Herpes simplex virus type 2 cross-sectional seroprevalence and the estimated rate of neonatal infections among a cohort of rural Malawian female adolescents.

Abstract

OBJECTIVE:

To assess herpes simplex virus type 2 (HSV-2) seroprevalence among rural Malawian adolescent women and estimate the number of neonatal herpes infections among infants of these adolescents.

METHODS:

A longitudinal cohort study of adolescents (14-16 years at entry) residing in rural Malawi was initiated in 2007 with annual observation. HSV-2 testing was introduced in 2010. In this study, we (1) determined, using cross-sectional analysis, risk factors for positive serostatus, (2) adjusted for non-response bias with imputation methods and (3) estimated the incidence of neonatal herpes infection using mathematical models.

RESULTS:

A total of 1195 female adolescents (age 17-20 years) were interviewed in 2010, with an observed HSV-2 seroprevalence of 15.2% among the 955 women tested. From a multivariate analysis, risk factors for HSV-2 seropositivity include older age (p=0.037), moving from the baseline village (p=0.020) and report of sexual activity with increasing number of partners (p<0.021). Adjusting for non-response bias, the estimated HSV-2 seroprevalence among the total female cohort (composed of all women interviewed in 2007) was 18.0% (95% CI 16.0% to 20.2%). HSV-2 seropositivity was estimated to be 25.6% (95% CI 19.6% to 32.5%) for women who refused to provide a blood sample. The estimated number of neonatal herpes infections among the total female cohort was 71.8 (95% CI 57.3 to 86.3) per 100 000 live births.

CONCLUSIONS:

The risk of HSV-2 seroconversion is high during adolescence, when childbearing is beginning, among rural Malawian women. Research on interventions to reduce horizontal and vertical HSV-2 transmission during adolescence in resource-limited settings is needed.

• Authors: Christopher R Sudfeld, Paul C Hewett, Nadia N Abuelezam, Satvika Chalasani, Erica Soler-Hampejsek, Christine A Kelly, Barbara S Mensch
• Journal: Sexually transmitted infections (Sex Transm Infect) Vol. 89 Issue 7 Pg. 561-7 (Nov 2013) ISSN: 1472-3263 [Electronic] England
• PMID: 23794069 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Viral

Topics

• Adolescent
• Antibodies, Viral (blood)
• Cohort Studies
• Female
• Herpes Genitalis (epidemiology, transmission)
• Herpesvirus 2, Human (immunology)
• Humans
• Incidence
• Infant, Newborn
• Infectious Disease Transmission, Vertical
• Longitudinal Studies
• Malawi (epidemiology)
• Male
• Models, Theoretical
• Pregnancy
• Rural Population
• Seroepidemiologic Studies
• Young Adult