Using Sero prevalence and Immunisation Coverage Data to Estimate the Global Burden of Congenital Rubella Syndrome, 1996-2010: A Systematic Review.

Tuesday, 15th of March 2016

PLoS One. 2016 Mar 10;11(3):e0149160. doi: 10.1371/journal.pone.0149160. eCollection 2016.

Using Sero prevalence and Immunisation Coverage Data to Estimate the Global Burden of Congenital Rubella Syndrome 1996-2010: A Systematic Review.

Vynnycky E¹² Adams EJ¹³⁴ Cutts FT² Reef SE⁵ Navar AM⁶⁷ Simons E⁸ Yoshida LM⁹ Brown DW¹¹⁰ Jackson C²¹¹ Strebel PM⁸ Dabbagh AJ⁸.

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Abstract

BACKGROUND:

The burden of Congenital Rubella Syndrome (CRS) is typically underestimated in routine surveillance. Updated estimates are needed following the recent WHO position paper on rubella and recent GAVI initiatives funding rubella vaccination in eligible countries. Previous estimates considered the year 1996 and only 78 (developing) countries.

METHODS:

We reviewed the literature to identify rubella seroprevalence studies conducted before countries introduced rubella-containing vaccination (RCV). These data and the estimated vaccination coverage in the routine schedule and mass campaigns were incorporated in mathematical models to estimate the CRS incidence in 1996 and 2000-2010 for each country region and globally.

RESULTS:

The estimated CRS decreased in the three regions (Americas Europe and Eastern Mediterranean) which had introduced widespread RCV by 2010 reaching <2 per 100000 live births (the Americas and Europe) and 25 (95% CI 4-61) per 100000 live births (the Eastern Mediterranean). The estimated incidence in 2010 ranged from 90 (95% CI: 46-195) in the Western Pacific excluding China to 116 (95% CI: 56-235) and 121 (95% CI: 31-238) per 100000 live births in Africa and SE Asia respectively. Highest numbers of cases were predicted in Africa (39000 95% CI: 18000-80000) and SE Asia (49000 95% CI: 11000-97000). In 2010 105000 (95% CI: 54000-158000) CRS cases were estimated globally compared to 119000 (95% CI: 72000-169000) in 1996.

CONCLUSIONS:

Whilst falling dramatically in the Americas Europe panerai replica and the Eastern Mediterranean after vaccination the estimated CRS incidence remains high elsewhere. Well-conducted seroprevalence studies can help to improve the reliability of these estimates and monitor the impact of rubella vaccination.