Rubella immunity among pregnant women and the burden of congenital rubella syndrome (CRS) in India, 2022.
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Shanmugasundaram Devika, Viswanathan Rajlakshmi, Winter Amy K, Agarwal Anjoo, Roychowdhury Bidisha, Muliyil Divya, Prasad G R V, Pushpalatha K, Gowda Mamatha, Singh Pradibha, Priyasree J, Bonu Rajeswari, Jha Sangam, Kumar Jena Saubhagya, Jain Shuchi, Suri Vanita, Hebbale Vidyavathi, Jain Amita, Mary Abraham Asha, Mishra Baijayantimala, Kumar Pati Binod, Biswas Debasis, Pratkeye Deepashri, Ashok M, Singh Mini P, Dhodapkar Rahul, Ray Raja, Gadepalli Ravishekhar, Ratho R K, Rani Sudha, Shukla Suruchi, Ali A Syed, Lakshmi Nag Vijay, Sabarinathan R, Saravana Kumar V, Priya R Padma, Dwibedi Bhagirathi, Sapkal Gajanan, Singh Himabindu, Singh Kuldeep, Tiwari Lokesh, Jain Manish, Mondal Nivedita, Sreenivasan Priya, Mahantesh S, Verma Sanjay, Awasthi Shally, Malik Shikha, Santhanam Sridhar, Datta Supratim, Kumar Amber, Kant Chowdhary Bhabesh, Khera Daisy, Jain Mahendra, Kumar Praveen, Pati Sananda, Tripathi Shalini, Murhekar Manoj
Аннотация
METHODS: We surveyed pregnant women at 13 sentinel sites across India from Aug to Oct 2022 to estimate seroprevalence of rubella IgG antibodies. Using age-specific seroprevalence data from serosurveys conducted during 2017/2019 (prior to and during the vaccination campaign) and 2022 surveys (after the vaccination campaign), we developed force of infection (FOI) models and estimated incidence and burden of CRS.
RESULTS: In 2022, rubella seroprevalence was 85.2% (95% CI: 84.0, 86.2). Among 10 sites which participated in both rounds of serosurveys, the seroprevalence was not different between the two periods (pooled prevalence during 2017/2019: 83.5%, 95% CI: 82.1, 84.8; prevalence during 2022: 85.1%, 95% CI: 83.8, 86.3). The estimated annual incidence of CRS during 2017/2019 in India was 218.3 (95% CI: 209.7, 226.5) per 100, 000 livebirths, resulting in 47,120 (95% CI: 45,260, 48,875) cases of CRS every year. After measles-rubella (MR) vaccination campaign, the estimated incidence of CRS declined to 5.3 (95% CI: 0, 21.2) per 100,000 livebirths, resulting in 1141 (95% CI: 0, 4,569) cases of CRS during the post MR-vaccination campaign period.
CONCLUSION: The incidence of CRS in India has substantially decreased following the nationwide MR vaccination campaign. About 15% of women in childbearing age in India lack immunity to rubella and hence susceptible to rubella infection. Since there are no routine rubella vaccination opportunities for this age group under the national immunization program, it is imperative to maintain high rates of rubella vaccination among children to prevent rubella virus exposure among women of childbearing age susceptible for rubella.