Susceptibility of congenital or acquired TORCH-infected children to neurodevelopmental disorders: A cross-sectional study at Cipto Mangunkusumo Hospital, Jakarta, Indonesia: Research Article

Semiramis; Tjhin Wiguna; Raden Ayu Anatriera; Muchtaruddin Mansyur; Natasha Supartono

doi:10.58372/2835-6276.1160

Authors

Semiramis Zislavsky
Tjhin Wiguna
Raden Ayu Anatriera
Muchtaruddin Mansyur
Natasha Supartono

DOI:

https://doi.org/10.58372/2835-6276.1160

Keywords:

child, neurodevelopmental disorders, TORCH infection, hearing loss

Abstract

Background: Congenital and acquired TORCH (Toxoplasmosis, Other agents, Rubella, Cytomegalovirus, and Herpes simplex) infections, are associated with hearing impairment and several chronic neurodevelopmental disorders. However, existing evidence on the association between TORCH infections and attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) remains equivoca. This study was performed to investigate the susceptibility of TORCH-infected children to neurodevelopmental disorders.

Methods: A cross-sectional study was conducted involving 72 children aged 3-6 years with a history of TORCH infections. ADHD and ASD were assessed using the Indonesian ADHD Rating Scale (IARS) and Modified Checklist for Autism in Toddlers (M-CHAT). TORCH infections were categorized as congenital or acquired, with congenital TORCH defined by persisting positive IgM results at birth or supportive clinical findings and acquired TORCH by the first positive TORCH result after 12 months of age.

Results: In this study, most subjects had single infections of Rubella, CMV, or a combination of both, with few findings of toxoplasmosis and HIV. Congenital and acquired TORCH infections were reported in 38 (52.7%) and 34 (47.2%) children, respectively. Among congenital TORCH infections, 47.3% had single Rubella infections, while in acquired infections, 11 children had both CMV and Rubella, 9 had single CMV infections, and 5 had single Rubella infections. Rubella and CMV were the most prevalent etiologies in both groups, with 81.9% of children at moderate-to-high risk of ASD and 68.2% at high risk of ADHD. Hearing-impaired children were 3.5 times more likely to develop ADHD (OR 3.5, 95% CI: 1.2-10.3, p=0.021). Among them, the risk of ADHD was 1.4 times higher in those with acquired TORCH infections compared to congenital TORCH (p=0.025) according to subgroup analysis.

Conclusion: Children with hearing impairment especially acquired TORCH infections are more susceptible to developing ADHD higher than in those with congenital TORCH infection or normal hearing peers.

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