Volume 22, Issue 8 (11-2024)                   Nursing and Midwifery Journal 2024, 22(8): 620-633 | Back to browse issues page

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Pakzad Moghadam S H, Navidi Z, Sarkoohi A, Fattah Ghazi S, Mohajeri Iravani M, Orandi A, et al . PREVALENCE OF CYTOMEGALOVIRUS INFECTION IN INFANTS IN IRAN: A SYSTEMATIC REVIEW AND META-ANALYSIS. Nursing and Midwifery Journal 2024; 22 (8) :620-633
URL: http://unmf.umsu.ac.ir/article-1-5252-en.html
PREVALENCE OF CYTOMEGALOVIRUS INFECTION IN INFANTS IN IRAN: A SYSTEMATIC REVIEW AND META-ANALYSIS
Seyed Hamid Pakzad Moghadam1 , Zia Navidi2 , Ali Sarkoohi1 , Samrand Fattah Ghazi3 , Mojhgan Mohajeri Iravani4 , Amirhossein Orandi5 , Mahdi Alemrajabi6 , Shahla Noori Ardebili7 , Ebadallah Shiri Malekabad8 , Saeed Khorramnia *9
1- Assistant Professor, Department of Anesthesiology, School of Medicine, Ali Ibn Abitaleb Educational and Tretment Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
2- Assistant Professor, Department of Anesthesiology, School of Medicine, Ali Ibn Abitaleb Educational and Treatment Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
3- Assistant Professor, Department of Anesthesiology and Critical Care, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
4- Assistant Professor, School of Allied Medical Sciences, 503 Hospital (Hajar), AJA University of Medical Sciences, Tehran, Iran
5- Associate Professor, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
6- Associate Professor, General Surgery Research Center, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran
7- Gynecologist Laparoscopic Surgeon, Department of Obstetrics and Gynecology, Atieh Hospital, Tehran, Iran
8- Epidemiologist, School of Nursing, AJA University of Medical Sciences, Tehran, Iran
9- Assistant Professor, Department of Anesthesiology, School of Medicine, Ali Ibn Abitaleb Educational and Treatment Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran , saeed.khorramnia@gmail.com
Abstract:   (920 Views)
Background & Aim: Cytomegalovirus is one of the most significant causes of infection in infants, leading to congenital disabilities, developmental disabilities, hearing loss, and even death. This study aimed to determine the prevalence of cytomegalovirus infection among infants in Iran through a systematic review and meta-analysis.
Materials & Methods: PubMed, Scopus, Web of Science, Science Direct, Scientific Information Database, as well as Magiran electronic databases were searched to find relevant articles published up to September 2024. A hand search was also conducted on primary review sources and key studies. The languages of the studies were limited to Persian and English. Bias assessment of the studies was performed using the Newcastle-Ottawa Scale checklist. Data analysis was conducted using Comprehensive Meta-Analysis software version 3.
Results: A total of 15 observational studies, including 5889 infants were included in the analysis. The results of the meta-analysis showed that the prevalence of cytomegalovirus in infants was 3% (95% confidence interval [CI]: 0.01–0.10; P < 0.05). Additionally, the prevalence of cytomegalovirus in male and female infants was 2% (95% CI: 0.004–0.10; P < 0.05) and 3% (95% CI: 0.007–0.16; P < 0.05), respectively. No statistically significant relationship was observed between the prevalence of cytomegalovirus in infants and the year of publication of the studies (P > 0.05). However, a statistically significant relationship was observed between the prevalence of cytomegalovirus in infants and the sample size of the studies (P < 0.05). Publication bias was noted in the study (P < 0.05).
Conclusion: The findings showed that cytomegalovirus prevalence is high in infants, and comprehensive surveillance programs are necessary for the effective management and prevention of cytomegalovirus infections in infants.
