Reduction in Rubella Virus Active Cases among Children and Adolescents after Rubella Vaccine Implementation in Tanzania: A Call for Sustained High Vaccination Coverage

Abstract

Rubella virus (RV) infection in susceptible women during the first trimester of pregnancy is associated with congenital Rubella syndrome (CRS). In countries where a vaccination program is implemented, active case surveillance is emphasized. This report documents the magnitude of active cases before and after vaccine implementation in Tanzania. A total of 8750 children and adolescents with signs and symptoms of RV infection were tested for Rubella IgM antibodies between 2013 and 2019 using enzyme immunoassay followed by descriptive analysis. The median age of participants was 3.8 (IQR: 2–6.4) years. About half (4867; 55.6%) of the participants were aged 1–5 years. The prevalence of RV active cases was 534 (32.6%, 95% CI: 30.2–34.9) and 219 (3.2%, 95% CI: 2.7–3.6) before and after vaccine implementation, respectively. Before vaccination, the highest prevalence was recorded in Pemba (78.6%) and the lowest was reported in Geita (15.6%), whereas, after vaccination, the prevalence ranged between 0.5% in Iringa and 6.5% in Pemba. Overall, >50% of the regions had a >90% reduction in active cases. The significant reduction in active cases after vaccine implementation in Tanzania underscores the need to sustain high vaccination coverage to prevent active infections and eventually eliminate CRS, which is the main goal of Rubella vaccine implementation.

The Susceptibility to Rubella Virus Infection among Pregnant Women Attending Antenatal Clinics in Unguja, Zanzibar: The Need to Employ Multiple Strategies to Control Congenital Rubella Syndrome in Tanzania

“…Most of the countries employing these strategies including the Russian federation and some of the Pacific countries are in CRS elimination phase [ 22,23]. Despite the efforts made by Tanzania government to introduce RV vaccine and the impact of its implementation [10], there is a paramount need to consider other strategies such as screening and vaccinating women of child bearing age and susceptible pregnant women during postpartum period as recommended previously [24]. This has been reported to be more cost-effective in High income countries (HICs) than vaccinating all children and adolescents blindly which is mostly practiced by low-and middle-income countries (LIMCs).…”

“…Tanzania government introduced a catchup campaign on Rubella vaccine in October 2014 which was followed by the introduction of Rubella vaccine in January 2015 (about 8 years ago) targeting children under five years of age. A recent report of surveillance data showed a notable decrease in RV active cases in different regions of Tanzania [10]. The world Health Organization (WHO) recommends multiple strategies to be employed including vaccinating susceptible women of reproductive age to reach a goal of CRS elimination [11].…”

Dynamical Analysis of Rubella Disease Model in the Context of Fractional Piecewise Derivative: Simulations with Real Statistical Data

“…To ensure the effectiveness of our proposed method, it is crucial to compare the theoretical results with real data in biological models. Thus, we present the comparisons between our simulated results and actual data in Figure 3a-c [34,35].…”