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Human herpes virus type-6 is associated with central nervous system infections in children in Sudan
Nada A Abdelrahim1, Nahla Mohamed2, Magnus Evander2
1Department of Medical Microbiology, Faculty of Medical Laboratory Sciences, Nile University, Khartoum, Sudan.
Insights
Human herpes virus type-6 (HHV-6) is a common cause of central nervous system (CNS) infections in Sudanese children. Further research is needed to understand HHV-6 chromosomal integration in this population.
Area of Science:
- Virology
- Paediatric Infectious Diseases
- Neuroscience
Background:
- Human herpes virus type-6 (HHV-6) is a recognized cause of fever in children.
- Data on HHV-6 prevalence in sub-Saharan African countries, such as Sudan, is limited.
Purpose of the Study:
- To investigate the role of HHV-6 in paediatric central nervous system (CNS) infections in Sudan.
- To determine the frequency of HHV-6 detection in febrile children with suspected CNS infections.
Main Methods:
- Analysis of cerebrospinal fluid (CSF) specimens from 503 febrile children (≤15 years) with suspected CNS infections in Khartoum, Sudan.
- Quantitative detection of HHV-6 viral DNA using real-time polymerase chain reaction (PCR).
Main Results:
- HHV-6 DNA was detected in 2.6% (13/503) of CSF specimens, rising to 33.0% in cases with proven infectious meningitis.
- Positive cases presented with fever, vomiting, and seizures, with a median viral load of 281.3 copies/PCR run.
- Demographic data showed a 1:1 male-to-female ratio, with most affected individuals being toddlers and infants.
Conclusions:
- HHV-6 is a significant pathogen in children with CNS infections in Sudan.
- Further studies are required to investigate HHV-6 chromosomal integration and its implications in this region.
Background:
Human herpes virus type-6 (HHV-6) is increasingly recognised as a febrile agent in children. However, less is known in sub-Saharan African countries, including Sudan.
Objective:
We investigated the involvement of HHV-6 in paediatric central nervous system (CNS) infections in Khartoum, Sudan.
Methods:
Febrile patients aged up to 15 years with suspected CNS infections at Omdurman Hospital for Children from 01 December 2009 to 01 August 2010 were included. Viral DNA was extracted from leftover cerebrospinal fluid (CSF) specimens and quantitatively amplified by real-time polymerase chain reaction (PCR) at Umeå University in Sweden.
Results:
Of 503 CSF specimens, 13 (2.6%) were positive for HHV-6 (33.0% [13/40 of cases with proven infectious meningitis]). The median thermal cycle threshold for all HHV-6-positive specimens was 38 (range: 31.9-40.8). The median number of virus copies was 281.3/PCR run (1 × 105 copies/mL CSF; range: 30-44 × 103 copies/PCR run [12 × 103 - 18 × 106 copies/mL CSF]). All positive patients presented with fever and vomiting; 86.0% had seizures. The male-to-female ratio was 1:1; 50.0% were toddlers, 42.0% infants and 8.0% teenagers. Most (83.0%) were admitted in the dry season and 17.0% in the rainy season. Cerebrospinal fluid leukocytosis was seen in 33.0%, CSF glucose levels were normal in 86.0% and low in 14.0%, and CSF protein levels were low in 14.0% and high in 43.0%.
Conclusion:
Among children in Sudan with CNS infections, HHV-6 is common. Studies on the existence and spread of HHV-6 chromosomal integration in this population are needed.
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