 
Keywords: Cytomegalovirus, Infant, Iran, Meta-Analysis, Prevalence, Systematic Review
Full-Text [PDF 839 kb]   (752 Downloads)    
Type of Study: Review article | Subject: پزشکی
References
1. Manicklal S, Emery VC, Lazzarotto T, Boppana SB, Gupta RK. The "silent" global burden of congenital cytomegalovirus. Clin Microbiol Rev 2013;26(1):86-102. [PMID: 23297260] [DOI:10.1128/CMR.00062-12] [PMCID: PMC3553672]
2. Rios-Barnes M, Fortuny C, Alarcón A, Noguera-Julian A. Renal involvement in congenital cytomegalovirus infection: a systematic review. Microorganisms 2021;9(6):1304. [PMID: 34203932] [DOI:10.3390/microorganisms9061304] [PMCID: PMC8232607]
3. Kenneson A, Cannon MJ. Review and meta-analysis of the epidemiology of congenital cytomegalovirus (CMV) infection. Rev Med Virol 2007;17(4):253-76. [PMID: 17579921] [DOI:10.1002/rmv.535]
4. Chiopris G, Veronese P, Cusenza F, Procaccianti M, Perrone S, Daccò V, et al. Congenital cytomegalovirus infection: update on diagnosis and treatment. Microorganisms 2020;8(10):1516. [PMID: 33019752] [DOI:10.3390/microorganisms8101516] [PMCID: PMC7599523]
5. Khorramnia S, Jafari A, Farahbakhsh F, Aliniaghara E, Amani B. Estimation of mortality in the intensive care units in Iran: a systematic review and meta-analysis. Nurs Midwifery J 2019;17(8):634-45. [URL:]
6. Lawrence SM. Human cytomegalovirus and neonatal infection. Curr Res Microb Sci 2024. [PMID: 39070527] [DOI:10.1016/j.crmicr.2024.100257] [PMCID: PMC7502381]
7. Fowler K, Mucha J, Neumann M, Lewandowski W, Kaczanowska M, Grys M, et al. A systematic literature review of the global seroprevalence of cytomegalovirus: possible implications for treatment, screening, and vaccine development. BMC Public Health 2022;22(1):1659. [PMID: 36050659] [DOI:10.1186/s12889-022-13971-7] [PMCID: PMC9435408]
8. Luck SE, Wieringa JW, Blázquez-Gamero D, Henneke P, Schuster K, Butler K, et al. Congenital cytomegalovirus: a European expert consensus statement on diagnosis and management. Pediatr Infect Dis J 2017;36(12):1205-13. [PMID: 29140947] [DOI:10.1097/INF.0000000000001763]
9. Rawlinson WD, Boppana SB, Fowler KB, Kimberlin DW, Lazzarotto T, Alain S, et al. Congenital cytomegalovirus infection in pregnancy and the neonate: consensus recommendations for prevention, diagnosis, and therapy. Lancet Infect Dis 2017;17(6):e177-e88. [PMID: 28291720] [DOI:10.1016/S1473-3099(17)30143-3]
10. Tran C, Bennett MV, Gould JB, Lee HC, Lanzieri TM. Cytomegalovirus infection among infants in neonatal intensive care units, California, 2005 to 2016. Am J Perinatol 2020;37(02):146-50. [PMID: 30895580] [DOI:10.1055/s-0039-1683958] [PMCID: PMC6754307]
11. Naghizadeh S, Azari S, Fathnejad Kazemi A, Ebrahimpour Mirzarezaei M, Alizadeh S. Assessing and comparing results of amniocentesis and triple marker tests to detect aneuploidies. Nurs Midwifery J 2015;13(7):596-604. [URL:]
12. Nijman J, de Vries LS, Koopman-Esseboom C, Uiterwaal CS, van Loon AM, Verboon-Maciolek MA. Postnatally acquired cytomegalovirus infection in preterm infants: a prospective study on risk factors and cranial ultrasound findings. Arch Dis Child Fetal Neonatal Ed 2012;97(4):F259-F63. [PMID: 22247412] [DOI:10.1136/archdischild-2011-300405]
13. Leruez-Ville M, Magny J-F, Couderc S, Pichon C, Parodi M, Bussières L, et al. Risk factors for congenital cytomegalovirus infection following primary and nonprimary maternal infection: a prospective neonatal screening study using polymerase chain reaction in saliva. Clin Infect Dis 2017;65(3):398-404. [PMID: 28419213] [DOI:10.1093/cid/cix337]
