Case based rubella surveillance in Abia State, South East Nigeria, 2007–2011

Umeh, Chukwuemeka A.; Onyi, Stella Chioma

doi:10.7717/peerj.580

Cited by 13 publications

(19 citation statements)

References 10 publications

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“…This was in agreement with previous findings from Ethiopia [11], Nigeria [12], and Kenya [14]. In an outbreak report from Poland, young male adults were the most affected [15].…”

Section: Discussionsupporting

confidence: 93%

“…The proportion of rubella positive cases increased from 4.2% (83) in 2009 to 23.9% (856) in 2013 but dropped to 10.6% (222 cases) and 15.3% (319 cases) in 2014 and 2015 respectively. This was higher than previous findings from Ethiopia [11] and Abia State of Nigeria [12] and was lower than a finding of 37.6% from Zimbabwe [13]. The increasing number of laboratory confirmations might be related with improvement in surveillance sensitivity, quality and coverage.…”

Section: Discussioncontrasting

confidence: 71%

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Epidemiology of rubella virus cases in the pre-vaccination era of Ethiopia, 2009–2015

Getahun¹,

Beyene²,

Gallagher³

et al. 2016

BMC Public Health

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BackgroundRubella is a common mild rash illness caused by rubella virus. The majority of infections occur in children and young adults. The infection is the cause of a serious birth defect known as Congenital Rubella Syndrome (CRS) when a woman acquires infection early in pregnancy. Ethiopia has not yet established rubella virus surveillance and has not yet introduced rubella vaccine into the routine immunization program. We characterize the epidemiology of laboratory confirmed rubella virus cases collected through measles surveillance from 2009 to 2015 to better understand the burden of the disease in the country.MethodsA descriptive analysis was made to characterize rubella cases reported through the national measles case based surveillance system. The measles case definition was used to capture potential rubella cases. A suspected measles case was a person with generalized rash and fever with cough, or coryza or conjunctivitis. Those cases whose sera were negative for measles IgM antibodies were tested for rubella IgM antibody. A confirmed rubella case was a person who tested positive for rubella IgM. Only laboratory confirmed rubella cases were analyzed in this article.ResultsBetween 2009 and 2015, a total of 28,284 serum/plasma samples were collected and tested for measles IgM antibody and 11,151 (39.4%) were found positive. A total of 17,066 measles IgM negative or indeterminate samples were tested for rubella virus IgM and 2615 (15.3%) were found positive during the same period. Of 2615 confirmed rubella cases, 52.2% were females. The age of confirmed cases ranged from one month to 42 years with a mean age of 7.3 years. Three-fourth of all confirmed rubella cases were aged less than 10 years. The number of laboratory confirmed rubella cases linearly increased from 83 in 2009 to 856 in 2013 but dropped to 222 and 319 in 2014 and 2015 respectively. Higher number of cases occurred in the hot dry season (January through June) and in the central and western part of Ethiopia with 127 lab-confirmed outbreaks in the study period.ConclusionsBased on our analysis, rubella was found to be endemic throughout Ethiopia. Children below the age of 10 years were the most affected. The burden of rubella cases varied from year to year but had a seasonal peak in March. To better understand the magnitude of rubella prior to vaccine introduction, establishing rubella surveillance system, conducting sero-prevalence studies among child bearing age females and establishing CRS sentinel surveillance among young infants are critical.

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“…This was in agreement with previous findings from Ethiopia [11], Nigeria [12], and Kenya [14]. In an outbreak report from Poland, young male adults were the most affected [15].…”

Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 71%

Epidemiology of rubella virus cases in the pre-vaccination era of Ethiopia, 2009–2015

Getahun¹,

Beyene²,

Gallagher³

et al. 2016

BMC Public Health

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“…In 2-dose measles-mumps-rubella (MMR) vaccine coverage, a third dose of MMR vaccine had been demonstrated to be safe and important in fighting and preventing measles outbreak [ 21 ]. A study in Abia state [ 22 ] showed the need to use measles-mumps-rubella (MMR) vaccine in place of measles vaccines alone during childhood immunization. Safe and effective vaccination programme is, therefore, a function of many factors especially effective cold chain maintenance [ 8 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

An evaluation of the cold chain technology in South-East, Nigeria using immunogenicity study on the measles vaccines

