification of factors behind this inadequate level of knowledge could provide a basis for future preventive measures. This study aimed at evaluating awareness of CMV and cCMV infection and its correlation with socio-demographic variables in a general population. Methods The survey was carried out by computer-assisted web interviewing (CAWI). A questionnaire was sent via e-mail to the 70,975 individuals who comprised the whole population (students, administrative staff, teaching staff) of Milan University, Italy in 2015. Results Out of the 10,190 respondents, 5,351 (52.5 %) had already heard of CMV but only 3,216 (31.8 %) knew that this virus could be implicated in congenital infection. Urine and breastfeeding were the least recognized transmission routes for CMV infection; less than half of respondents accurately identified the right symptoms and sequelae caused by cCMV infection. The correct hygienic measures against cCMV infection were identified in percentages ranging from 55.6 to 75 % depending on the measures proposed but about one in three of interviewees deemed those measures unnecessary in the event of a pregnant woman already being CMV seropositive. From the mean knowledge scores the most complete quality of awareness of CMV turned out to be linked to childbearing-age (25–40 year) and with not having children, even if results for non-parents showed less of them having heard of cCMV than parents. Conclusion Our results indicate a limited and confused awareness of cCMV infection in a large, fairly young and well-educated Italian population.
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Affiliation(s)
- Sandro Binda
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36-20133, Milan, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36-20133, Milan, Italy.
| | - Marco Terraneo
- Department of Sociology and Social Research, University of Milano-Bicocca, Milan, Italy
| | | | - Valeria Primache
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36-20133, Milan, Italy
| | - Laura Bubba
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36-20133, Milan, Italy
| | - Maria Barbi
- Department of Biomedical Sciences for Health, University of Milan, Via C. Pascal 36-20133, Milan, Italy
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11
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Thackeray R, Wright A, Chipman K. Congenital cytomegalovirus reference material: a content analysis of coverage and accuracy. Matern Child Health J 2015; 18:584-91. [PMID: 23620274 PMCID: PMC3951885 DOI: 10.1007/s10995-013-1275-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Congenital cytomegalovirus (CMV) is the leading cause of birth defects and developmental delays in the United States. However, only 13-22% of women in the United States have heard of CMV. This research assessed (1) the quantity and accuracy of CMV information included on pregnancy-related websites and reference books, and (2) whether CMV information was included less often than information about other birth defects or infections. A content analysis of 37 pregnancy reference books and seven websites was conducted. The data collection instrument represented categories describing CMV, transmission, and prevention. CMV subject matter experts at the Centers for Disease Control and Prevention reviewed the instrument. Each book and website was coded independently by two different coders. Twenty-one reference books and seven websites included CMV content. CMV was less likely to be included as a topic than other infections or birth defects. There were fewer sentences about CMV than toxoplasmosis, Down syndrome, or HIV. Book length was associated with increased likelihood of including CMV. How to prevent CMV transmission was discussed only half the time. Though limited, nearly all the CMV information was accurate. Pregnancy-related reference books and websites contain limited CMV information. Books are less likely to include CMV as compared to other infections and birth defects. Most of the CMV information is accurate. There is inadequate coverage given to prevention of CMV transmission, which may contribute to CMV remaining a continued leading cause of birth defects in the United States.
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Affiliation(s)
- Rosemary Thackeray
- Department of Health Science, Brigham Young University, 221 Richards Building, Provo, UT, 84602, USA,
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12
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Benova L, Mohamoud YA, Calvert C, Abu-Raddad LJ. Vertical transmission of hepatitis C virus: systematic review and meta-analysis. Clin Infect Dis 2014; 59:765-73. [PMID: 24928290 PMCID: PMC4144266 DOI: 10.1093/cid/ciu447] [Citation(s) in RCA: 311] [Impact Index Per Article: 31.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Updated pooled estimates of vertical hepatitis C (HCV) infection risk to children of HCV RNA–positive mothers ranges between 5.8% and 10.8%, depending on maternal HIV coinfection. Additional risk factors need to be captured and reported by future studies. Background. We conducted a systematic review of estimates of hepatitis C virus (HCV) vertical transmission risk to update current estimates published more than a decade ago. Methods. PubMed and Embase were searched and 109 articles were included. Pooled estimates of risk were generated for children born to HCV antibody–positive and viremic women, aged ≥18 months, separately by maternal human immunodeficiency virus (HIV) coinfection. Results. Meta-analysis of the risk of vertical HCV infection to children of HCV antibody–positive and RNA-positive women was 5.8% (95% confidence interval [CI], 4.2%–7.8%) for children of HIV-negative women and 10.8% (95% CI, 7.6%–15.2%) for children of HIV-positive women. The adjusted meta-regression model explained 51% of the between-study variation in the 25 included risk estimates. Maternal HIV coinfection was the most important determinant of vertical transmission risk (adjusted odds ratio, 2.56 [95% CI, 1.50–4.43]). Additional methodological (follow-up rate and definition of infection in children) and risk factors independently predicted HCV infection and need to be captured and reported by future studies of vertical transmission. Studies assessing the contribution of nonvertical exposures in early childhood to HCV prevalence among children at risk of vertical transmission are needed. Conclusions. More than 1 in every 20 children delivered by HCV chronically infected women are infected, highlighting that vertical transmission likely constitutes the primary transmission route among children. These updated estimates are a basis for decision making in prioritization of research into risk-reducing measures, and inform case management in clinical settings, especially for HIV-positive women in reproductive age.
