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Séroépidémiologie de la rubéole, de la varicelle et des infections par le cytomégalovirus et le parvovirus B19 chez les femmes enceintes dans la région de Sousse, Tunisie

Seroprevalence of rubella virus, varicella zoster virus, cytomegalovirus and parvovirus B19 among pregnant women in the Sousse region, Tunisia

  • Santé Publique / Public Health
  • Published:
Bulletin de la Société de pathologie exotique

Résumé

Le but de cette étude est de déterminer les séroprévalences des virus de la rubéole (VR), du cytomégalovirus (CMV), du virus de la varicelle et du zona (VZV) et du parvovirus B19 (PB19) chez 404 femmes enceintes tunisiennes consultant à la maternité du CHU Farhat-Hached de Sousse et d’étudier la fiabilité des antécédents éruptifs rapportés. Les caractéristiques sociodémographiques et les antécédents ont été recueillis à l’aide d’un questionnaire. L’analyse des facteurs de risque a été réalisée par régression logistique uni- et multivariée. Les prévalences étaient de 79,7 % pour la rubéole, 96,3 % pour le CMV, 80,9 % pour la varicelle et 76,2 % pour le PB19. Les facteurs associés à une forte prévalence étaient: le nombre de personnes par pièce pendant l’enfance (> 2) pour le CMV (p = 0,004), l’activité professionnelle irrégulière du mari pour le VZV (p = 0,04) et l’âge (> 30 ans) pour le PB19 (p = 0,02). Les valeurs prédictives positives (VPP) et négatives (VPN) de l’interrogatoire étaient respectivement de 92,6 et 17,2 % pour la rubéole et de, respectivement 84,9 et 20,9 % pour la varicelle. Une réceptivité importante demeure pour le VR, le VZV et le PB19 chez les femmes enceintes de notre région. Les mesures préventives instaurées contre la rubéole congénitale doivent être renforcées. Une vaccination contre la varicelle serait intéressante chez les femmes séronégatives. Le dépistage de l’infection par le CMV n’est pas justifié, en raison d’une large immunité acquise probablement dès l’enfance. La faible fiabilité des antécédents rapportés incite à se baser sur les tests sérologiques pour établir le statut immunitaire.

Abstract

The aim of the study is to evaluate seroprevalence of rubella virus (RV), cytomegalovirus (CMV), varicella zoster virus (VZV), and parvovirus B19 (PB19) in 404 Tunisian pregnant women, and to determine reliability of maternal past history of eruption. Sociodemographic characteristics, risk factors, and past history of eruption were collected through a questionnaire. Serologic tests were performed using enzyme immunoassays. Risk factors were analyzed using univariate and multivariate logistic regression models. Seroprevalences were 79.7% for rubella, 96.3% for CMV, 80.9% for VZV, and 76.2% for PB19. In multivariate analysis, the number of persons per room (> 2) in the house during childhood was associated with CMV infection (P = 0.004), irregular professional husband’s activity was correlated with VZV infection (P = 0.04), and an age of more than 30 years was associated with PB19 infection (P = 0.02). History of rubella, varicella, and PB19 infection was unknown for, respectively, 55.8%, 20%, and 100% of women. False history of rubella and varicella were found for 7.4% and 15% of women, respectively. The positive and negative predictive values (PPV and NPV) of rubella history were, respectively, 92.6% and 17.2%, and were, respectively, 84.9% and 20.9% for varicella history. Susceptibility to RV, VZV, and PB19 infection remains high in pregnancy in our population. Preventive strategies against congenital rubella must be reinforced. Vaccination against VZV should be considered in seronegative women. Systemic CMV screening is not warranted in our country where high immunity is acquired probably in childhood. Since maternal history of eruption is not reliable, we recommend serologic testing to determine immune status of women.

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Authors and Affiliations

  1. Laboratoire de microbiologie-immunologie, unité de recherche « caractérisation génomique des agents infectieux UR 02SP13 », avenue Ibn-Jazzar, 4000, Sousse, Tunisie

    N. Hannachi, M. Marzouk, A. Ferjani, Z. Ksouri & J. Boukadida

  2. Service d’épidémiologie, CHU Farhat-Hached, avenue Ibn-Jazzar, 4000, Sousse, Tunisie

    I. Harrabi & H. Ghannem

  3. Service de gynécologie-obstétrique, CHU Farhat-Hached, avenue Ibn-Jazzar, 4000, Sousse, Tunisie

    H. Khairi & S. Hidar

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  1. N. Hannachi
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  2. M. Marzouk
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  4. A. Ferjani
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  7. H. Khairi
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  9. J. Boukadida
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Correspondence to N. Hannachi.

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Hannachi, N., Marzouk, M., Harrabi, I. et al. Séroépidémiologie de la rubéole, de la varicelle et des infections par le cytomégalovirus et le parvovirus B19 chez les femmes enceintes dans la région de Sousse, Tunisie. Bull. Soc. Pathol. Exot. 104, 62–67 (2011). https://doi.org/10.1007/s13149-010-0119-z

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