The epidemiology and disease burden of congenital TORCH infections among hospitalized children in China: A national cross-sectional study

Abstract

Background Congenital TORCH (Toxoplasma gondii (T. gondii), rubella virus (RV), cytomegalovirus (CMV), and herpes simplex virus (HSV)) infections are associated with a variety of adverse prenatal and neonatal events, including miscarriage, malformations and developmental abnormalities, and they remain an issue that cannot be neglected in China. However, the current research focuses more on the general screening of TORCH in women of childbearing age, and the medical information of children hospitalized due to congenital and perinatal TORCH infections has not been described in detail. This study summarized and analyzed the epidemiological characteristics, clinical manifestations, length of stay (LOS), and the disease burden of hospitalized children diagnosed with congenital TORCH infections in 27 children’s hospitals in China. Methodology Based on the face sheet of discharge medical records (FSMRs) of hospitalized children in 27 tertiary children’s hospitals collected in the Futang Research Center of Pediatric Development and aggregated into FUTang Update medical REcords (FUTURE), we summarized and analyzed the epidemiological characteristics, clinical manifestations, LOS, the disease burden (in US dollars, USD) and potential risk factors for hospitalized children diagnosed with congenital toxoplasmosis, congenital rubella syndrome, congenital cytomegalovirus infection, and congenital HSV in 27 children’s hospitals in China from 2015 to 2020. Results One hundred seventy-three patients aged 0–<1 year were hospitalized for congenital TORCH infections. Among infections with TORCH, hospitalization with congenital toxoplasmosis was the least common, with only five cases were reported (2.89%), while the LOS was the highest. The proportion of patients with congenital rubella syndrome (CRS) was 15.61%, and 86% of children hospitalized with CRS had cardiovascular malformations, and the economic burden was the highest. Congenital CMV infection cases accounted for the largest proportion (76.30%). Overall, 5.20% of patients were infected with HSV, and the expense of hospitalization for congenital HSV infection was relatively low. Conclusion In the present study, the hospitalization proportion due to congenital TORCH infection was extremely low (17.56 per 100,000 neonates), indicating that China’s congenital TORCH infection prevention and control policies remain effective. The lowest proportion of patients was hospitalized with congenital toxoplasmosis, while the LOS was the longest. The economic burden of CRS was heavy, and infants are recommended be vaccinated against RV in a timely manner. Congenital CMV infections accounted for the largest proportion of patients, suggesting that the disease burden of congenital CMV infection cannot be ignored, and the prevention of congenital CMV infection during pregnancy is still an important issue that needs to pay attention. The expense of hospitalization for congenital HSV infection was relatively low, while the disease burden increases significantly when patients develop complications. These data illustrate the importance of improving screening for congenital TORCH infections in the early diagnosis and treatment of neonatal patients.

Clinical epidemiology and disease burden of adenoviral encephalitis in hospitalized children in China: A nationwide cross‐sectional study

“…Beijing Children's Hospital Affiliated with Capital Medical University has undertaken an initiative to collect the FSMRs of inpatient children from 27 tertiary children's hospitals, creating the Futang Update Medical Records (FUTURE) database 15 . This database has been leveraged to publish numerous studies on diverse illnesses that affect children 10,16–19 . In this particular study, the FSMR details of children admitted with adenovirus encephalitis from the FUTURE database were gathered and organized.…”

The effect of living environment on developmental disorders in cold regions

“…A populationbased cohort study demonstrated that the hazard of fetal DDs in cytomegalovirus infection pregnancy women was 233-fold higher than that in on-infected ones [94] . Another report on the burden of TORCH (Toxoplasma gondii, rubella virus, cytomegalovirus, herpes simplex virus) infection in newborns from China indicated that roughly 86% of rubella infected fetuses were accompanied by DD of cardiovascular system [95] . Some drugs used for antiinfection treatment (such as fluoroquinolones, tetracyclines, etc.)…”

Seroepidemiology study of rubella virus antibodies among neonates and pregnant women at hospitals in Henan province, China

“…The immunity to rubella is usually determined by detecting the rubella‐specific IgG antibody 19 . Vaccination, prompt detection, and other preventive strategies can reduce the adverse pregnancy outcomes from rubella virus infection 20,21 …”

“…19 Vaccination, prompt detection, and other preventive strategies can reduce the adverse pregnancy outcomes from rubella virus infection. 20,21 The rubella-containing vaccine has been available in China since 1993 and was introduced nationally into the Expanded Program on Immunization (EPI) in 2008. 22 Rubella vaccines are available either in monovalent formulation or in combination with other vaccines, such as against measles (MR) or measles and mumps (MMR).…”