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Cytomegalovirus, Parvovirus B19 and Rubella Co-Infection among Pregnant Women Attending Antenatal Clinics in Mwanza City: The Need to be considered in Tanzanian Antenatal Care Package

Mariam M. Mirambo, Elieza Chibwe, Martha F. Mushi, Mtebe Majigo and Stephen E. Mshana

Background: Viral infections are common in pregnancy and have been associated with poor pregnancy outcome. In many developing countries including Tanzania, the magnitude of these infections and their impact to pregnancy outcome is not clearly understood. The aim of this study was to determine the magnitude of these infections. The information from this study may influence policy makers to consider routine screening of these infections during antenatal visits.

Methods: A cross sectional hospital based study involving 214 pregnant women was conducted between December 2014 to and August 2015 in two antenatal clinics in Mwanza city. Rubella, cytomegalovirus and parvovirus B19 (B19) specific IgG and IgM antibodies were detected by using commercial indirect enzyme linked immunosorbent assay. Data were analyzed using STATA version 11.

Results: The median age of enrolled pregnant women was 21 (Interquartile range: 20-26) years. Previous co-infections of rubella, cytomegalovirus and B19 was detected in 78 (36.5%) of pregnant women tested. A total of 20 (9.4%) pregnant women had acute co-infection of rubella and parvovirus B19 while 1(0.5%) had acute co-infection of cytomegalovirus and parvovirus B19. The odds of having previous co-infection (IgG sero-positivity) increase significantly as the age increases (odd ratio: 1.056, 95% CI: 1.00-1.11, P=0.03). Moreover, as the gestation age increases the odds of having co-infection decreases significantly (odd ratio: 0.923, 95% CI: 0.88-0.96, P=0.001).

Conclusion: Considerable proportion of pregnant women in Mwanza is co-infected with rubella, Cytomegalovirus and parvovirus B19. We recommend routine screening for these infections during antenatal visits so as to reduce the possibility of congenital infection.