Prevalence of infectious risk factors during pregnancy: An infectiological snapshot of 180 pregnant women in a rural setting of Western Ghana

by Fabian Völker
Doctoral thesis
Date of Examination:2017-03-09
Date of issue:2017-03-03
Advisor:Prof. Dr. Uwe Groß
Referee:Prof. Dr. Günter Emons
Referee:Prof. Dr. Eva Hummers-Pradier
Referee:Prof. Dr. Thomas Meyer
Persistent Address: http://dx.doi.org/10.53846/goediss-6155

 

 

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Abstract

English

Prevalence of infectious risk factors during pregnancy: An infectiological snapshot of 180 pregnant women in a rural setting of Western Ghana A cross-sectional pilot study in a rural area of Western Ghana was carried out to develop an infectiological risk profile of pregnant women. For this, 180 expectant mothers were screened for the presence of pathogens, known to compromise the health of mother and child. Vaginal swabs were examined by microbiological or virological testings to detect group B streptococci (GBS), Listeria monocytogenes, Neisseria gonorrhoeae, Chlamydia trachomatis and herpes simplex virus (HSV-1/- 2). Furthermore, blood and serum samples were investigated to detect non-vaginal pathogens like Plasmodium sp., Toxoplasma gondii, hepatitis viruses (HBV, HCV, HEV), cytomegalovirus (CMV), human immunodficiency virus (HIV), rubella virus, varicella-zoster virus (VZV) and parvovirus B 19 (PB19). Finally, bacterial pathogens like Treponema pallidum and Brucella spp. were subjects of our examinations. The microbiological methods based either on direct detection of the pathogens by culture, MALDI-TOF MS and PCR, or indirect identification by serological markers. Additionally, all study participants were interviewed for the presence of potential risk factors, outcome of previous pregnancies, socio-economic aspects and antenatal medical care services. Our results showed a prevalence of acute or past infections with a broad spectrum of parasitic, viral and bacterial pathogens. Maternal malaria was shown to be frequent (10.6%), despite increasing acceptance of the intermittent preventive treatment (IPTp) and primary prevention. We showed a high prevalence of infections caused by the hepatotropic viruses HBV (16.7% HBs Ag positive) and HEV (20.7% HEV-IgM) but not for HCV (1.1% anti-HCV). With 0.6%, the prevalence of HIV was very low and might be judged as an encouraging step in the fight against AIDS. We determined a significant IgG -seroprevalence for other pregnancy-related viral pathogens, such as CMV, HSV, VZV, rubella virus, and PB19 virus. However, absence of antibodies against rubella virus in 15.7% and against VZV in 43.2% makes a significant proportion of woman susceptible for acquiring primary infection during pregnancy. Seroprevalence of Toxoplasma gondii-specific antibodies was 73.2% with three possible acute infections acquired during pregnancy. GBS, the major risk factor for neonatal sepsis, were isolated from the birth canal of 10.6% of all pregnant women. Our pilot study proofs the existence of pregnancy-related infections in a rural population of Ghana at different prevalence rates, thereby offers guidance for health officials to discuss possible future intervention schemes.
Keywords: Infections; Pregnancy; Sub-Saharan Africa; Mother and Child health
Schlagwörter: Infections; Pregnancy; Sub-Saharan Africa; Mother and Child health
 
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