1. SERO-CHARACTERIZATION OF HUMAN CYTOMEGALOVIRUS AMONG PREGNANT WOMEN IN THIKA. PUBLISHERS: Zakayo Maingi (corresponding author) Dr Anthony Kebira Prof Yixing Zhang

2. Background of study
Cytomegalovirus (CMV) is the commonest among viral infections during perinatal period that cause congenital infections
Seroprevalence in pregnant women ranges from 45% to 100%.
Its clinical manifestations range from asymptomatic forms to severe foetal damage
It is transmitted from person-to-person via close non-sexual contact, sexual activity, breastfeeding, blood transfusions, and organ transplantation.

3. Problem statement
Studies of CMV during pregnancy have not been conducted in pregnant women in this region.
Evidence of pregnancy complications and congenital malformations
Caring for these children with congenital problems is a challenging task.

4. Justification of the study
Significance and impact of CMV -serious complications.
CMV infection during pregnancy poses a 30% to 40% risk of intrauterine transmission
No surveillance framework done among pregnant women in Kenya
negligence is part of the contributing factors to high intrauterine transmission leading to high recorded cases of irreversible sequeal and mental disorders in foetuses

5. hypothesis
Cytomegalovirus infection is high among Pregnant women attending Thika Hospitals.
Social demographic factors are not significant in CMV transmission and infection among pregnant women

6. objectives objectives
To determine the prevalence of CMV among pregnant women
To determine the number of acute and chronic CMV cases.
To establish the level of active and protective CMV antibodies in the pregnant women.
To determine the social demographic characteristics among study participants

7. methodology Research design This was a cross sectional study.
serves a population from both urban and rural setting.
signing a consent form filled the provided questionnaire then proceeded to the laboratory for sample collection.

8. Eligibility criteria Inclusion criteria:
Pregnant women attending the ante natal clinic of Thika Hospitals.
Pregnant women in their first or second trimester of pregnancy.
Pregnant women in the age group of years
Exclusion criteria
Pregnant women in their third trimester
Pregnant women not sure of their gestational period.

9. Expected results and applications.
The study was carried out to show the importance of CMV testing in pregnant women.
Identify the groups at risk
The study also recommended that infected pregnant women be put on antiviral therapy.

10. methodology
Consenting pregnant women filled a questionnaire to obtain socio-demographic data
A 5ml blood specimen was obtained for each subject.
Quantitative analysis for CMV antibodies(IgG and IgM) was performed, and the assay result interpreted as IU/mL.
Avidity testing was carried out on samples having both antibodies.

11. results serostatus f % both 54 20.8% IgG 158 60.8% IgM 10 3.8% none 38
14.6%
total
260
100.0%

12. Results cont’d avidity index Participants(n) % <35% 11 20.37
>35% 43
79.63
Total 54
100.0

13. variable
participants (%)
IgM (%)
IgG (%)
total(%)
p value
Age group:
16-20 12
19.4
70.9
90.3
21-25 22
22.26
34.26
26-30 38
13.68
81.05
94.73
0.001*
31-35 25
3.7
85.19
88.89
36-40 9
22.22
55.56
77.78
41-45 6 10 90
100
marital status:
single
24.39
13.6
57.6
71.2
married
64.61
7.2 82
89.2
divorced
10.39
96.3
parity:
none 45
10.35
65.5
75.85
one to four
53.08
5.8
87.7
93.5
0.0006*
>four
13.59
66.7
education
1.2
primary
4.6 20
86.7
secondary
30.4
11.4
73.4
84.8
0.014*
tertiary
63.8
4.8
79.5
84.3

14. Active and protective abs
variable
active abs
protective abs
age group:
16-20
2(28.6%)
10(58.8%)
21-25
2(100%)
32(76.2%)
26-30
3(60%)
61(79.2%)
31-35
1(50%)
38(82.6%)
36-40
2(50%)
9(90%)
41-45
0(0)
8(88.9%)
marital status:
single
4(30%)
33(86.8%)
married
6(50%)
105(76.45%)
divorced
20(76.86%)
parity:
none
7(58.3%)
56(73.67 %)
one to four
3(37.5%)
108(89.2%)
>four
education
primary
4(50%)
secondary
5(55.56%)
43(74.1%)
tertiary
111(84.1%)

15. results
Out of 260 pregnant women, 201 (77.3%) were CMV IgG 21(8.1%) CMV IgM being
on acute stage of the disease. Marital status (OR = , 95% CI = , P < ),
parity (OR = , 95% CI = ,
P < ), and education (OR = , 95% CI = , P < ), history of
blood transfusion (OR = ,
95% CI = , OR = )
were found to significantly influence seropostivity in univariate analysis.
Those with AI >35% were 43 (79.63%) while those with AI<or equal to 35% were 11 (20.37%).

16. discussion
This is the first data on the epidemiology of CMV infections among pregnant women in Kenya.
women who were married, illiterate, aged or with high parity, were found to be at higher risk for CMV infection
These factors increased susceptibility to acquisition of CMV infection.
These findings were similar to those obtained in other developing countries

17. conclusion The prevalence of CMV is high
significant relationship between CMV prevalence and social demographic information
The level of chronic infection is higher than acute infection
Protective antibodies were higher than active antibodies

18. recommendation A follow up study is necessary.
Further studies be carried out on the different strains of CMV-(awaiting ethical approval)
Large scale studies to ascertain the consequences of CMV infection in infants
The 88.4% CMV prevalence rate being detected among pregnant women calls for
vaccine and routine screening for CMV infections and its associated risk factors in this kind of settings.

19. Special thanks National Research Institute of Chinese Medicine
Kenyatta University Microbiology department

20. THANK YOU