Abstract
BackgroundData on the burden of mumps in South Africa are limited and the epidemiology of mumps in this setting is not well understood. We present an analysis of mumps data in South Africa from 2012 to 2017.MethodsThis cross-sectional study included secondary data on laboratory-confirmed mumps infections from 2012 to 2017, archived at the South African National Health Laboratory Services’ data repository as well as from four private laboratories. Mumps-specific immunoglobulin M (IgM) and/or viral nucleic acid positive results represented acute infections. We used age-specific mid-year population estimates for each study year as denominators when calculating annual cumulative incidence. Seasonality was based on the season that showed a peak in infections.ResultsOut of 48,580 records obtained from the public and private sectors, 46,713 (96.2%) were from the private sector. Over the study period, there were 7494 acute infections, 7085 (94.5%) of which were recorded in the private sector. Of these 7494 infections, 3924 (52.4%) occurred in males. The proportion of samples tested that were IgM positive was 18.6% (1058/5682) in 2012, 15% (1016/6790) in 2013, 15.8% (1280/8093) in 2014, 15.5% (1384/8944) in 2015, 13.1% (1260/9629) in 2016 and 15.8% (1496/9442) in 2017. The cumulative incidence rate per 100,000 was highest in children between one and 9 years throughout the study period. The cumulative incidence of infections was highest in the Western Cape, Gauteng and the Northern Cape. Infections peaked in June and November.ConclusionLaboratory-confirmed mumps infections predominantly occurred in spring, affecting children below 10 years of age and individuals who were male. There were fewer tests performed in the public sector compared to the private sector. Since only laboratory data was analysed our results represent and underestimate of disease burden. Further studies that include clinical data are required to provide better estimates of disease burden in South Africa.
Highlights
Data on the burden of mumps in South Africa are limited and the epidemiology of mumps in this setting is not well understood
An increase in age has been associated with more severe disease in many childhood diseases, and in mumps infections, this increased risk occurs more commonly in males compared to females [10, 14] The World Health Organization (WHO) recommends that should a mumps-containing vaccine (MuCV) be introduced by a country, it should be as two doses given at 12–18 months from 2 up to 6 years in the form of the trivalent measles-mumps-rubella (MMR) vaccine
By 2017, only four countries in the African region (Seychelles, Mauritius, Cabo Verde and Algeria) had introduced the MuCV in their respective national vaccination program, while in South Africa, MuCV was only available in the private health sector as MMR and was not part of the Extended Programme of Immunizations (EPI) that provides vaccines to children in the public health sector [15,16,17]
Summary
Data on the burden of mumps in South Africa are limited and the epidemiology of mumps in this setting is not well understood. Important policy and programmatic considerations regarding the introduction of a MuCV into a country’s immunization programme include the burden of mumps disease, the efficiency of the country’s national immunization programme, the socioeconomic impact of the vaccine introduction, and the ability of the country to achieve and maintain a coverage > 80% for the measlesand rubella-containing vaccines [13]. An increase in age has been associated with more severe disease in many childhood diseases, and in mumps infections, this increased risk occurs more commonly in males compared to females [10, 14] The World Health Organization (WHO) recommends that should a MuCV be introduced by a country, it should be as two doses given at 12–18 months from 2 up to 6 years in the form of the trivalent measles-mumps-rubella (MMR) vaccine. By 2017, only four countries in the African region (Seychelles, Mauritius, Cabo Verde and Algeria) had introduced the MuCV in their respective national vaccination program, while in South Africa, MuCV was only available in the private health sector as MMR and was not part of the Extended Programme of Immunizations (EPI) that provides vaccines to children in the public health sector [15,16,17]
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