Surveillance of congenital rubella syndrome (CRS) in tertiary care hospitals in Hanoi,Vietnam during a rubella epidemic |
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| Affiliation: | 1. Department of Paediatrics, Hanoi Medical University, Hanoi, Viet Nam;2. Department of Paediatrics, Bachmai Hospital, Hanoi, Viet Nam;3. Department of Medical Education and Skill Laboratory, Hanoi Medical University, Hanoi, Viet Nam;4. Department of Microbiology, Bach Mai University Hospital, Hanoi, Viet Nam;5. National Hospital of Paediatrics, Hanoi, Viet Nam;6. Department of Paediatrics, Saint Paul Hospital, Hanoi, Viet Nam;7. National Centre for Immunisation Research and Surveillance (NCIRS), The Children''s Hospital at Westmead, NSW, Australia;8. Discipline of Paediatrics and Child Health, The Children''s Hospital at Westmead Clinical School, Sydney Medical School, The University of Sydney, NSW, Australia;9. Australian Paediatric Surveillance Unit (APSU), Sydney, NSW, Australia;1. Albany School of Public Health, State University of New York, University at Albany, Albany, NY, United States;2. Institute for Health and the Environment, University at Albany, State University of New York, Albany, NY, United States;3. Upstate Golisano Children''s Hospital, State University of New York, Syracuse, NY, United States;1. Center of Maternal–Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan;2. National Center for Child Health and Development, Tokyo, Japan;3. Clinical Research Center, National Center for Child Health and Development, Tokyo, Japan;1. Medizinisches Versorgungszentrum, Dr. Stein & Kollegen, Laboratoriumsmedizin, Mikrobiologie, Infektionsepidemiologie, Virologie, Transfusionsmedizin und Humangenetik, Mönchengladbach, Germany;2. Hôpital Antoine-Béclère Service de Microbiologie-Immunologie Biologique, Clamart, France;3. LABM BIOPATH Cité de l’Europe Ouest, Coquelles, France;4. Fondazione IRCCS, Policlinico San Matteo, Struttura Complessa di Ostetricia e Ginecologia, Pavia, Italy;1. Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium;2. Epidemiology of Infectious Diseases, Sciensano, Brussels, Belgium;3. Department of Paediatrics, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium;4. Department of Obstetrics-Gynecology, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium;5. Microbiology, Laboratoire Hospitalier Universitaire de Bruxelles-Universitair Laboratorium Brussel (LHUB-ULB), Brussels, Belgium;6. Centre for Environmental Health and Occupational Health, School of Public Health, Université libre de Bruxelles (ULB), Belgium;7. Institute for Medical Immunology, Université libre de Bruxelles (ULB), Belgium;1. Department of Preventive Medicine and Epidemiology, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain;2. ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain;3. Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique;4. Department of Maternal-Fetal Medicine, BCNatal – Barcelona Center of Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain |
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| Abstract: | ObjectiveTo describe the epidemiology and clinical features of congenital rubella syndrome (CRS) in Hanoi, Vietnam.MethodsProspective surveillance of CRS between May 2011 and March 2012 in Hanoi, Vietnam. CRS burden was assessed by clinical examination and collection of serum samples from infants in neonatology, cardiology and pediatric departments of two tertiary care hospitals in Hanoi. All infants born during the study period with clinical manifestations of CRS and seropositivity (IgM) for rubella were included in this study.ResultsDuring the surveillance period 113 infants were identified with confirmed CRS (clinical features and positive rubella IgM). Their mean age at diagnosis was 38.4 days (range 1–152 days) and 61% were female. Clinical manifestations of CRS included low birth weight <2500 g (86.0%), congenital heart disease (63.7%), hearing impairment (63.7%) and ophthalmological abnormalities (46.9%). Other clinical features at birth included: thrombocytopenia (85.0%), neonatal purpura (74.3%), splenomegaly (63.7%), hepatomegaly (62.8%) and blueberry muffin rash (61.1%). Among the mothers of infants with confirmed CRS none had received a rubella vaccine in the past and 88.4% gave a history of rubella contact during the pregnancy under study. In most cases (84.1%) maternal infection occurred in the first trimester. During the surveillance period the estimated annual incidence of CRS was 1.13/1000 live births (95% CI 0.92–1.34).ConclusionsThese preliminary baseline data show a high burden of CRS in Hanoi, Vietnam and the urgent need for universal vaccination. Surveillance to determine and monitor the national burden of CRS is essential. |
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| Keywords: | Rubella Congenital rubella Congenital rubella syndrome Vietnam |
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