Epidemiology of Congenital Rubella Syndrome (CRS) in India, 2016-18, based on data from sentinel surveillance.
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Murhekar Manoj, Verma Sanjay, Singh Kuldeep, Bavdekar Ashish, Benakappa Naveen, Santhanam Sridhar, Sapkal Gajanan, Viswanathan Rajlakshmi, Singh Mini P, Nag Vijaya Lakshmi, Naik Sadanand, Ashok Munivenkatappa, Abraham Asha Mary, Shanmugasundaram Devika, Sabarinathan R, Verghese Valsan Philip, George Suji, Sachdeva Ravinder Kaur, Kolekar Jyoti, Manasa S, Ram Jagat, Gupta Madhu, Rohit Manoj K, Kumar Praveen, Gupta Parul Chawla, Ratho R K, Munjal Sanjay Kumar, Nehra Urvashi, Khera Daisy, Gupta Neeraj, Kaushal Nidhi, Singh Pratibha, Gadepalli Ravisekhar, Vaid Neelam, Kadam Sandeep, Shah Sanjay, Mahantesh S, Gowda Vykuntaraju K, Haldar Pradeep, Aggarwal M K, Gupta Nivedita
Аннотация
METHODOLOGY/PRINCIPAL FINDINGS: We used case definitions adapted from the WHO-recommended standards for CRS surveillance. Suspected patients underwent complete clinical examination including cardiovascular system, ophthalmic examination and assessment for hearing impairment. Sera were tested for presence of IgM and IgG antibodies against rubella. Of the 645 suspected CRS patients enrolled during two years, 137 (21.2%) were classified as laboratory confirmed CRS and 8 (1.2%) as congenital rubella infection. The median age of laboratory confirmed CRS infants was 3 months. Common clinical features among laboratory confirmed CRS patients included structural heart defects in 108 (78.8%), one or more eye signs (cataract, glaucoma, pigmentary retinopathy) in 82 (59.9%) and hearing impairment in 51. (38.6%) Thirty-three (24.1%) laboratory confirmed CRS patients died over a period of 2 years. Surveillance met the quality indicators in terms of adequacy of investigation, adequacy of sample collection for serological diagnosis as well as virological confirmation.
CONCLUSIONS/SIGNIFICANCE: About one fifth suspected CRS patients were laboratory confirmed, indicating significance of rubella as a persistent public health problem in India. Continued surveillance will generate data to monitor the progress made by the rubella control program in the country.