Seroprevalence of rubella in the cord blood of pregnant women and congenital rubella incidence in Nha Trang,Vietnam |
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Authors: | Masami Miyakawa Hiroshi Yoshino Lay Myint Yoshida Emilia Vynnycky Hideki Motomura Le Huu Tho Vu Dinh Thiem Koya Ariyoshi Dang Duc Anh Hiroyuki Moriuchi |
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Institution: | 1. Department of Molecular Microbiology and Immunology, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan;2. Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Sakamoto, Nagasaki, Japan;3. Modelling & Economics Unit, Public Health England, Colindale Ave, London, Greater London, UK;4. Khanh Hoa Provincial Public Health Service, Nha Trang, Viet Nam;5. National Institute of Hygiene and Epidemiology, Yecxanh, Hai Ba Trung, Ha Noi, Viet Nam;6. Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, England, United Kingdom |
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Abstract: | To investigate susceptibility to and factors associated with rubella infection among pregnant mothers and to estimate the burden of congenital rubella infection (CRI) in Vietnam where rubella-containing vaccine (RCV) is not included in the routine immunization program, we conducted a prospective cohort study in Nha Trang, Vietnam between 2009 and 2010. Rubella-specific immunoglobulin-M and immunoglobulin-G were investigated in cord blood samples by enzyme immunoassay. Corresponding clinical–epidemiological data were analyzed and the national congenital rubella syndrome (CRS) incidence was estimated using modeling. We enrolled 1988 pairs of mothers aged 17–45 years and their newborn babies. No mothers had received RCV. Multivariate analysis revealed that mothers aged 17–24 (aOR 2.5, 95% CI: 1.7–3.8) or 25–34 (1.4, 1.0–2.1) years were more likely to be susceptible than those aged 35–45 years. Overall 28.9% (574/1988, 95% CI: 26.9–30.9%) of mothers were seronegative. The CRI rate was 151 (95% CI: 0–322) per 100,000 live births. Modeling estimated that 3788 babies (95% CI: 3283–4143) were born with CRS annually in Vietnam with an overall CRS incidence of 234 (95% CI: 207–262) cases per 100,000 live births. A substantial proportion of women of childbearing age (WCBA) are at risk of rubella infection during pregnancy and this can result in a high frequency of miscarriage or burden of CRS across Vietnam. Prompt introduction of RCV into national immunization program with catch-up vaccination to children and WCBA will reduce CRI in Vietnam. |
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Keywords: | Incidence Seroprevalence Women of childbearing age Congenital rubella syndrome Cord blood IgG IgM Modeling |
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