Clinical manifestations of congenital rubella syndrome at the Korle-Bu Teaching Hospital, Ghana

Abstract

Background: Congenital rubella syndrome (CRS) is a variable constellation of birth defects related to intrauterine rubella infection which may result in visual, hearing, intellectual and cardiac impairments. Objective: The objective of this study is to describe the clinical manifestations in patients presenting with CRS at the Korle Bu Teaching Hospital using the World Health Organization criteria. Methods: A retrospective analysis of the medical charts of 16 children under 16 years old who presented with CRS at the Lions International Eye and the National Cardiothoracic Centres of the Korle Bu Teaching Hospital from 2012 to 2015, was done. Ocular, cardiac and other systemic clinical and laboratory findings were documented for each patient using predesigned forms. Results: Sixteen cases of CRS were recorded over the period (2012-2015) comprising 9 males and 7 females. The median (interquartile range) age at diagnosis was 4.0 months (2.0-7.0 months), age range at diagnosis was 1.0-24.0 months. The main ocular manifestations were; cataract 10 (62.5 %), microcornea 10 (62.5 %), microphthalmia 9 (56.3 %), nystagmus 7 (43.8 %) and strabismus 4 (25.0 %). The main cardiac defects included patent ductus arteriosus 12 (75.0 %), pulmonary stenosis 5 (31.3 %), ventricular septal defect 5 (31.3 %) and small branch pulmonary artery5 (31.3 %). Systemic conditions recorded included hearing defects 7 (43.8 %), microcephaly 7 (43.8 %), failure to thrive 5 (31.3 %) and mental retardation 2 (12.5 %). Conclusion: Cataract, microcornea and microphthalmia were the main ocular manifestations in children presenting with CRS at the Korle Bu Teaching Hospital. Patent ductus arteriosus and hearing defects were the main cardiac and systemic defects among children presenting with CRS at the Korle Bu Teaching Hospital.