Prevalence of pregnancy-relevant infections in a rural setting of Ghana

Abstract

BackgroundAlthough infectious diseases still account for a high burden of morbidity and mortality in sub-Saharan Africa, simultaneous investigations on multiple infections affecting maternal and child health are missing.MethodsWe conducted a cross-sectional, single-centre pilot study in a rural area of Ghana to assess the infectiological profile during pregnancy. Screening of 180 expectant mothers was done by vaginal swabs and serology to detect the most common pregnancy-relevant infections. They were also interviewed for potential risk factors, outcome of previous pregnancies, and socio-economic aspects.ResultsWe found a high prevalence of infections caused by hepatitis B virus (16.7% HBs antigen positive). In contrast, infections caused by hepatitis C virus (1.1% anti-HCV) and HIV (0.6%) were rare. Maternal malaria was frequent (10.6%), despite increasing acceptance of intermittent preventive treatment during pregnancy (IPTp). Group B streptococci were present in 10.6% of all pregnant women. Absence of antibodies against varicella zoster virus in 43.2%, Toxoplasma gondii in 26.8%, parvovirus B19 in 20.0%, and rubella virus in 15.7% makes a significant proportion of pregnant women susceptible for acquiring primary infections. Whereas all study participants had specific IgG antibodies against human cytomegalovirus, infections with Listeria, Brucella, or Neisseria gonorrhoeae as well as active syphilis were absent.ConclusionsOur pilot study in a rural community in Ghana indicates an urgent need for action in dealing at least with high-prevalent pregnancy-relevant infections, such as hepatitis B, malaria and those caused by group B streptococci. In addition, the resulting prevalence rates of various other infections may offer guidance for health officials to prioritize possible future intervention schemes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-017-1351-3) contains supplementary material, which is available to authorized users.

Epidemiology of Cytomegalovirus among pregnant women in Africa

“…We accessed 11 full articles reporting the prevalence of CMV in pregnancy in Africa. Of the 11 studies, two were conducted in North Africa (both in Egypt [29,30]), four in West Africa (one in each of Gambia [31] and Ghana [32], two in Nigeria [33,34]), four in East Africa (one in each of the following countries; Ethiopia [35], Kenya [36], Sudan [37] and Tanzania [38]); and one in Southern Africa (Malawi) [39].…”

“…Exposure to CMV among African pregnant women in the reviewed studies was very high, but appears to vary across the continent. The prevalence of active infection, denoted by presence of IgM antibodies (0-15.5%), was much lower than that of IgG antibodies (60-100%) [29][30][31][32][33][34][35][36][37][38][39]. However, the seroprevalence of both CMV IgG and IgM antibodies did not show any geographic trends across the African continent.…”

“…Studies from Kenya, Sudan and one of the two from Nigeria report the lowest CMV seroprevalence frequencies (< 80%) [34,[36][37], while the rest of the studies reviewed reported frequencies greater than 90% [29][30][31][32][33]35,[38][39]. The differences in the prevalence rate across the African populations could be due to differences in other suggested or reported risk factors for CMV infection as well as study designs.…”

Seroprevalence of Hepatitis B virus infection and associated factors among pregnant women at Korle-Bu Teaching Hospital, Ghana

“…The prevalence found in this study is lower than prevalence from in rural settings. A cross-sectional survey among pregnant women in rural Ghana found a seroprevalence of 16.7% [26]. This indicates that HBV prevalence is higher in rural Ghana [23].The differences in findings might be due to differences in awareness and access to vaccination centers.…”

Congenital cytomegalovirus, parvovirus and enterovirus infection in Mozambican newborns at birth: A cross-sectional survey

“…A South African study exploring prevalence of B19V infection among pregnant women found 20 asymptomatic neonates born to IgM positive mothers, although no samples from newborns were obtained[ 66 ]. Different African studies on maternal B19 V seroprevalence found IgG AB between 24.9 and 80% and IgM between 3 and 19%[ 66 – 70 ]. Unfortunately, maternal seroprevalence was not performed in this study and further research should be done in order to know the real burden of congenital B19V.…”