Abstract
Background: Congenital Rubella Syndrome (CRS) has long been characterized by the triad of deafness, cataract and cardiovascular malformations with or without mental retardation. Objective: This study was conducted to observe the clinical manifestations of CRS in children of Bangladesh. Materials and method: This cross sectional study was carried out in Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh and National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh. Total 40 cases of CRS were enrolled from indoor and outpatient departments of these two hospitals, who were diagnosed according to standard case definition. Serological test for rubella antibody, chest X-ray, colour Doppler echocardiography, visual examination and hearing assessment were done in relative specialised centres. Results: The mean(±SD) age of the study subjects was 6.6(±5.7) months (range: 0-24 months). Among the subjects, 68% were male and 32% were female. Serum for rubella specific antibody revealed positive IgG in 60% cases and IgM in 28% cases. Neurological problem was the most frequently observed (90%) systemic complication followed by visual problem (83%), congenital hearing loss (80%) and congenital heart disease (78%). Cataract was the commonest (55%) among visual problems and microcephaly (62%) among neurological manifestations. Patent ductus arteriosus (PDA) was the most common (37.5%) isolated structural cardiac defect. Maximum (62.5%) children came from poor socioeconomic status. Maternal onset of infection was commonly detected in 1st trimester of pregnancy. Conclusion: Diagnosis of CRS and recognition of its versatile pattern of clinical presentation are crucial for better prognosis of the affected children. DOI: http://dx.doi.org/10.3329/dmcj.v2i2.20522 Delta Med Col J. Jul 2014; 2(2): 42-47
Highlights
Rubella virus is a member of the togavirus family which is transmitted by direct droplet contact from nasopharyngeal secretions, replicates in the lymphoid tissue of the upper respiratory tract, and spreads hematogenously.[1]
This cross sectional study was conducted from December 2011 through July 2012 in Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh and National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh
Among the 4160 registered cases, 40 children were suspected as Congenital Rubella Syndrome (CRS) cases according to the case definition and enrolled in the study
Summary
Rubella virus is a member of the togavirus family which is transmitted by direct droplet contact from nasopharyngeal secretions, replicates in the lymphoid tissue of the upper respiratory tract, and spreads hematogenously.[1]. The most devastating consequences of rubella infection during pregnancy are abortion, stillbirth, and foetal malformation that arise from maternal infection during the first trimester of pregnancy.[2]. 1. Resident Medical Officer, Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh. 2. Professor of Paediatrics, Bangladesh Institute of Child Health, Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh. 3. Professor & Head of Paediatric Cardiology, Bangladesh Institute of Child Health, Director, Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh. Congenital Rubella Syndrome (CRS) has long been characterized by the triad of deafness, cataract and cardiovascular malformations with or without mental retardation. Objective: This study was conducted to observe the clinical manifestations of CRS in children of Bangladesh. Materials and method: This cross sectional study was carried out in Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh and National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh. Conclusion: Diagnosis of CRS and recognition of its versatile pattern of clinical presentation are crucial for better prognosis of the affected children
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