Abstract
BackgroundEpidemiological data about congenital rubella syndrome (CRS) are scarce and rubella vaccine is not yet included in the childhood immunization schedule in Sudan. This study aimed to identify and describe CRS cases among Sudanese infants with congenital eye or heart defects.MethodsBetween February and September 2010, paired oral fluid and dried blood spot samples were collected from 98 infants aged up to 12 months. These infants were enrolled during their visits to five hospitals in Khartoum, Sudan. Clinical samples were screened for rubella IgM and for ≥ 6 months old infants also for IgG antibodies by ELISA. The oral fluid of IgM and/or IgG positive patients was tested for rubella RNA by reverse transcriptase PCR.ResultsOur findings revealed that two children (2.0%) were IgM positive and another five children (5.1%) were positive for IgG antibodies. None of the five infants of which enough oral fluid was available for RNA investigation was PCR positive.ConclusionsThis study documented the presence of CRS in Sudan and highlighted the importance of rubella vaccine introduction for preventing future CRS cases in the country.
Highlights
Epidemiological data about congenital rubella syndrome (CRS) are scarce and rubella vaccine is not yet included in the childhood immunization schedule in Sudan
24.5% of the infants were classified as clinically-confirmed CRS cases and 75.5% as suspected CRS cases according to the World Health Organization (WHO) case definitions [13]
The analysis of maternal history revealed that the median age of the mothers was 25 years, none of them was vaccinated against rubella and only 5 mothers (5.1%) had febrile rashes during their pregnancy
Summary
Epidemiological data about congenital rubella syndrome (CRS) are scarce and rubella vaccine is not yet included in the childhood immunization schedule in Sudan. This study aimed to identify and describe CRS cases among Sudanese infants with congenital eye or heart defects. Infection during the first trimester of pregnancy can lead to a spectrum of birth defects known as congenital rubella syndrome (CRS) including congenital eye defects, deafness, congenital heart diseases and mental retardation [2]. The incidence of CRS has been reduced in many developed countries by effective vaccination programs [4]. Effective rubella vaccination programs as well as high-quality surveillance of rash/fever diseases have been implemented in the Americas and resulted in rubella and CRS elimination in those countries since 2010 [5,6]. The burden of CRS in these countries is underestimated and few reports documenting the incidence
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