Mother-to-child transmission of Chikungunya virus: A systematic review and meta-analysis

Abstract

BackgroundChikungunya virus (CHIKV) is an emerging arboviral infection with a global distribution and may cause fetal and neonatal infections after maternal CHIKV-infections during gestation.MethodologyWe performed a systematic review to evaluate the risk for: a) mother-to-child transmission (MTCT), b) antepartum fetal deaths (APFD), c) symptomatic neonatal disease, and d) neonatal deaths from maternal CHIKV-infections during gestation. We also recorded the neonatal clinical manifestations after such maternal infections (qualitative data synthesis). We searched PubMed (last search 3/2017) for articles, of any study design, with any of the above outcomes. We calculated the overall risk of MTCT, APFDs and risk of symptomatic neonatal disease by simple pooling. For endpoints with ≥5 events in more than one study, we also synthesized the data by random-effect-model (REM) meta-analysis.Principal findingsAmong 563 identified articles, 13 articles from 8 cohorts were included in the quantitative data synthesis and 33 articles in the qualitative data synthesis. Most cohorts reported data only on symptomatic rather than on all neonatal infections. By extrapolation also of these data, the overall pooled-MTCT-risk across cohorts was at least 15.5% (206/1331), (12.6% by REMs). The pooled APFD-risk was 1.7% (20/1203); while the risk of CHIKV-confirmed-APFDs was 0.3% (3/1203). Overall, the pooled-risk of symptomatic neonatal disease was 15.3% (203/1331), (11.9% by REMs). The pooled risk of symptomatic disease was 50.0% (23/46) among intrapartum vs 0% (0/712) among antepartum/peripartum maternal infections. Infected newborns, from maternal infections during gestation were either asymptomatic or presented within their first week of life, but not at birth, with fever, irritability, hyperalgesia, diffuse limb edema, rashes and occasionally sepsis-like illness and meningoencephalitis. The pooled-risk of neonatal death was 0.6% (5/832) among maternal infections and 2.8% (5/182) among neonatal infections; long-term neurodevelopmental delays occurred in 50% of symptomatic neonatal infections.Conclusions/SignificancePublished cohorts with data on the risk to the fetus and/or newborn from maternal CHIKV-infections during gestation were sparse compared to the number of recently reported CHIKV-infection outbreaks worldwide; however perinatal infections do occur, at high rates during intrapartum period, and can be related to neonatal death and long-term disabilities.

Sero-prevalence of arthropod-borne viral infections among Lukanga swamp residents in Zambia

“…Future studies should include children in order to report on correlation of the arboviruses to the recently reported cases of microcephaly in Zambia as well participants with fever as this has been recorded among the main complaints of patients diagnosed with arboviral infection [39]. Finally, an important consideration is that we were not able to run RT-PCR or sequencing assays to report on actual virus presence or spread of MAYV to other parts of Africa, as we have considered that MAYV circulation has only been reported in the Americas [55,56].…”

Understanding the interactability of chikungunya virus proteinsviamolecular recognition feature analysis

“…We believe that the analysis of the MoRF-based interactions of CHIKV proteins could represent an important platform for better understanding the molecular mechanisms of the pathogenicity of this virus because in some studies, it is reported that Aedes aegypti mosquitos show a co-infection with ZIKV and CHIKV without affecting its vector prociency. 77,78 In recent studies, it was found that the transmission of ZIKV & CHIKV also take place from mother to child during gestation and through breast milk, respectively, which could cause fatal infections in the infants. 79,80 MoRF-based analysis of ZIKV has been completed and has shown the functional importance of the MoRF regions in its proteome.…”

Tomatidine, a natural steroidal alkaloid shows antiviral activity towards chikungunya virus in vitro

“…Among those was an explosive epidemic on the Indian Ocean island of La Reunion, where over 266.000 people were affected 4 . Furthermore, since its introduction in the Americas in 2013, CHIKV has spread to over 45 countries in Central and South America causing more than 1.7 million infections 5 .…”