Seroprevalence of Toxoplasma gondii, Rubella Virus, Cytomegalovirus, and Herpes Simplex Virus Among Children and Women in Bhutan's National Referral Hospital: A Cross-Sectional Study.

BACKGROUND: Congenital infections caused by Toxoplasma gondii, rubella virus, cytomegalovirus, and herpes simplex virus (TORCH) infections remain an important but under-documented contributor to adverse maternal and neonatal outcomes in low- and middle-income countries, including Bhutan. OBJECTIVES: This study aimed to determine the seroprevalence of TORCH infections among children and women in Bhutan's national referral hospital. METHODS: A retrospective cross-sectional review of TORCH antibody test records was conducted at the Jigme Dorji Wangchuck National Referral Hospital for tests carried out between January 2019 and December 2022. The study included all children <18 years and adult women. Serological testing used rapid immunochromatographic assays (OnSite TORCH Panel) to detect immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies, and data were analyzed descriptively with subgroup comparisons by age. RESULTS: A total of 624 participants were included, comprising 359 children (<18 years) and 265 adult females. Among children, 202 (56.9%) were male, and 153 (43.1%) were female. Seropositivity for TORCH infections varied across age groups, with the highest IgG and IgM positivity observed in neonates and infants and a subsequent rise in the reproductive age group. Herpes simplex virus (HSV) showed the highest overall seropositivity (83.8%), followed by cytomegalovirus (CMV) (82.7%), rubella (65.7%), whereas T. gondii had the lowest (14.7%). CMV had the highest IgM (4.8%) and combined IgG/IgM positivity (4.3%). CONCLUSIONS: TORCH seropositivity varied across age groups, with HSV and CMV being the most frequently detected infections and IgG antibodies predominating. These findings provide the first baseline TORCH seroprevalence data in Bhutan, which can serve as a reference for future maternal and child health programs.