Congenital rubella syndrome surveillance in India, 2016-21: Analysis of five years surveillance data.
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Shanmugasundaram Devika, Verma Sanjay, Singh Kuldeep, Dwibedi Bhagirathi, Awasthi Shally, Mahantesh S, Singh Himabindu, Santhanam Sridhar, Mondal Nivedita, S Geetha, Sreenivasan Priya, Malik Shikha, Jain Manish, Viswanathan Rajlakshmi, Tripathi Shalini, Patel Bhupeshwari, Sapkal Gajanan, Sabarinathan R, Singh Mini P, Ratho R K, Nag Vijaylakshmi, Gadepalli Ravishekhar, Som Tapas Kumar, Mishra Baijayantimala, Jain Amita, Ashok M, Madhuri Devara Sudha, Rani V Sudha, Abraham Asha Mary, John Deepa, Dhodapkar Rahul, Syed Ali A, Biswas Debasis, Pratyeke Deepashri, Bavdekar Ashish, Prakash Jayant, Singh Varsha, Prasad Nidhi, Ray Jaydeb, Majumdar Agniva, Dutta Shanta, Gupta Nivedita, Murhekar Manoj, CRS Surveillance Group, Sharma Akhil, Ghosh Aniruddha, Alexander Arun, Baranwal Arun, Anantharaj Avinash, Bethou Adhisivam, Shekhawat Dolat S, Kiruthika G, Ram Jagat, Gupta Madhu, Gowda Mamatha, Rohit Manoj K, Dash Nabaneeta, Sankhyan Naveen, Kaushal Nidhi, Shivanna Niranjan Hunasanahalli, Kasturi Nirupama, Kumar P Prem, Gupta Parul Chawla, Gunasekaran Pradeep Kumar, Singh Pratibha, Kumar Praveen, Munjal Sanjay Kumar, Agarwal Siddharth, Manasa Suhani, Shukla Suruchi, Nehra Urvashi, Verghese Valsan P, Vyas Varuna, Gupta Vikas
Аннотация
METHOD: We analyzed the surveillance data to describe the distribution of suspected and laboratory confirmed CRS patients by time, place and person characteristics. We compared clinical signs of laboratory confirmed CRS and discarded case-patients to find independent predictors of CRS using logistic regression analysis and developed a risk prediction model.
RESULTS: During 2016-21, surveillance sites enrolled 3940 suspected CRS case-patients (Age 3.5 months, SD: 3.5). About one-fifth (n = 813, 20.6%) were enrolled during newborn examination. Of the suspected CRS patients, 493 (12.5%) had laboratory evidence of rubella infection. The proportion of laboratory confirmed CRS cases declined from 26% in 2017 to 8.7% in 2021. Laboratory confirmed patients had higher odds of having hearing impairment (Odds ratio [OR] = 9.5, 95% confidence interval [CI]: 5.6-16.2), cataract (OR = 7.8, 95% CI: 5.4-11.2), pigmentary retinopathy (OR = 6.7, 95 CI: 3.3-13.6), structural heart defect with hearing impairment (OR = 3.8, 95% CI: 1.2-12.2) and glaucoma (OR = 3.1, 95% CI: 1.2-8.1). Nomogram, along with a web version, was developed.
CONCLUSIONS: Rubella continues to be a significant public health issue in India. The declining trend of test positivity among suspected CRS case-patients needs to be monitored through continued surveillance in these sentinel sites.