14. Nicloux M, Peterman L, Parodi M, Magny J-F. Outcome and management of newborns with congenital cytomegalovirus infection. Arch Pediatr 2020;27(3):160-5. [PMID: 32127242] [DOI:10.1016/j.arcped.2020.01.006]
15. Pesch MH, Saunders NA, Abdelnabi S. Cytomegalovirus infection in pregnancy: prevention, presentation, management and neonatal outcomes. J Midwifery Womens Health 2021;66(3):397-402. [PMID: 34031974] [DOI:10.1111/jmwh.13228]
16. Nazarpour S, Simbar M. A systematic review of pregnancy outcomes in mothers with COVID-19 infection. Nurs Midwifery J 2023;21(1):78-88. [URL:] [DOI:10.61186/unmf.21.1.78]
17. Peterson J, Welch V, Losos M, Tugwell P. The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa: Ottawa Hospital Research Institute 2011;2(1):1-12. [URL:]
18. Arabzadeh A, Mosavat SA, Eftekhari N. Seroepidemiology of human cytomegalovirus in pregnant women and their neonates in Kerman city during 2005. J Kerman Univ Med Sci 2007;14(2):279-88. [URL:]
19. Ebrahimi-Rad M, Shakeri TS, Shirvani F, Shahrokhi K, Shahrokhi N. Prevalence of congenital cytomegalovirus infection in symptomatic newborns under 3 weeks in Tehran Iran. BMC Infect Dis 2017;17:1-7. [PMID: 29047343] [DOI:10.1186/s12879-017-2799-5] [PMCID: PMC5645930]
20. Erfanianahmadpoor M, Nasiri R, Vakili R, Hassannia T. Seroprevalence transmission and associated factors of specific antibodies against cytomegalovirus among pregnant women and their infants in a regional study. Saudi Med J 2014;35(4):360-4. [URL:]
21. Fahimzad A, Afgeh SA, Eghbali E, Abdinia B, Shiva F, Rahbar M. Screening of congenital CMV infection in saliva of neonates by PCR: report of a pilot screening study in Iran. Clin Lab 2013;59(9-10):1171-4. [PMID: 24273943] [DOI:10.7754/Clin.Lab.2013.120910]
22. Karimi A, Manaberi M, Azimi L, Taleghani NT, Shirvani F, Shariati MK, et al. Incidence and prognosis of congenital cytomegalovirus infection: a retrospective single-center experience, Tehran Iran. Arch Pediatr Infect Dis 2023;11(4):e135767. [URL:] [DOI:10.5812/apid-135767]
23. Karimian P, Yaghini O, Nasr Azadani H, Mohammadizadeh M, Arabzadeh SAM, Adibi A, et al. Prevalence characteristics and one-year follow-up of congenital cytomegalovirus infection in Isfahan City Iran. Interdiscip Perspect Infect Dis 2016;2016(1):7812106. [PMID: 28070187] [DOI:10.1155/2016/7812106] [PMCID: PMC5192306]
24. Kazemian M, Mehri M, Fallahi M, Shariati MK, Hajipour M, Nikkhah A. CMV serovirulence in mothers and their very low birth weight (< 1,500) neonates in Tehran City Iran in a year. Iran J Neonatol 2022;13(2). [URL:]
25. Mahdipour S, Sharafi R, Alam Shooshtari M, Helforoush A. Assessing the frequency of cytomegalovirus in the small for gestational age neonates in Al-Zahra hospital during 2015-2016. J Pediatr Nurs 2020;6(4):40-6. [URL:]
26. Mirsalehi N, Yavarian J, Ghavami N, Naseri M, Khodakhah F, Shatizadeh Malekshahi S, et al. Congenital cytomegalovirus infection in newborns suspected of congenital rubella syndrome in Iran: a cross-sectional study. BMC Pediatr 2024;24(1):31. [PMID: 38200453] [DOI:10.1186/s12887-023-04502-3] [PMCID: PMC10777647]
27. Monavari SH, Keyvani H, Kiasari BA, Mollaei H, Fazlalipour M, Vaziri MS, et al. Detection of cytomegalovirus (CMV) antibodies or DNA sequences from ostensibly healthy Iranian mothers and their neonates. Int J Med Med Sci 2012;4(8):155-59. [URL:]
28. Noorbakhsh S, Farhadi M, Haghighi F, Minaeian S, Hasanabad MH. Neonatal screening for congenital cytomegalovirus infection in Tehran Iran using Guthrie cards. Iran J Microbiol 2020;12(3):198. [PMID: 32685115] [DOI:10.18502/ijm.v12i3.3236]
