Measles-Rubella Supplementary Immunization Activity Readiness Assessment — India, 2017–2018

Gurnani, Vandana; Haldar, Pradeep; Khanal, Sudhir; Bhatnagar, Pankaj; Singh, Balwinder; Ahmed, Danish A.; Samiuddin, Mohammad; Kumar, Amit; Negi, Yashika; Gupta, Satish Chand; Harvey, Pauline; Bahl, Sunil; Dabbagh, Alya; Alexander, James P.; Goodson, James L.

doi:10.15585/mmwr.mm6726a3

Cited by 9 publications

(7 citation statements)

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“…The facility-based surveillance for CRS revealed that about one-fifth of the suspected CRS patients during 2016-18 had evidence of laboratory confirmed rubella infection indicating continued transmission of rubella in India [12]. The nationwide SIAs conducted among children aged 9 months to <15 PLOS NEGLECTED TROPICAL DISEASES years using MR vaccine in 2017 is expected to reduce the transmission of rubella and thereby the burden of CRS in the country [8]. In order to monitor the progress made towards elimination of rubella in the country, it is essential to estimate the incidence of CRS [20].…”

Section: Discussionmentioning

confidence: 99%

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Burden of congenital rubella syndrome (CRS) in India based on data from cross-sectional serosurveys, 2017 and 2019–20

et al. 2021

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Background India has set a goal to eliminate measles and rubella/Congenital Rubella Syndrome (CRS) by 2023. Towards this goal, India conducted nationwide supplementary immunization activity (SIA) with measles-rubella containing vaccine (MRCV) targeting children aged between 9 months to <15 years and established a hospital-based sentinel surveillance for CRS. Reliable data about incidence of CRS is necessary to monitor progress towards the elimination goal. Methods We conducted serosurveys in 2019–20 among pregnant women attending antenatal clinics of 6 hospitals, which were also sentinel sites for CRS surveillance, to estimate the prevalence of IgG antibodies against rubella. We systematically sampled 1800 women attending antenatal clinics and tested their sera for IgG antibodies against rubella. We used rubella seroprevalence data from the current survey and the survey conducted in 2017 among antenatal women from another 6 CRS surveillance sites to construct a catalytic models to estimate the incidence and burden of CRS. Result The seroprevalence of rubella antibodies was 82.3% (95% CI: 80.4–84.0). Rubella seropositivity did not differ by age group and educational status. Based on the constant and age-dependent force of infection models, we estimated that the annual incidence of CRS in India was 225.58 per 100,000 live births (95% CI: 217.49–232.41) and 65.47 per 100,000 live births (95% CI: 41.60–104.16) respectively. This translated to an estimated 14,520 (95% CI: 9,225–23,100) and 50,028 (95% CI: 48,234–51,543) infants with CRS every year based on age-dependent and constant force of infection models respectively. Conclusions Our findings indicated that about one fifth of women in the reproductive age group in India were susceptible for rubella. The estimates of CRS incidence will serve as a baseline to monitor the impact of MRCV SIAs, as well progress towards the elimination goal of rubella/CRS.

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Section: Discussionmentioning

confidence: 99%

“…Towards achieving this goal, India conducted phased nationwide SIAs between 2017 and 2019, using MRCV targeting children aged 9 months to <15 years [ 8 , 9 ]. These SIAs have been completed in all Indian States, except Delhi and West Bengal, with high reported coverage [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Burden of congenital rubella syndrome (CRS) in India based on data from cross-sectional serosurveys, 2017 and 2019–20

et al. 2021

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“…In 2013, during the 66 th session of the Regional Committee of the World Health Organization South-East Asia Region (SEAR), 11 SEAR countries adopted goals to eliminate measles and control rubella and congenital rubella syndrome by 2020 [6]. In India, a phased nationwide supplementary immunization activity using measles-rubella vaccine targeting children aged 9 months to 14 years commenced in 2017 [7] and has been completed in most Indian States. The Indian Council of Medical Research and the Ministry of Health and Family Welfare, Government of India, initiated surveillance for CRS in five sentinel sites in five Indian States in November 2016 with the objective of estimating disease burden [8].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Congenital Rubella Syndrome (CRS) in India, 2016-18, based on data from sentinel surveillance

