Pregnant Women in and Around Dhaka City: Are Their Children at Risk of Developing Congenital Rubella Syndrome?

Abstract

Rubella Virus (RUBV) is a common cause of childhood rash and fever in non-immunized populations, and its public health importance relates to teratogenic effects of primary rubella infection in women with early pregnancy. Infection of the fetus may lead to congenital rubella syndrome (CRS). This work aimed to assess the degree of risk associated in acquiring rubella virus infection by the women during pregnancy and developing CRS among their children in Bangladesh. The study population (n = 275) included pregnant mothers (15-38 years) from various socioeconomic backgrounds attending a women health care based hospital. All subjects were personally interviewed, clinically examined and a standardized questionnaire was filled up for each of them. From each participant 3 ml blood was taken and serum was separated. Commercially available ELISA kit was used for the qualitative and quantitative determination of IgM and IgG class antibodies against RUBV in collected serum samples. 209 women were found to contain detectable level of anti-RUBV IgG antibodies, but did not possess IgM antibodies against rubella. Only 9% participants were vaccinated previously against rubella virus among the whole antenatal population studied. Ninety-two percent of these vaccinated pregnant women contained serum anti-rubella IgG antibody which was significantly (P = 0.05) higher than that of the nonvaccinated study population (75%). Pregnant women from lower middle and poor socioeconomic class had significantly (P = 0.05) more intra uterine growth retardation (IUGR) of fetus than the upper middle class. 20% of the women of child bearing age examined in this work were not yet exposed to RUBV and at risk of acquiring this virus during pregnancy and subsequently transmitting the virus to the fetus. Our work demonstrates rubella attack rate among antenatal population in Bangladesh as 14.5 in 1000 during pregnancy. A proper and reliable vaccination policy against rubella virus is not yet adopted at the national level in many developing countries including Bangladesh. This work identifies the requirement of detailed study for the identification of intrauterine rubella infection and its related influence on perinatal morbidity and mortality. Thorough epidemiological studies are also considered necessary prior to the development and acceptance of national immunization program against rubella virus in Bangladesh.

Informing rubella vaccination strategies in East Java, Indonesia through transmission modelling

“…Although East Java has had good coverage with measles vaccine for several years [26], Indonesia currently does not report cases of CRS to the WHO, and the lack of sufficient surveillance on rubella and CRS may undermine efforts to control and eliminate rubella disease. Since early 2000, surveillance networks have been established in countries like Bangladesh which has introduced routine rubella vaccine (as MR at 9 months) since 2014 [38,40,41]. The maintenance of high coverage together with effective and ongoing disease surveillance have been considered vital for successful rubella control and eradication [13].…”

Seroprevalence of Rubella IgG in Pregnant Females

“…The overall seropositivity was 92.3%, indicated the presence of immunity for Rubella infection and the remaining 7.70% females were at risk for developing Rubella infection. 8 There is insufficient data about the current immune status of pregnant women against Rubella in our country. We carried out a study to assess the seroprevalence of Rubella IgG in pregnant females.…”

Analysis of Different Prognostic Indicators for Malnutrition and Shigella flexneri Infection Among the Children in Bangladesh

“…The tubes were centrifuged (Eppendorf, Germany; Model: 22331) at 3,000 rpm for 10 min to settle the remaining erythrocytes down and clear serum was collected into sterile eppendorf. The serum was stored at -20°C until use [18].…”