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Affiliation(s)
- Lenka Benova
- Infectious Disease Epidemiology Group, Weill Cornell Medical College-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Yousra A Mohamoud
- Infectious Disease Epidemiology Group, Weill Cornell Medical College-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar
| | - Clara Calvert
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medical College-Qatar, Cornell University, Qatar Foundation-Education City, Doha, Qatar Department of Healthcare Policy and Research, Weill Cornell Medical College, Cornell University, New York, New York Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
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13
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Stanberry LR. Genital and Perinatal Herpes Simplex Virus Infections. Sex Transm Dis 2013. [DOI: 10.1016/b978-0-12-391059-2.00012-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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14
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STI screening and treatment in pregnancy. Nurse Pract 2012; 37:30-7. [PMID: 23165134 DOI: 10.1097/01.npr.0000422203.95229.ee] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Nurse practitioners provide care for pregnant women with sexually transmitted infections. This article discusses the latest guidelines for treatment of sexually transmitted infections in pregnant women and provides recommendations for screening, treatment, prophylaxis, and follow-up.
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15
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Cost-effectiveness analysis of preventing mother-to-child transmission of hepatitis B by injecting hepatitis B immune globulin. Eur J Gastroenterol Hepatol 2012; 24:1363-9. [PMID: 22922527 DOI: 10.1097/meg.0b013e32835847c6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Hepatitis B immune globulin (HBIG) injection during pregnancy and/or after birth is an intervention for preventing mother-to-child transmission of the hepatitis B (HB) virus. However, varying cost-effectiveness ratios among various HBIG therapies remain unclear. This study explored these differences in cost-effectiveness ratios. METHODS Four districts in Wuhan, China, were selected for the current study using stratified random sampling. Pregnant women who were positive for HB surface antigen (HBsAg) and who received prenatal care in district-level maternal and child health hospitals were interviewed. The mothers and their children underwent follow-up visits from the time of pregnancy until the children were six-and-a-half months old. RESULTS A total of 324 cases completed the follow-up visits on a voluntary basis. Among the 324 HBsAg-positive pregnant women investigated, 60.49% (196/324) were injected with HBIG at different trimesters. A total of 249 neonates (76.85%) received an HBIG injection within 24 h after birth. The HBsAg-positive rate in infants was 5.56% (18/324). The HBIG-injected mother and infant group had the lowest chronic infection rate among children [odds ratio=0.14, 95% confidence interval (CI) 0.02-0.90, P=0.039]. The HBIG-injected infant group exhibited the lowest HBsAb-positive rate (odds ratio=0.07, 95% CI 0.02-0.23). The cost per averted disability-adjusted life years was lowest in the infant group: USD 118.61 (95% CI 105.23-131.99). CONCLUSION These results indicate that active and passive immunizations (HBIG and HB vaccine) entail the lowest cost in the prevention of chronic HB infection in infants. However, this programme has the lowest HBsAb-positive rate, which possibly prevents children from self-acquiring antibodies.
