Prevalence of HTLV-1/2 infection in pregnant women in Central and South America and the Caribbean: a systematic review and meta-analysis.

BACKGROUND: Human T-lymphotropic viruses (HTLV)-1 infection is endemic in many countries of Central and South America and Caribbean (CSA&C). Neither screening nor surveillance programs exist for HTLV-1/2 infection among pregnant women in this region. Neither in Western nations with large migrant flows from HTLV-1/2 endemic regions. METHODS: Systematic review and meta-analysis of the prevalence of HTLV-1/2 infection among CSA&C pregnant women. We included studies searching EMBASE, PubMed/MEDLINE, Scopus, and Web of Science from inception to February 15, 2023. This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. RESULTS: We identified a total of 620 studies. Only 41 were finally included in the meta-analysis. Most studies (61.0%) were from Brazil and Peru (14.6%). The total number of participants was 343,707. The pooled prevalence of HTLV-1/2 infection among CSA&C pregnant women was 1.30% (95% CI: 0.96-1.69) using anti-HTLV-1/2 antibody screening tests. There was a high heterogeneity (I2 = 98.6%). Confirmatory tests gave an HTLV-1 infection rate of 1.02% (95% CI: 0.75-1.33). CONCLUSIONS: The prevalence of HTLV-1/2 infection among CSA&C pregnant women is 1.3%, most cases being HTLV-1. This rate is greater than for other microbial agents regularly checked as part of antenatal screening (such as HIV, hepatitis B, or syphilis). Thus, HTLV-1/2 antenatal testing should be mandatory among CSA&C pregnant women everywhere.

Seroprevalence of dengue IgG and associated risk factors in symptomatic and asymptomatic adults in Posadas (Misiones, Argentina), 2017-2019.

BACKGROUND: Dengue represents a major public health problem in the Americas in general, and in Posadas (Misiones, Argentina) in particular. This study aimed to assess the seroprevalence of dengue virus infection, analyze associated factors, and determine the proportion of asymptomatic cases. METHODS: This prospective cross-sectional study took place from November 2017 to April 2019 in the High Complexity Laboratory of Misiones, at the School Hospital Dr. Ramón Madariaga in Posadas. A random sample of 301 adults (≥ 15 years) was selected from the electoral registry and stratified by geographical area of residence. Sociodemographic, clinical, and laboratory data were collected by means of a survey and serology. Results were analyzed using multivariable logistic regression. RESULTS: The median age of the sample was 33 years; 66% were women, and 46.5% had completed at least secondary school. Anti-dengue IgG antibodies were present in 40.2% of the sample (95% confidence interval [CI] 34.5-45.9%), including 90% of those who reported dengue and 20.5% who did not (odds ratio [OR] 33.25, 95% CI 15.46-71.51, p < 0.001). In the multivariable analysis, adjusted for age, group, gender, and vaccination against yellow fever, seropositivity was associated with having relatives with dengue (adjusted OR 3.96, 95% CI 2.18-7.23; p < 0.001). CONCLUSION: Seroprevalence for dengue in Posadas was higher than estimates based on the notification records, and there was a high proportion of asymptomatic cases. Educational level and having a family member who had suffered from dengue were associated with positive serology.