29. Noorbakhsh S, Farhadi M, Minaeian S, Haghighi Hasanabad M. Prevalence of congenital cytomegalovirus infection in newborns admitted to the intensive care units in Tehran Iran. Tehran Univ Med J 2023;81(3):216-23. [URL:]
30. Sanjideh M, Naeimi S, Moradi Nasab M, Moradi R, Vahdat K. Cytomegalovirus infection in NICU admitted neonates in Boushehr Iran South Med J 2016;18(6):1171-8. [URL:] [PMCID: 27677342]
31. Yari R, Javadi A, Morovvati A, Shakeri T. Rapid detection and prevalence of cytomegalovirus in infants under three weeks by PCR and real time PCR. J Ilam Univ Med Sci 2016;24(5):175-84. [URL:] [DOI:10.18869/acadpub.sjimu.24.5.175]
32. Zandieh T, Kavyani S, Rakhshan M. The evaluation of cytomegalovirus in infants following exchange transfusion in children medical hospital. Sci J Iran Blood Transfus Organ 2005;2(4):83-9. [URL:]
33. 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 Netw Open 2021;4(8):e2120736-e. [PMID: 34424308] [DOI:10.1001/jamanetworkopen.2021.20736] [PMCID: PMC8383138]
34. Boppana SB, Ross SA, Novak Z, Shimamura M, Tolan RW, Palmer AL, et al. Dried blood spot real-time polymerase chain reaction assays to screen newborns for congenital cytomegalovirus infection. JAMA 2010;303(14):1375-82. [PMID: 20388893] [DOI:10.1001/jama.2010.423] [PMCID: PMC2997517]
35. Manicklal S, Van Niekerk A, Kroon S, et al. Birth prevalence of congenital cytomegalovirus among infants of HIV-infected women on prenatal antiretroviral prophylaxis in South Africa. Clin Infect Dis 2014;58(10):1467-72. [PMID: 24567248] [DOI:10.1093/cid/ciu096]
36. Lanzieri TM, Dollard SC, Bialek SR, Grosse SD. Systematic review of the birth prevalence of congenital cytomegalovirus infection in developing countries. Int J Infect Dis 2014;22:44-8. [PMID: 24631522] [DOI:10.1016/j.ijid.2013.12.010] [PMCID: PMC4829484]
37. van der Sande MA, Kaye S, Miles DJ, Waight P, Jeffries DJ, Ojuola OO, et al. Risk factors for and clinical outcome of congenital cytomegalovirus infection in a peri-urban West-African birth cohort. PLoS One 2007;2(6):e492. [PMID: 17551573] [DOI:10.1371/journal.pone.0000492] [PMCID: PMC1876257]
38. Zhang X-W, Li F, Yu X-W, Shi X-W, Shi J, Zhang J-P. Physical and intellectual development in children with asymptomatic congenital cytomegalovirus infection: a longitudinal cohort study in Qinba mountain area China. J Clin Virol 2007;40(3):180-5. [PMID: 17919973] [DOI:10.1016/j.jcv.2007.08.018]
39. Espy M, Uhl J, Sloan L, Buckwalter S, Jones M, Vetter E, et al. Real-time PCR in clinical microbiology: applications for routine laboratory testing. Clin Microbiol Rev 2006;19(1):165-256. [PMID: 16418529] [DOI:10.1128/CMR.19.1.165-256.2006] [PMCID: PMC1360278]
40. Pathirana J, Groome M, Dorfman J, Kwatra G, Boppana S, Cutland C, et al. Prevalence of congenital cytomegalovirus infection and associated risk of in utero human immunodeficiency virus (HIV) acquisition in a high-HIV prevalence setting South Africa. Clin Infect Dis 2019;69(10):1789-96. [PMID: 30615106] [DOI:10.1093/cid/ciz019]
41. Lanzieri TM, Bialek SR, Bennett MV, Gould JB. Cytomegalovirus infection among infants in California neonatal intensive care units 2005-2010. J Perinat Med 2014;42(3):393-9. [PMID: 24334425] [DOI:10.1515/jpm-2013-0183] [PMCID: PMC4834882]
42. Paradiž KR, Seme K, Puklavec E, Paro-Panjan D, Poljak M. Prevalence of congenital cytomegalovirus infection in Slovenia: a study on 2,841 newborns. J Med Virol 2012;84(1):109-15. [PMID: 22028094] [DOI:10.1002/jmv.22230]