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Din ES, Brown CJ, Grosse SD, Wang C, Bialek SR, Ross DS, Cannon MJ. Attitudes toward newborn screening for cytomegalovirus infection. Pediatrics 2011; 128:e1434-42. [PMID: 22084323 DOI: 10.1542/peds.2011-1444] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Newborns are not routinely screened for cytomegalovirus (CMV), the leading infectious cause of developmental disability. Congenital CMV satisfies a number of criteria for inclusion in newborn screening, and screening potentially offers benefits. Screening could also introduce harms such as anxiety and unnecessary costs for the families of the substantial proportion of CMV-infected children who never develop CMV-related disabilities. Our objective was to assess attitudes toward newborn screening for CMV. METHODS We analyzed responses to 5 statements about CMV and newborn screening from 3922 participants in the 2009 HealthStyles survey, a national mail survey designed to include a group similar to the US population with respect to gender, age, race/ethnicity, income, and household size. Two-step cluster analysis was performed to identify clusters of parental attitudes. RESULTS The majority of respondents strongly or somewhat agreed that they would want to have their newborn tested for CMV even if it was not performed routinely (84%), they had to pay $20 (87%), or CMV-related problems never developed (84%). Nearly half (47%) of them "would worry that the CMV test would lead to unneeded doctor visits and expenses," and 32% "think CMV problems are too rare to worry about." Three clusters of parent respondents were identified on the basis of their attitudes toward CMV screening: "strongly in favor" (31%), "moderately in favor" (49%), and "weakly opposed" (20%). CONCLUSIONS Among most parents, costs, worry, and anxiety associated with newborn screening for CMV would be acceptable. Although attitudes were generally favorable, a minority of the parents were weakly opposed to newborn screening for CMV.
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Affiliation(s)
- Erica S Din
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Sbai A, Baha W, Ougabrai H, Allalia T, Dersi N, Lazaar F, Ennaji MM, Benjouad A, El Malki A, Hassar M, Benani A. [Hepatitis B prevalence and risk factors in Morocco]. ACTA ACUST UNITED AC 2011; 60:e65-9. [PMID: 21816547 DOI: 10.1016/j.patbio.2011.06.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Accepted: 06/21/2011] [Indexed: 01/26/2023]
Abstract
AIM The aim of this study was to determine the prevalence of hepatitis B and the risk factors in Morocco. STUDY DESIGN A total number of 16,634 individuals were screened for HBsAg using the Murex HBsAg Version 3 assay and were interviewed using a structured standard questionnaire to collect information about risk factor. RESULTS Two hundred seventy-six subjects were positive for HBsAg, the prevalence of HBV infection was 1.66%. Using a structured standard questionnaire we reported that sexual behaviours (43.84%) are among the main risk factors for HBV transmission. CONCLUSION This study indicates that the prevalence of HBsAg in Morocco is currently estimated at 1.66% in the active population. The risk factors for HBV infection identified here indicate that prevention is the most cost-effective method for successfully controlling HBV infection, so vaccination remains the best way to control this infection and its related complications.
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Affiliation(s)
- A Sbai
- Laboratoire d'immunologie et de biochimie, faculté des sciences, 4, avenue Ibn Battouta, BP 1014 RP, Rabat, Maroc.
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Abstract
After completing this article, readers should be able to: 1. Describe the procedure and interpretation of the laboratory evaluation of hepatitis. 2. Recognize the signs and symptoms of acute and chronic hepatitis.3. Describe the immediate and long-term complications of hepatitis. 4. List the multiple causes of hepatitis in an older child.
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Patel P, Davis S, Tolle M, Mabikwa V, Anabwani G. Prevalence of hepatitis B and hepatitis C coinfections in an adult HIV centre population in Gaborone, Botswana. Am J Trop Med Hyg 2011; 85:390-4. [PMID: 21813864 PMCID: PMC3144842 DOI: 10.4269/ajtmh.2011.10-0510] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Accepted: 05/09/2011] [Indexed: 01/09/2023] Open
Abstract
The objective of this study was to assess the prevalence of hepatitis B and hepatitis C coinfections in human immunodeficiency virus (HIV) -infected adults at an HIV center in Gaborone, Botswana. A retrospective review was performed of charts of currently active HIV-infected adult patients in the Family Model Clinic (FMC) of the Botswana-Baylor Children's Clinical Center of Excellence (BCOE) in Gaborone, Botswana, for the results of serum hepatitis B surface antigen (HBsAg) and antihepatitis C IgG tests performed between January 1, 2005 and December 15, 2009. Of 308 active FMC patients, 266 underwent HBsAg serology testing within the period of study. The HBsAg coinfection prevalence was 5.3% (14/266); 2 of 252 patients had at least one positive antihepatitis C IgG serology, a 0.8% prevalence. Hepatitis B coinfection is relatively common in HIV-infected adults at our center in Botswana, whereas hepatitis C coinfection is rare. In this setting, where the diagnosis of hepatitis B coinfection with HIV has implications for choice of first-line antiretroviral therapy and prevention of perinatal hepatitis B transmission, broader sampling to establish the true population prevalence of hepatitis B coinfection and the desirability of adding screening to HIV management should be considered. These findings provide little justification for adding hepatitis C coinfection screening to the management of HIV infection in Botswana.
