Serological Markers of Viral Infections (Rubella Virus, Human Cytomegalovirus and Arboviruses) among Symptomatic Pregnant Women in Rural and Urban Areas of Mwanza, Tanzania

Abstract

Viral infections have been associated with poor pregnancy outcomes. We investigated the magnitude of rubella virus (RV), dengue virus (DENV), Zika virus (ZIKV) and human cytomegalovirus (HCMV) among symptomatic pregnant women in rural and urban areas of Mwanza. A cross-sectional study was conducted between July 2017 and April 2018 in Mwanza. A rapid immunochromatographic test was done to detect ZIKV IgM and IgG as well as DENV IgM and IgG antibodies. A multiplex_RT-PCR was also done to detect the viral RNA genome. Enzyme immunoassays were done to detect RV and HCMV. Out of 171 participants, 1 (0.6%) was found to be seropositive for ZIKV_IgM antibodies, while 5 (2.9%) were ZIKV_IgG seropositive. DENV seropositivity was 9 (5.3%) and 3 (1.8%) for IgM and IgG, respectively, with all being PCR negative. Two participants (1.2%) were RV_IgM seropositive. 100% were HCMV_IgG seropositive and none was HCMV_IgM seropositive. Among 70 women with high HCMV_IgG titters, 10 (14.3%) had a low avidity index, indicating recent infections. Residing in rural areas (p = 0.044) and advanced age (p = 0.024) independently predicted ZIKV/DENV seropositivity. A substantial proportion of pregnant women had markers for viral infections. There is a need for introducing routine screening and monitoring pregnancy outcomes of positive cases to establish the relationship of these viruses and adverse pregnancy outcomes in endemic areas.

Keywords

• rubella virus
• human cytomegalovirus
• Zika virus
• dengue virus
• pregnant women
• Tanzania