A Relatively High Number of Pregnant Women in Kuwait Remain Susceptible to Rubella: A Need for an Alternative Vaccination Policy

Abstract

Objective: To measure the prevalence of anti-rubella IgG and hepatitis B surface antigen (HBsAg) among pregnant women in Kuwait in order to assess the effectiveness of the current vaccination programs. Subjects and Methods: This retrospective study involved 4,062 pregnant women evaluated in health centers in the Hawalli Province of Kuwait. They were screened for anti-rubella IgG and HBsAg using commercially available assays. The data were obtained from medical laboratory records. Results: The mean age of the pregnant women was 29.2 ± 5.26 years (range 17-49). The rubella IgG prevalence among the pregnant women was 88.4% (n = 3,589); 276 (6.8%) of the pregnant women had no antibody to rubella, and 197 (4.8%) had rubella antibody levels ≤10 IU/ml. Therefore, 473 (11.6%) of the pregnant women were susceptible to rubella. The proportion of susceptible women increased with increasing age from 3.4 to 10.3% and from 3.4 to 6.7% among women aged <20 years and those aged ≥40 years, respectively (p = 0.016). The prevalence of HBsAg was 0.3%, and it did not vary with age. Conclusion: The prevalence of both anti-rubella IgG and HBsAg among pregnant women in Kuwait was relatively high. However, about 11.6% of pregnant women in Kuwait remain susceptible to rubella infection and hence congenital infection and fetal malformation.

Systematic Review of Measles and Rubella Serology Studies

“…We identified over 220 studies that provided cross‐sectional data and nearly 180 studies that reported on immunity for women of child‐bearing age, primarily for rubella. Table summarizes the over 400 cross‐sectional and women of child‐bearing age measles and rubella serological studies…”

Seroprevalence of rubella virus among pregnant women: A 4‐year registered‐based study from family medicine and obstetric clinics in Saudi Arabia

“…1,4,13 However, the seroprevalence of rubella immunity in the current study was higher than findings from other countries like southern India (65%), Niger (53%), and lower than findings from Nigeria (97.9%), Mexico (97.1%), Turkey (96.1%), Spain (94.1%), Western Province in KSA (91.6%), Cameroon (88.6%) and Kuwait (88.4%). 1,3,14,15 The differences in seroprevalence between different studies could be attributed to the variation in the epidemiology of the infection, the differences in the sample size and the methodology of the studies, the utilised laboratory tests, discrepancies in the used cut-off points used to confirm the immunity, and the involvement of rubella immunisation in their national vaccination programs. 1,16 There were no significant variations in antenatal characteristics of patients between susceptible and immune groups.…”

Asian Pacific association for the study of liver (APASL) guidelines: hepatitis B virus in pregnancy

“…A study done in 2012-2013 in 4062 pregnant females in the Hawalli Province in Kuwait found 0.3% HBsAg positivity [35].…”