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Affiliation(s)
- Premal Patel
- Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana.
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Schoenfisch AL, Dollard SC, Amin M, Gardner LI, Klein RS, Mayer K, Rompalo A, Sobel JD, Cannon MJ. Cytomegalovirus (CMV) shedding is highly correlated with markers of immunosuppression in CMV-seropositive women. J Med Microbiol 2011; 60:768-774. [PMID: 21393456 DOI: 10.1099/jmm.0.027771-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Cytomegalovirus (CMV) enters latency following primary infection and can subsequently reactivate. Reinfection with a different viral strain can also occur. During these events, CMV is shed in bodily fluids. This study examined correlates of CMV shedding in specimens obtained from the HIV Epidemiology Research Study, a multicenter cohort study of US women with or at high risk for human immunodeficiency virus (HIV) infection. Among the women studied, 91.4 % (911/997) were CMV IgG seropositive. Of these women, 2.7 % (25/911) were CMV IgM seropositive. CMV DNA was detected via real-time PCR more frequently in cervicovaginal lavage (CVL) specimens (55/764, 7.2 %) than in peripheral blood mononuclear cells (PBMCs) (26/897, 2.9 %). CMV viral loads in 1 ml CVL (median 534; mean 2598; range = 40-74, 844) were higher than in 10⁶ PBMCs (median 264; mean 1287; range = 35-13 ,250). CMV DNA in PBMCs was associated with HIV seropositivity [odds ratio (OR) 13.5; 95 % confidence interval (CI) 1.8-100], increasing HIV viral load (P<0.001 for trend), decreasing CD4 cell counts (P<0.001 for trend) and CMV DNA in CVL (OR 26; 95 % CI 10.7-64). CMV DNA in CVL specimens was associated with CMV IgM seropositivity (OR 4.3; 95 % CI 1.5-12.3), HIV seropositivity (OR 7.3; 95 % CI 2.6-20), increasing HIV viral load (P<0.001 for trend) and decreasing CD4 cell counts (P<0.001 for trend). The positive predictive value of CMV IgM seropositivity for CMV DNA shedding in either PBMCs or CVL was 20 %. In summary, CMV shedding in CVL and PBMCs was highly correlated with each other and with markers of immune suppression.
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Affiliation(s)
- Ashley L Schoenfisch
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sheila C Dollard
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Minal Amin
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lytt I Gardner
- National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Robert S Klein
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Kenneth Mayer
- Brown University School of Medicine, Providence, RI, USA
| | | | - Jack D Sobel
- Wayne State School of Medicine, Detroit, MI, USA
| | - Michael J Cannon
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Hyde TB, Schmid DS, Cannon MJ. Cytomegalovirus seroconversion rates and risk factors: implications for congenital CMV. Rev Med Virol 2010; 20:311-26. [PMID: 20645278 DOI: 10.1002/rmv.659] [Citation(s) in RCA: 168] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Terri B Hyde
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
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Korver A, de Vries J, de Jong J, Dekker F, Vossen A, Oudesluys-Murphy A. Awareness of congenital cytomegalovirus among doctors in the Netherlands. J Clin Virol 2009; 46 Suppl 4:S11-5. [DOI: 10.1016/j.jcv.2009.09.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2009] [Accepted: 08/24/2009] [Indexed: 10/20/2022]
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Cannon MJ. Congenital cytomegalovirus (CMV) epidemiology and awareness. J Clin Virol 2009; 46 Suppl 4:S6-10. [PMID: 19800841 DOI: 10.1016/j.jcv.2009.09.002] [Citation(s) in RCA: 200] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2009] [Accepted: 09/04/2009] [Indexed: 11/30/2022]
Abstract
This commentary highlights and discusses the implications of a number of recent studies that refine epidemiologic knowledge of CMV infection and assess awareness of congenital CMV among clinicians and the public. These studies highlight that: (1) congenital CMV results in a disease burden that is substantial and severe; (2) a high proportion of United States women of reproductive age are susceptible to CMV infection; (3) the majority of congenital CMV infections in the United States result from recurrent infections among pregnant women; (4) CMV seroprevalence and seroincidence are much higher among racial/ethnic minorities and persons of lower socioeconomic status (SES); (5) household transmission of CMV appears to be an important transmission route in the United States; (6) sexual transmission of CMV appears to be an important transmission route in some population sub-groups in the United States; (7) women have limited awareness and knowledge about congenital CMV; (8) most obstetrician/gynecologists do not counsel women about prevention of congenital CMV; (9) most women view CMV prevention messages positively.
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Affiliation(s)
- Michael J Cannon
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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