Cytomegalovirus prevalence and its association with neurodevelopmental outcomes among preschool children in the Adjara region, Georgia: study protocol and background review
DOI:
https://doi.org/10.66636/gmj.v1.i3.a183Keywords:
cytomegalovirus, congenital CMV, neurodevelopmental, impairment, sensorineural hearing loss, ASQ-3, preschool children, seroprevalence, Georgia, AdjaraAbstract
Background: Human cytomegalovirus (CMV) is the most common infectious cause of non-hereditary sensorineural hearing loss and a leading contributor to neurodevelopmental impairment in early childhood. Population-level epidemiological data on CMV burden in the Adjara region of Georgia are lacking, limiting evidence-based public health planning.
Aims: (1) To estimate CMV seroprevalence (IgG and IgM) among preschool children aged 6 months to 5 years and 11 months in Adjara; and (2) to assess the association between CMV seropositivity and neurodevelopmental impairment as measured by the Ages and Stages Questionnaire, Third Edition (ASQ-3).
Methods: This pre-registered cross-sectional study is embedded within a planned regional epidemiological survey covering approximately 12,000 households in Adjara using multi-stage cluster sampling. ASQ-3 is administered to all eligible children; those screening positive are referred for CMV IgG/IgM serology. Multivariable logistic regression will estimate the odds of developmental impairment associated with CMV seropositivity, adjusting for age, sex, prematurity, low birth weight, maternal education, household socioeconomic status, childcare attendance, and lead exposure.
Expected results: Regional CMV seroprevalence estimates with 95% confidence intervals, stratified by age group, sex, and urban/rural residence; domain-specific ASQ-3 screening rates; and adjusted odds ratios for the CMV–developmental impairment association.
Significance: This study will generate the first regionally representative CMV burden data in Adjara and provide the evidence base for targeted newborn screening, maternal hygiene education, and early intervention programmes in Georgia and comparable middle-income settings.
Keywords: cytomegalovirus; congenital CMV; neurodevelopmental impairment; sensorineural hearing loss; ASQ-3; preschool children; seroprevalence; study protocol; Georgia; Adjara
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Copyright (c) 2026 Irina Kokoladze, Natia Kharati, Teona Gogitidze, Omar Mohammed, Gela Gogadze , Mtvarisa Bolkvadze ; Mariam Dumbadze ; Anano Dumbadze, Giga Paschenko, Shota Zoidze
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