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Congenital Cytomegalovirus Infection Burden and Epidemiologic Risk Factors in Countries With Universal Screening: A Systematic Review and Meta-analysis

JAMA Network Open, 2021-08, Vol.4 (8), p.e2120736-e2120736 [Peer Reviewed Journal]

2021. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;Copyright 2021 Ssentongo P et al. . ;ISSN: 2574-3805 ;EISSN: 2574-3805 ;DOI: 10.1001/jamanetworkopen.2021.20736 ;PMID: 34424308

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  • Title:
    Congenital Cytomegalovirus Infection Burden and Epidemiologic Risk Factors in Countries With Universal Screening: A Systematic Review and Meta-analysis
  • Author: Ssentongo, Paddy ; Hehnly, Christine ; Birungi, Patricia ; Roach, Mikayla A ; Spady, Jada ; Fronterre, Claudio ; Wang, Ming ; Murray-Kolb, Laura E ; Al-Shaar, Laila ; Chinchilli, Vernon M ; Broach, James R ; Ericson, Jessica E ; Schiff, Steven J
  • Subjects: Cytomegalovirus ; Cytomegalovirus Infections - congenital ; Cytomegalovirus Infections - epidemiology ; Developed Countries ; Developing Countries ; Humans ; Infant, Newborn ; Infections ; Infectious Diseases ; Neonatal Screening ; Online Only ; Original Investigation ; Prevalence ; Risk Factors ; Serology
  • Is Part Of: JAMA Network Open, 2021-08, Vol.4 (8), p.e2120736-e2120736
  • Description: IMPORTANCE: Congenital cytomegalovirus (cCMV) infection is the most common congenital infection and the leading acquired cause of developmental disabilities and sensorineural deafness, yet a reliable assessment of the infection burden is lacking. OBJECTIVES: To estimate the birth prevalence of cCMV in low- and middle-income countries (LMICs) and high-income countries (HICs), characterize the rate by screening methods, and delineate associated risk factors of the infection. DATA SOURCES: MEDLINE/PubMed, Scopus, and Cochrane Database of Systematic Reviews databases were searched from January 1, 1960, to March 1, 2021, and a total of 1322 studies were identified. STUDY SELECTION: Studies that provided data on the prevalence of cCMV derived from universal screening of infants younger than 3 weeks were included. Targeted screening studies were excluded. DATA EXTRACTION AND SYNTHESIS: Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was followed. Extraction was performed independently by 3 reviewers. Quality was assessed using the Newcastle-Ottawa Scale for cohort studies. Random-effects meta-analysis was undertaken. Metaregression was conducted to evaluate the association of sociodemographic characteristics, maternal seroprevalence, population-level HIV prevalence, and screening methods with the prevalence of cCMV. MAIN OUTCOMES AND MEASURES: Birth prevalence of cCMV ascertained through universal screening of infants younger than 3 weeks for CMV from urine, saliva, or blood samples. RESULTS: Seventy-seven studies comprising 515 646 infants met the inclusion criteria from countries representative of each World Bank income level. The estimated pooled overall prevalence of cCMV was 0.67% (95% CI, 0.54%-0.83%). The pooled birth prevalence of cCMV was 3-fold greater in LMICs (1.42%; 95% CI, 0.97%-2.08%; n = 23 studies) than in HICs (0.48%; 95% CI, 0.40%-0.59%, n = 54 studies). Screening methods with blood samples demonstrated lower rates of cCMV than urine or saliva samples (odds ratio [OR], 0.38; 95% CI, 0.23-0.66). Higher maternal CMV seroprevalence (OR, 1.19; 95% CI, 1.11-1.28), higher population-level HIV prevalence (OR, 1.22; 95% CI, 1.05-1.40), lower socioeconomic status (OR, 3.03; 95% CI, 2.05-4.47), and younger mean maternal age (OR, 0.85; 95% CI, 0.78-0.92, older age was associated with lower rates) were associated with higher rates of cCMV. CONCLUSIONS AND RELEVANCE: In this meta-analysis, LMICs appeared to incur the most significant infection burden. Lower rates of cCMV were reported by studies using only blood or serum as a screening method.
  • Publisher: United States: American Medical Association
  • Language: English
  • Identifier: ISSN: 2574-3805
    EISSN: 2574-3805
    DOI: 10.1001/jamanetworkopen.2021.20736
    PMID: 34424308
  • Source: Journals@Ovid Open Access Journal Collection Rolling
    MEDLINE
    Alma/SFX Local Collection
    ProQuest Central
    DOAJ Directory of Open Access Journals
    JAMA Network (Open Access)
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