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Seroprevalence, predictors and estimated incidence of maternal and neonatal Herpes Simplex Virus Type 2 infection in semi-urban women in Kilifi, Kenya

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Nyiro, Joyce U., Sanders, Eduard J., Ngetsa, Caroline, Wale, Steve, Awuondo, Ken, Bukusi, Elizabeth Anne, Price, Matthew A., Amornkul, Pauli N. and Nokes, D. James. (2011) Seroprevalence, predictors and estimated incidence of maternal and neonatal Herpes Simplex Virus Type 2 infection in semi-urban women in Kilifi, Kenya. BMC Infectious Diseases, Vol.11 (No.155). ISSN 1471-2334

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Official URL: http://dx.doi.org/10.1186/1471-2334-11-155

Abstract

Background: Herpes Simplex Virus type 2 (HSV-2) has public health importance as a leading cause of genital ulcers, a co-factor in HIV-1 acquisition and transmission and as a cause of neonatal herpes infections. Little is known of its epidemiology and burden in Coastal Kenya. Methods: We screened plasma samples for HSV-2 infection from 826 women aged 15-34 years who participated in an HIV-1 survey in Kilifi in 2004. The sample comprised 563 women selected randomly from a demographic surveillance system (DSS) and 263 women who presented for voluntary counseling and testing (VCT). Predictors for HSV-2 seropositivity were determined using multivariate logistic regression. The incidence of HSV-2 infection and risk of neonatal herpes were estimated by a simple catalytic model fitted to age-seroprevalence data. Results: HSV-2 prevalence was 32% in the DSS recruits vs. 44% in the VCT recruits (P < 0.001), while, HIV-1 prevalence was 8% in the DSS recruits vs. 12% in the VCT recruits (P = 0.12). Independent risk factors for HSV-2 infection in all women were: older age (30-34 years; odds ratio (OR) 10.5, 95% confidence interval (CI): 5.2 - 21.0), recruitment from VCT (OR 1.5, 95% CI: 1.1 - 2.1), history of genital ulcers (OR 1.7, 95% CI: 1.2 - 2.3) and HIV infection (OR 2.7, 95% CI: 1.6-4.6). Education beyond primary (OR 0.7, 95% CI: 0.5 - 0.9) was inversely associated with HSV-2 infection. In the DSS sample, HSV-2 incidence was estimated at 4 cases (95% CI: 3.3 - 4.4) per 100 women per year, 17 cases (95% CI: 16-18) per 1,000 pregnancies per year and 33 neonatal cases (95% CI: 31-36) per 100,000 births per year. Conclusions: HSV-2 transmission is rapid following the onset of sexual activity and likely to result in a significant burden of genital ulcer disease. Nevertheless, the burden of neonatal HSV-2 can be predicted to be low. Educating young women about HSV-2 infection may help in reducing its burden in this semi-urban population.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Science > Life Sciences (2010- )
Library of Congress Subject Headings (LCSH):	Herpes simplex -- Kenya -- Kilifi, Mothers -- Health and hygiene -- Kenya -- Kilifi, Newborn infants -- Health and hygiene -- Kenya -- Kilifi
Journal or Publication Title:	BMC Infectious Diseases
Publisher:	BioMed Central Ltd.
ISSN:	1471-2334
Date:	31 May 2011
Volume:	Vol.11
Number:	No.155
Identification Number:	10.1186/1471-2334-11-155
Status:	Peer Reviewed
Access rights to Published version:	Open Access
Funder:	United States. Agency for International Development (USAID), Kenya Medical Research Institute, University of California, San Francisco
Grant number:	5 D43 TW007388 (KEMRI-UCSF)
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URI:	http://wrap.warwick.ac.uk/id/eprint/35929