et al. 2020

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Background Government of India is committed to eliminate measles and control rubella/congenital rubella syndrome (CRS) by 2020. In 2016, CRS surveillance was established in five sentinel sites. We analyzed surveillance data to describe the epidemiology of CRS in India. Methodology/Principal findings We used case definitions adapted from the WHO-recommended standards for CRS surveillance. Suspected patients underwent complete clinical examination including cardiovascular system, ophthalmic examination and assessment for hearing impairment. Sera were tested for presence of IgM and IgG antibodies against rubella. Of the 645 suspected CRS patients enrolled during two years, 137 (21.2%) were classified as laboratory confirmed CRS and 8 (1.2%) as congenital rubella infection. The median age of laboratory confirmed CRS infants was 3 months. Common clinical features among laboratory confirmed CRS patients included structural heart defects in 108 (78.8%), one or more eye signs (cataract, glaucoma, pigmentary retinopathy) in 82 (59.9%) and hearing impairment in 51. (38.6%) Thirty-three (24.1%) laboratory confirmed CRS patients died over a period of 2 years. Surveillance met the quality indicators in terms of adequacy of investigation, adequacy of sample collection for serological diagnosis as well as virological confirmation.

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“…To achieve this goal, India conducted a phased national SIA from 2017 to 2019, using MRCVs targeting children aged 9 months to less than 15 years old in each district through routine and/or supplementary immunization activities (SIAs). 36,37 These SIAs were implemented in all Indian states except Delhi and West Bengal with high coverage reported. 38 In accordance with the National Strategic Plan for Achieving and Sustaining Measles and Rubella Elimination in India, nearly 324 million children in India received the MR immunisation between 2017 and 2020.…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence of Rubella IgG in Women of Reproductive Age Group in a Tertiary Care Teaching Hospital

Karunakaran¹,

Madhavan²,

Devadasan³

et al. 2022

J. Pure Appl. Microbiol.

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Rubella is a highly contagious infection caused by the rubella virus. Mothers who develop rubella early in pregnancy have a 90% chance of transmitting the infection to their unborn babies. Adverse effects on the fetus include stillbirth and congenital rubella syndrome. Pregnant women are not regularly screened for rubella antibodies in government hospitals in Kerala. Therefore, to raise awareness of healthcare providers, it is necessary to collect epidemiological data on the seroprevalence of rubella in this vulnerable group. Several sociodemographic variables as potential predictors of immunity to rubella were also analyzed. A cross-sectional descriptive study was conducted at Govt TD Medical College in Alappuzha, Kerala, of 604 women of childbearing potential who attended the Out patient department of the Obstetrics and gynecology division for the year from June 2016 to June 2017. Rubella-specific IgG (Quantitative) ELISA was done on patients after obtaining informed consent and filling out a questionnaire through direct interview. The test sera were considered seropositive (>15 IU/ml), seronegative (<13 IU/ml), or intermediate (13 -15 IU/ml) as per the manufacturer’s instructions. Rubella seroprevalence in the study group was found to be 73.3%. Around 26.65% were nonimmune to rubella infection. About 27.4% of antenatal cases in the present study were susceptible to rubella. The primigravidae had lower seroprevalence(28.5%) than multigravidae. The percentage of seropositivity was found to increase with age. Our observations show that women of childbearing age are highly susceptible to rubella. High seroprevalence without regular childhood vaccination indicates continued infection transmission of the rubella virus in the community. Hence there is a need for proper sero surveillance in this group who has not been vaccinated, before conception to eradicate CRS and Rubella.

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Measles-Rubella Supplementary Immunization Activity Readiness Assessment — India, 2017–2018

Cited by 9 publications

References 1 publication

Burden of congenital rubella syndrome (CRS) in India based on data from cross-sectional serosurveys, 2017 and 2019–20

Burden of congenital rubella syndrome (CRS) in India based on data from cross-sectional serosurveys, 2017 and 2019–20

Epidemiology of Congenital Rubella Syndrome (CRS) in India, 2016-18, based on data from sentinel surveillance

Seroprevalence of Rubella IgG in Women of Reproductive Age Group in a Tertiary Care Teaching Hospital

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