Symptomatic neonatal congenital infections in North Vietnam: a single-centre observational study

Objective: Little is known about the prevalence and characteristics of symptomatic congenital infections in developing countries. To determine them in Vietnam, we conducted a study of neonates managed at the Neonatal Centre, Vietnam National Children’s Hospital for congenital infections caused by Toxoplasma gondii, Treponema pallidum, hepatitis B virus, rubella virus, cytomegalovirus (CMV), or herpes simplex virus (HSV). Patients and Methods: This retrospective observational study was conducted between January 2018 and June 2021. The diagnosis of symptomatic congenital infection in neonates was confirmed by serological testing. CMV polymerase chain reaction (PCR) testing in the blood was performed when the results of CMV serology were inconclusive. Results: Sixty-eight infants were diagnosed with congenital infections (32 preterm). The highest infection rate, either as a single pathogen infection or in association with other organisms, was for CMV (n=38, 58.8%), followed by syphilis (n=29, 42.6%), rubella (n=3, 4.4%) and toxoplasmosis (n= 3, 4.4%). Co-infections were observed in eight infants (11.7%). Clinical manifestations included petechial rash (47.1%), hepatomegaly (45.6%), splenomegaly (44.1%), congenital sensorineural hearing loss (23.5%), and congenital heart disease (22.0%). The mortality rate was 10.3%, attributed mainly to CMV and syphilis, increasing with the number of co-infections. At the 6-month evaluation of the surviving 61 neonates, developmental delay was present in 13 (21.3%), all of whom had congenital CMV infection. Conclusions: Symptomatic congenital infections were common, with a high mortality rate. Implementation of appropriate public health measures is therefore required.