Home > Research > Publications & Outputs > Congenital Cytomegalovirus Infection Burden and...

Links

Text available via DOI:

View graph of relations

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

Research output: Contribution to Journal/MagazineJournal articlepeer-review

Published

Standard

Congenital Cytomegalovirus Infection Burden and Epidemiologic Risk Factors in Countries with Universal Screening : A Systematic Review and Meta-analysis. / Ssentongo, P.; Hehnly, C.; Birungi, P. et al.

In: JAMA Network Open, Vol. 4, No. 8, e2120736, 23.08.2021.

Research output: Contribution to Journal/MagazineJournal articlepeer-review

Harvard

Ssentongo, P, Hehnly, C, Birungi, P, Roach, MA, Spady, J, Fronterre, C, Wang, M, Murray-Kolb, LE, Al-Shaar, L, Chinchilli, VM, Broach, JR, Ericson, JE & Schiff, SJ 2021, 'Congenital Cytomegalovirus Infection Burden and Epidemiologic Risk Factors in Countries with Universal Screening: A Systematic Review and Meta-analysis', JAMA Network Open, vol. 4, no. 8, e2120736. https://doi.org/10.1001/jamanetworkopen.2021.20736

APA

Ssentongo, P., Hehnly, C., Birungi, P., Roach, M. A., Spady, J., Fronterre, C., Wang, M., Murray-Kolb, L. E., Al-Shaar, L., Chinchilli, V. M., Broach, J. R., Ericson, J. E., & Schiff, S. J. (2021). Congenital Cytomegalovirus Infection Burden and Epidemiologic Risk Factors in Countries with Universal Screening: A Systematic Review and Meta-analysis. JAMA Network Open, 4(8), [e2120736]. https://doi.org/10.1001/jamanetworkopen.2021.20736

Vancouver

Ssentongo P, Hehnly C, Birungi P, Roach MA, Spady J, Fronterre C et al. Congenital Cytomegalovirus Infection Burden and Epidemiologic Risk Factors in Countries with Universal Screening: A Systematic Review and Meta-analysis. JAMA Network Open. 2021 Aug 23;4(8):e2120736. doi: 10.1001/jamanetworkopen.2021.20736

Author

Bibtex

@article{dd24b48cd2ea455cbab9b5eb75b42a7c,
title = "Congenital Cytomegalovirus Infection Burden and Epidemiologic Risk Factors in Countries with Universal Screening: A Systematic Review and Meta-analysis",
abstract = "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 515646 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.. {\textcopyright} 2021 American Medical Association. All rights reserved.",
keywords = "aged, Cochrane Library, cohort analysis, Cytomegalovirus, data extraction, demography, female, high income country, human, Human immunodeficiency virus prevalence, human tissue, infant, maternal age, Medline, meta analysis, middle income country, Newcastle-Ottawa scale, nonhuman, pathogen load, Preferred Reporting Items for Systematic Reviews and Meta-Analyses, review, risk factor, saliva, Scopus, serum, social status, synthesis, systematic review, World Bank",
author = "P. Ssentongo and C. Hehnly and P. Birungi and M.A. Roach and J. Spady and C. Fronterre and M. Wang and L.E. Murray-Kolb and L. Al-Shaar and V.M. Chinchilli and J.R. Broach and J.E. Ericson and S.J. Schiff",
year = "2021",
month = aug,
day = "23",
doi = "10.1001/jamanetworkopen.2021.20736",
language = "English",
volume = "4",
journal = "JAMA Network Open",
number = "8",

}

RIS

TY - JOUR

T1 - Congenital Cytomegalovirus Infection Burden and Epidemiologic Risk Factors in Countries with Universal Screening

T2 - A Systematic Review and Meta-analysis

AU - Ssentongo, P.

AU - Hehnly, C.

AU - Birungi, P.

AU - Roach, M.A.

AU - Spady, J.

AU - Fronterre, C.

AU - Wang, M.

AU - Murray-Kolb, L.E.

AU - Al-Shaar, L.

AU - Chinchilli, V.M.

AU - Broach, J.R.

AU - Ericson, J.E.

AU - Schiff, S.J.

PY - 2021/8/23

Y1 - 2021/8/23

N2 - 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 515646 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.. © 2021 American Medical Association. All rights reserved.

AB - 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 515646 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.. © 2021 American Medical Association. All rights reserved.

KW - aged

KW - Cochrane Library

KW - cohort analysis

KW - Cytomegalovirus

KW - data extraction

KW - demography

KW - female

KW - high income country

KW - human

KW - Human immunodeficiency virus prevalence

KW - human tissue

KW - infant

KW - maternal age

KW - Medline

KW - meta analysis

KW - middle income country

KW - Newcastle-Ottawa scale

KW - nonhuman

KW - pathogen load

KW - Preferred Reporting Items for Systematic Reviews and Meta-Analyses

KW - review

KW - risk factor

KW - saliva

KW - Scopus

KW - serum

KW - social status

KW - synthesis

KW - systematic review

KW - World Bank

U2 - 10.1001/jamanetworkopen.2021.20736

DO - 10.1001/jamanetworkopen.2021.20736

M3 - Journal article

VL - 4

JO - JAMA Network Open

JF - JAMA Network Open

IS - 8

M1 - e2120736

ER -