Oli¹,

Agu²,

Ihekwereme³

et al. 2017

Pan Afr Med J

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IntroductionVaccines are biological products and their efficacy is affected by storage conditions. They are vital in promoting public health. Failures in immunization programmes often times are blamed on disruption in vaccine cold-chain. This study assessed the immunogenicity/potency of the measles vaccines utilized in childhood immunization in South-East, Nigeria and indirectly assessed the effectiveness of the cold-chain technology in the region.MethodsThis was an experimental study carried out between December 2011 and June 2013. Antibody induction method was used to evaluate the immunogenicity/potency of the measles vaccines sourced from the central cold chain facilities in South-east, Nigeria and indirectly, the effectiveness of the cold chain technology in the zone in maintaining vaccine potency. The neutralizing antibodies in a control group (administered with measles vaccines stored at 37°C for 12 months) and in immunized group were determined after 30 days of immunization using ELISA.ResultsThe mean storage temperature of the vaccines at the states vaccines central cold chain facilities was -2.4°C and before storage at study site, it was 5.8°C but at the study site it was -4.54°C. Mean ±Standard Error in the Mean (SEM) IgG titers for the measles vaccines sourced from “Open Market”, Ebonyi, Enugu, Imo, Anambra and Abia States were 0.793±0.051, 1.621±0.015, 1.621±0.015, 1.715±0.081, 1.793±0.051 and 1.683±0.078 respectively while the mean ±Standard Error in the Mean (SEM) IgM titres were 0.857±0.037, 1.400±0.030, 1.391±0.032, 1.339±0.037, 1.405±0.066 and 1.279±0.025 respectively. One way analysis of variance shows that there is statistical difference in the IgG and IgM antibodies titers produced by the control compared to the vaccines (P value < 0.0001). Also, Bartlett's test for equal variances showed that there was statistical difference (P value < 0.0001 for IgG and = 0.036 for IgM). The antibodies elicited by the vaccines from the states were enough to confer protection but the vaccine samples from “Open Market” (control) could not evoke enough antibodies.ConclusionThe cold-chain technology in the region was judged to be optimal as at the time of vaccine sampling since all the measles vaccines had good immunogenicity profile. However, efforts are still needed to maintain these facilities in good condition in order to ensure effective immunization program in the region.

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“…In another vein, one of the few studies done in Nigeria, precisely, in Abia State, southeastern Nigeria showed an incidence of new rubella infection of 6.81/1,000,000 population in 2007 which decreased to 2.28/1,000,000 in 2009, but soared to 6.34/1,000,000 in 2011[ 10 ]. According to the study, the reason for the decrease in 2009 was not clear since there is no routine rubella vaccination in Nigeria.…”

Section: Introductionmentioning

confidence: 99%

“…According to the study, the reason for the decrease in 2009 was not clear since there is no routine rubella vaccination in Nigeria. The authors argued that the decrease could be due to inadequate rubella surveillance activity [ 10 ]. Eighty six percent of the new rubella cases occurred in children who were younger than 15 years old.…”

Section: Introductionmentioning

confidence: 99%

Incidence of rubella in a state in North-western Nigeria: a call for action

Omoleke¹,

Udenenwu²

2016

Pan Afr Med J

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IntroductionRubella cases are often under-reported, especially in many developing countries, owing to inadequate attention and weak funding of elimination strategies, despite being an epidemic-prone disease. Based on available data, this paper, therefore, seeks to bring the attention of public health practitioners, researchers and policy makers to threats of rubella in our environment, and also recommend measures to mitigate the threats.MethodsThe authors conducted a retrospective cross-sectional study in which the laboratory results of febrile-rash-illness cases in Kebbi State, Northwest Nigeria, from January 1, 2014 to December 31, 2015 were analysed, using descriptive statistics and chi-square test. We obtained the data set through the routine Integrated Disease Surveillance System and Response being conducted in Nigeria.ResultsA total of 413 febrile-rash-illness cases were reported and investigated in Kebbi State from 2014 to 2015, 5 (3.5%) tested positive for rubella IgM in 2014 while 7(2.6%) tested positive in 2015. There was no statistically significant difference in the incidence of rubella between 2014 and 2015 (p> 0.05). Rubella infection was mainly found in children less than 5 years of age with peak incidence period during the hot season (between February and April). There was no significant sex bias in this study. However, our practice experiences in this environment suggest a systematic under-reporting and under-diagnosis of febrile- rash-illnesses.ConclusionThere was no statistically significant difference in the incidence of rubella in children in our setting for the 2-years studied. However, there is a potential for increase in the transmission of the disease due to non-availability of routine childhood vaccination against rubella and the systematic under-reporting of suspected cases and weak laboratory support. In order to better appreciate the burden of rubella infection, there may be a need to undertake a prevalence survey, and simultaneously, strengthening case-based surveillance in Northwestern Nigeria. Further, WHO should support national government in accelerating the introduction of rubella-containing vaccine to stem the potential spread of this infectious disease.

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Case based rubella surveillance in Abia State, South East Nigeria, 2007–2011

Cited by 13 publications

References 10 publications

Epidemiology of rubella virus cases in the pre-vaccination era of Ethiopia, 2009–2015

Epidemiology of rubella virus cases in the pre-vaccination era of Ethiopia, 2009–2015

An evaluation of the cold chain technology in South-East, Nigeria using immunogenicity study on the measles vaccines

Incidence of rubella in a state in North-western Nigeria: a call for action

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