Prevalence of IgG Antibody Against Measles, Mumps and Rubella in Bangladeshi Children: A Pilot Study to Evaluate the Need for Integrated Vaccination Strategy

Abstract

The present study was carried out to determine the seroprevalence of IgG antibodies in Bangladeshi children against measles (irrespective of vaccination status), mumps and rubella (MMR) to assess strategic need of combined vaccination for these diseases. A total of 456 children of 1 month to 15 years, were studied. Serum IgG antibodies against MMR were measured by enzyme‐linked immunosorbent assay (ELISA). By 3 months, protective IgG antibody level (>40 AU for measles and mumps and >15 IU/ml for rubella) for the diseases found to be between 50% and 80% among the studied children. Protective measles antibody (IgG) was not detected in all the children of 3–9 months and significant number of children between 9 months and 5 years were unprotected (87–65%; P < 0.001). Moreover, children of 3–15 months had no protective antibody level against mumps and significant number of children between 15 months and 5 years were unprotected (92–71%; P < 0.001). Between 5 and 15 years of age, significant number of children became protective (63–85%, P < 0.001). Although, a majority of children between 3 months and 5 years had shown to have no protective antibody against rubella (89–71%; P < 0.01–0.001) between >10 and 15 years 71% children had protective level of antibodies (P < 0.001). No significant difference was observed in antibody prevalence regarding socioeconomic classes, nutritional status and parental education. The data showed that: (i) a significant number of children remain unprotected against MMR in childhood and (ii) an extensive nationwide survey is required to suggest an integrated vaccination strategy in order to implement appropriate control measures of the three infectious diseases.

A 16-year review of seroprevalence studies on measles and rubella

“…All countries surveyed, having a developed or developing status, had national vaccination programmes. However, of the countries in the least developed status, two of the 13 countries (Guinea-Bissau and Bangladesh) [10,25,70,77,89] reporting measles serosurveys and six of the eight countries (Bangladesh, Burkina Faso, Nepal, Nigeria, Sudan and Tanzania) [25,54,56,81,85,97,98] reporting rubella serosurveys reported having no nationally coordinated vaccination programme at the time of the study. Forty-three percent of published measles serosurveys were conducted in developed countries, reflecting the need to identify susceptible populations and immunization gaps as these countries move towards achieving the measles elimination goal.…”

“…Several authors demonstrated that vaccinated individuals have lower GMT compared with those acquiring immunity through natural infection [9,10,[15][16][17]19,[24][25][26]30,34,69,96,99]. There was insufficient information provided to determine if certain vaccination programmes resulted in a lower GMT.…”

“…There was insufficient information provided to determine if certain vaccination programmes resulted in a lower GMT. This means that the amount of maternal antibodies passively transferred to the infant is lower in populations where vaccination programmes are available [16,19,20,25,30,[32][33][34]60]. Therefore, infants are likely to become susceptible to infection earlier than when the mother's antibodies were from wild-type infection [6,20,25,33,60,99].…”

“…However, if the mother was vaccinated, this decline was significantly faster, exposing the infant to risk of infection earlier [6,13,16,19,20,25,33,101]. Apart from unvaccinated infants, the lowest sero-positivity rate for measles was found in young adults (19-25 years) [3,29,75].…”

“…There were five measles [6,12,13,19,20] and 10 rubella studies [6,12,14,19,25,43,44,63,74,87] in category 2. Each study reported testing specimens obtained from individuals having a range of ages, from infants to adulthood, and compared the seroprevalence in each age group.…”