43. Barbi M, Binda S, Primache V, Clerici D. Congenital cytomegalovirus infection in a northern Italian region. Eur J Epidemiol 1998;14:791-6. [PMID: 9928874] [DOI:10.1023/A:1007554726449]
44. Halwachs-Baumann G, Genser B, Danda M, Engele H, Rosegger H, Fölsch B, et al. Screening and diagnosis of congenital cytomegalovirus infection: a 5-y study. Scand J Infect Dis 2000;32(2):137-42. [PMID: 10826897] [DOI:10.1080/003655400750045222]
45. Buonsenso D, Serranti D, Gargiullo L, Ceccarelli M, Ranno O, Valentini P. Congenital cytomegalovirus infection: current strategies and future perspectives. Eur Rev Med Pharmacol Sci 2012;16(7). [URL:]
46. Puhakka L, Lappalainen M, Lönnqvist T, Niemensivu R, Lindahl P, Nieminen T, et al. The burden of congenital cytomegalovirus infection: a prospective cohort study of 20 000 infants in Finland. J Pediatr Infect Dis Soc 2019;8(3):205-12. [PMID: 29554325] [DOI:10.1093/jpids/piy027]
47. Putri ND, Wiyatno A, Dhenni R, Sriyani IY, Dewantari AK, Handryastuti S, et al. Birth prevalence and characteristics of congenital cytomegalovirus infection in an urban birth cohort Jakarta Indonesia. Int J Infect Dis 2019;86:31-9. [PMID: 31207385] [DOI:10.1016/j.ijid.2019.06.009]
48. Ebrahim MG, Ali AS, Mustafa MO, Musa DF, El Hussein ARM, et al. Molecular detection of human cytomegalovirus (HCMV) among infants with congenital anomalies in Khartoum State Sudan. Open Virol J 2015;9:38. [PMID: 26862356] [DOI:10.2174/1874357901509010038] [PMCID: PMC4740961]
49. Schlesinger Y, Reich D, Eidelman AI, Schimmel MS, Hassanin J, Miron D. Congenital cytomegalovirus infection in Israel: screening in different subpopulations. Isr Med Assoc J 2005;7(4):237-40. [URL:]
50. Neirukh T, Qaisi A, Saleh N, Rmaileh AA, Zahriyeh EA, et al. Seroprevalence of cytomegalovirus among pregnant women and hospitalized children in Palestine. BMC Infect Dis 2013;13:1-7. [PMID: 24206533] [DOI:10.1186/1471-2334-13-528] [PMCID: PMC3830538]
51. Olusanya BO, Slusher TM, Boppana SB. Prevalence of congenital cytomegalovirus infection in Nigeria: a pilot study. J Pediatr Infect Dis 2015;34(3):322-4. [PMID: 25742080] [DOI:10.1097/INF.0000000000000555] [PMCID: PMC4352715]
52. Yamagishi Y, Miyagawa H, Wada K, Matsumoto S, Arahori H, Tamura A, et al. CMV DNA detection in dried blood spots for diagnosing congenital CMV infection in Japan. J Med Virol 2006;78(7):923-5. [PMID: 16721859] [DOI:10.1002/jmv.20642]
53. Yamagishi Y, Miyagawa H, Wada K, Matsumoto S, Arahori H, Tamura A, et al. The prevalence of congenital cytomegalovirus infection in newborn infants at an intensive care unit in a public hospital. J Pediatr 2006;82:46-50. [PMID: 16532147] [DOI:10.2223/JPED.1436]
54. Marin LJ, Dos Santos PR, Ramos FC, Dos Santos UR, Marques M, de Carvalho LD, et al. Congenital CMV infection in a Brazilian neonatal intensive care unit: high prevalence among twin newborns. Virol J 2024;21(1):63. [PMID: 38459575] [DOI:10.1186/s12985-024-02324-y] [PMCID: PMC10924335] []
55. Alwan SN, Shamran HA, Ghaib AH, Kadhim HS, Al-Mayah QS, Al-Saffar AJ, et al. Genotyping of cytomegalovirus from symptomatic infected neonates in Iraq. Am J Trop Med Hyg 2019;100(4):957-63. [PMID: 30810104] [DOI:10.4269/ajtmh.18-0152] [PMCID: PMC6447132]
56. Sezgin E, An P, Winkler CA. Host genetics of cytomegalovirus pathogenesis. Front Genet 2019;10:616. [PMID: 31396258] [DOI:10.3389/fgene.2019.00616] [PMCID: PMC6664682]
57. Taneja V. Sex hormones determine immune response. Front Immunol 2018;9:1931. [PMID: 30210492] [DOI:10.3389/fimmu.2018.01931] [PMCID: PMC6119719]
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