Seroprevalence and Factors Associated with Zika and Dengue Virus Infections Among Symptomatic Pregnant Women Attending Antenatal Clinics in Rural and Urban Areas of Mwanza Tanzania
- Mwanza, Tanzania: Catholic University of Health and Allied Sciences [CUHAS - Bugando] : 2018
- xiii; 43 Pages Includes References and Appendices
ABSTRACT:
Background: Zika and Dengue viruses are vector borne viral infections of public health importance in tropical and subtropical countries and have been associated with adverse pregnancy outcomes. Infection with these viruses during pregnancy may results into adverse pregnancy outcomes. Zika virus also has been associated with complications such as Guillen Barre Syndrome, myelitis and meningoencephalitis. Despite increasing reports of Zika and Dengue virus related complications during pregnancy in most of Latin America countries, there is scarcity of data regarding the magnitude of these viruses in most African countries where they are considered to be endemic.
Objectives: This study aimed at determining the seroprevalence and factors associated with Zika and Dengue viruses among symptomatic pregnant women attending antenatal clinics in rural and urban areas of Mwanza, Tanzania
Methodology: This was hospital based cross sectional study with a follow up component involving 171 pregnant women with signs and symptoms of these viruses in the current pregnancy which was, conducted July 2017 to April 2018. Sera were collected and used for detection of Zika and Dengue viruses specific antibodies (IgM and IgG) using rapid immunochromatographic test as per manufacturer’s instructions (TELL ME FAST, Canada) followed by multiplex polymerase chain reaction (PCR).
Results: The median age of enrolled women was 24 [IQR: 21-30] years with the median gestation age of 25[IQR 20-32] weeks. Seroprevalence of Zika virus was found to be 5(2.9%) while that of Dengue virus was 12(7.0%). The overall seroprevalence (Dengue/Zika virus) was 16 (9.4%) (95% CI: 5.0-13.7). The odds of being Zika/Dengue seropositive were significantly high among women with advanced age (OR=1.16, 95% CI: 1.02 – 1.32, p=0.024) and those residing in rural areas (OR=5.03, 95% CI: 1.04-24.29, p=0.044) compared to their counterparts.
Conclusion and recommendations: About 9% of pregnant women in Mwanza are seropositive to Zika/Dengue viruses which are predicted by having advanced age and residing in rural areas. This calls for the need for attending doctors/nurses to put much emphasis on mosquito control measures to reduce the transmission of this infection especially in rural settings well as inclusion of screening of these infections for high risk women.
= OPERATIONAL DEFINITIONS Zika and Dengue clinical signs Any of the following signs & symptoms: & symptoms Headache, fever, myalgia, Arthritis, Conjunctivitis, runny nose, itching or rush OPERATIONAL DEFINITIONS Low Birth Weight Birth weight below 2.5kgs OPERATIONAL DEFINITIONS Prematurity Delivery before 37weeks of GA
= LIST OF ABBREVATIONS AHSR Any history of skin Rashes ANC Antenatal Clinic BMC Bugando Medical Centre CSF Cerebral Spinal fluid CUHAS Catholic University of Health and Allied Sciences DENV Dengue Virus EDD Expected date of delivery ELISA Enzyme-Linked immune sorbent assay GA Gestational age GBS Guillen Barre Syndrome LBW Low Birth Weight LNMP Last Normal Menstrual Period RNA Ribonucleic acid RT-PCR Reverse transcriptase Polymerase Chain Reaction WNV West Nile Virus YFV Yellow fever Virus ZIKV Zika virus
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