Unseen blindness, unheard deafness, and unrecorded death and disability: congenital rubella in Kumasi, Ghana

Lawn, Joy E; Reef, Susan E.; Baffoe-Bonnie, Benjamin; Adadevoh, S.W.K.; Caul, E.O.; Griffin, George E.

doi:10.2105/ajph.90.10.1555

Cited by 53 publications

(27 citation statements)

References 39 publications

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“…A review of 16,394 births in southern Nigeria showed a congenital rubella syndrome rate of 1.16 per 1,000 live births ( George, Frank-Briggs & Oruamabo, 2009 ). This is compared to an estimated rate of 0.8 per 1,000 live births in Kumasi Ghana ( Lawn et al, 2000 ).…”

Section: Discussionmentioning

confidence: 89%

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

Umeh

Onyi

2014

PeerJ

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Introduction. Rubella infection has the potential of causing severe fetal birth defects collectively called congenital rubella syndrome (CRS) if the mother is infected early in pregnancy. However, little is known about rubella and CRS epidemiology in Nigeria and rubella vaccines are still not part of routine childhood immunization in Nigeria.Methods. Analysis of confirmed cases of rubella in Abia State, Nigeria from 2007 to 2011 detected through Abia State Integrated Disease Surveillance and Response system.Results. Of the 757 febrile rash cases, 81(10.7%) tested positive for rubella immunoglobulin M (IgM). New rubella infection decreased from 6.81/1,000,000 population in 2007 to 2.28/1,000,000 in 2009 and increased to 6.34/1,000,000 in 2011. The relative risk of rubella was 1.5 (CI [0.98–2.28]) times as high in females compared to males and 1.6 times (CI [0.90–2.91]) as high in rural areas compared to urban areas. Eighty six percent of rubella infections occurred in children less than 15 years with a high proportion of cases occurring between 5 and 14 years.Conclusion. Rubella infection in Abia State, Nigeria is predominantly in those who are younger than 15 years old. It is also more prevalent in females and in those living in rural areas of the state. Unfortunately, there is no surveillance of CRS in Nigeria and so the public health impact of rubella infection in the state is not known. Efforts should be made to expand the rubella surveillance in Nigeria to incorporate surveillance for CRS.

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Section: Discussionmentioning

confidence: 89%

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

Umeh

Onyi

2014

PeerJ

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“…This result is in line with the global incidence of the CRS in the pre-vaccine era in 1969 [ 58 ]. Prior to the introduction of rubella vaccine, the incidence of CRS varied from 0.1–0.2/1000 live births during endemic periods and 0.8-4/1000 live births during rubella epidemics [ 59 , 60 ].…”

Section: Discussionmentioning

confidence: 99%

Hospital based surveillance of congenital rubella syndrome cases in the pre-vaccine era in Amhara Regional State, Ethiopia: A base line information for the country

et al. 2018

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BackgroundRubella virus infection in early pregnancy lead to serious multi-organ birth defects known as congenital rubella syndrome (CRS). The incidence of CRS varies in different populations and the highest burden is found in developing countries in which rubella vaccination is not included in their national immunization programs. In Ethiopia, there is scarcity of data about congenital rubella syndrome. Therefore, the aim of this study was to determine the burden of CRS-related birth defects and its incidence in the pre-vaccine era in Amhara Regional State, Ethiopia.Materials and methodsA cross sectional study was conducted in Dessie, Felege-Hiwot and University of Gondar Referral Hospitals, from December 2015 to August 2017. After getting informed assent from each parent/guardian, blood was collected from infants < 1 year of age for laboratory determination of anti-rubella virus antibodies. Their socio-demographic data and clinical information compatible with congenital rubella syndrome were collected using WHO guideline.ResultsDuring the study period, a total of 50 infants suspected for congenital rubella syndrome were included in the study. All infants suspected for CRS were tested against rubella specific IgM and IgG [for infants ≥ 6 months of age] antibodies using ELISA method. Of these, 9/50 (18%) and 4/14 (28.6%) of them were laboratory confirmed and potential CRS cases, respectively. In the present study, the most common laboratory confirmed defect was ocular manifestations 6 (66.7%) followed by heart related problems 5 (55.6%). In the present study, most of the laboratory confirmed cases (66.7%) were reported among 1–5 months of age infants. In addition, 5 (55.6%) of the infants with laboratory confirmed CRS cases were male and 6 (66.7%) of them were from urban settings. In this study, the incidence of CRS was 0.4 per 1000 live births.ConclusionIn this study, nearly one fifth of the infants had laboratory confirmed congenital rubella syndrome and most of them had multiple rubella associated congenital defects at a time. Most of these congenital anomalies were reported among infants ≥ 1 month of age. Based on our result, the incidence of the CRS was line with the global incidence of the CRS in the pre-vaccine era. Therefore, establishing strong rubella/CRS surveillance system as well as introducing the rubella containing vaccine in the national immunization program might be important to reduce the burden of rubella and CRS in the country.

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“…Moreover, a large population vulnerable to acquiring rubella infection later in life was identified: 92.6% of students with normal hearing were negative for rubella IgG. Other studies have estimated the rate of rubella serosusceptibility among women of reproductive age in West Africa to be 10% to 30% [ 26 ]. These results suggest that infection during gestation is possible in these vulnerable individuals, making future cases of CRS inevitable without intervention.…”

Section: Discussionmentioning

confidence: 99%

Identification of Ocular and Auditory Manifestations of Congenital Rubella Syndrome in Mbingo

Jivraj

Rudnisky

Tambe

et al. 2014

International Journal of Telemedicine and Applications

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Purpose. Congenital rubella syndrome (CRS) is a global cause of preventable hearing impairment, blindness, and intellectual impairment. The present study sought to identify ocular and auditory manifestations of CRS in school-aged children in Mbingo, Cameroon. Design. Cross sectional study. Subjects. Students at two schools, one for children with hearing impairment, were screened for cataract, congenital glaucoma, and pigmentary retinopathy. Methods. Students underwent seven-field digital fundus photography through a dilated pupil using a Topcon NW200 nonmydriatic camera. Images were assessed by retina specialists in Canada via teleophthalmology. Clinical evidence was integrated to form case definitions for CRS based on Center for Disease Control and Prevention guidelines. Serological evidence of rubella infection was obtained using standardized IgG antibody titers. Main Outcome Measure. Number of probable and suspicious cases of CRS. Results. Between September 2009 and May 2010, 320 students participated. There were 28 (10.2%) probable cases, 104 (37.8%) suspects, and 143 (52.0%) unaffected. Rubella IgG serology was positive in 79 (48.7%) of children with hearing impairment and 11 (7.4%) of children with normal hearing. Conclusions. The present study identified 28 probable cases of CRS. Furthermore, 92.6% of students with normal hearing did not possess rubella IgG antibodies making future cases of CRS likely without intervention.

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Unseen blindness, unheard deafness, and unrecorded death and disability: congenital rubella in Kumasi, Ghana

Cited by 53 publications

References 39 publications

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

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

Hospital based surveillance of congenital rubella syndrome cases in the pre-vaccine era in Amhara Regional State, Ethiopia: A base line information for the country

Identification of Ocular and Auditory Manifestations of Congenital Rubella Syndrome in Mbingo

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