Congenital Rubella Syndrome Surveillance in South Africa Using a Sentinel Site Approach: A Cross-sectional Study

Nkengafac Villyen Motaze^{1

2}, Jack Manamela¹, Sheilagh Smit¹, Helena Rabie³, Kim Harper⁴, Nicolette duPlessis⁵, Gary Reubenson⁶, Melantha Coetzee⁷, Daynia Ballot⁸, David Moore⁹, James Nuttall¹⁰, Lucy Linley¹¹, Lloyd Tooke¹², Jeannette Kriel¹³, Ute Hallbauer¹³, Christopher Sutton¹⁴, Pravi Moodley¹⁵, Diana Hardie¹⁶, Ahmad Haeri Mazanderani¹, Felicity Goosen¹⁷, Thanda Kyaw¹⁸, Dave Leroux¹⁹, Akhtar Hussain²⁰, Radhika Singh²¹, Christopher Kelly²², Graham Ducasse²³, Michelle Muller²⁴, Magdaleen Blaauw²⁵, Mohlabi Hamese²⁶, Tumelo Leeuw²⁷, Omphile Mekgoe²⁸, Philemon Rakgole²⁹, Norman Dungwa³⁰, Thulisile Maphosa³¹, Kgomotso Sanyane³², Wolfgang Preiser³³, Cheryl Cohen^{1

34}, Melinda Suchard^{1

35}

Affiliations

¹ National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa.
² Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.
³ Department of Pediatrics, Tygerberg Hospital, Stellenbosch University, South Africa.
⁴ Department of Pediatrics, Frere Hospital, East London, South Africa.
⁵ Department of Pediatrics, Kalafong Hospital, University of Pretoria, South Africa.
⁶ Department of Pediatrics and Child Health, Empilweni Service and Research Unit, Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
⁷ Department of Paediatrics and Child Health, Steve Biko Academic Hospital, University of Pretoria, South Africa.
⁸ Department of Pediatrics and Child Health, Charlotte Maxeke Academic Hospital, Johannesburg.
⁹ Department of Pediatrics and Child Health, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa.
¹⁰ Department of Pediatrics, Red Cross War Memorial Children's Hospital, South Africa.
¹¹ Department of Pediatrics, Mowbray Maternity Hospital, South Africa.
¹² Department of Pediatrics, Groote Schuur Hospital, University of Cape Town, South Africa.
¹³ Department of Pediatrics and Child Health, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
¹⁴ Department of Pediatrics and Child Health, Polokwane Hospital, University of Limpopo, South Africa.
¹⁵ Department of Virology, Inkosi Albert Luthuli Central Hospital, University of Kwazulu-Natal, South Africa.
¹⁶ Division of Medical Virology, Groote Schuur Hospital, University of Cape Town, South Africa.
¹⁷ Department of Pediatrics, Cecilia Makiwane Hospital, East London, South Africa.
¹⁸ Department of Virological Pathology, Dr George Mukhari Academic Hospital, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
¹⁹ Department of Pediatrics, New Somerset Hospital, University of Cape Town, South Africa.
²⁰ Department of Pediatrics, Prince Mshiyeni Memorial Hospital, Durban.
²¹ Department of Pediatrics, King Edward VIII Hospital, Durban.
²² Department of Pediatrics, Inkosi Albert Luthuli Hospital, Durban.
²³ Department of Pediatrics, Grey's Hospital, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
²⁴ Department of Pediatrics, Kimberley Hospital, South Africa.
²⁵ Department of Pediatrics and Neonatology, Dr Harry Surtie Hospital, Upington, South Africa.
²⁶ Department of Pediatrics and Child Health, Mankweng Hospital, University of Limpopo, South Africa.
²⁷ Department of Pediatrics, Mafikeng Provincial Hospital, South Africa.
²⁸ Department of Pediatrics, Klerksdorp Hospital, South Africa.
²⁹ Department of Pediatrics, Job Shimankana Tabane Hospital, Rustenburg, South Africa.
³⁰ Department of Pediatrics, Witbank Hospital, South Africa.
³¹ Department of Pediatrics, Rob Fereirra Hospital, Nelspruit, South Africa.
³² Department of Pediatrics, Dr George Mukhari Hospital, Sefako Makgatho University, Pretoria, South Africa.
³³ Division of Medical Virology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service Tygerberg, South Africa.
³⁴ Division of Epidemiology and Biostatistics, School of Public Health, Johannesburg, South Africa.
³⁵ Chemical Pathology, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

PMID: 30203002
PMCID: PMC6495013
DOI: 10.1093/cid/ciy758

Congenital Rubella Syndrome Surveillance in South Africa Using a Sentinel Site Approach: A Cross-sectional Study

Nkengafac Villyen Motaze et al. Clin Infect Dis. 2019.

. 2019 May 2;68(10):1658-1664.

doi: 10.1093/cid/ciy758.

Authors

Affiliations

¹ National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa.
² Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.
³ Department of Pediatrics, Tygerberg Hospital, Stellenbosch University, South Africa.
⁴ Department of Pediatrics, Frere Hospital, East London, South Africa.
⁵ Department of Pediatrics, Kalafong Hospital, University of Pretoria, South Africa.
⁶ Department of Pediatrics and Child Health, Empilweni Service and Research Unit, Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
⁷ Department of Paediatrics and Child Health, Steve Biko Academic Hospital, University of Pretoria, South Africa.
⁸ Department of Pediatrics and Child Health, Charlotte Maxeke Academic Hospital, Johannesburg.
⁹ Department of Pediatrics and Child Health, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa.
¹⁰ Department of Pediatrics, Red Cross War Memorial Children's Hospital, South Africa.
¹¹ Department of Pediatrics, Mowbray Maternity Hospital, South Africa.
¹² Department of Pediatrics, Groote Schuur Hospital, University of Cape Town, South Africa.
¹³ Department of Pediatrics and Child Health, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
¹⁴ Department of Pediatrics and Child Health, Polokwane Hospital, University of Limpopo, South Africa.
¹⁵ Department of Virology, Inkosi Albert Luthuli Central Hospital, University of Kwazulu-Natal, South Africa.
¹⁶ Division of Medical Virology, Groote Schuur Hospital, University of Cape Town, South Africa.
¹⁷ Department of Pediatrics, Cecilia Makiwane Hospital, East London, South Africa.
¹⁸ Department of Virological Pathology, Dr George Mukhari Academic Hospital, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
¹⁹ Department of Pediatrics, New Somerset Hospital, University of Cape Town, South Africa.
²⁰ Department of Pediatrics, Prince Mshiyeni Memorial Hospital, Durban.
²¹ Department of Pediatrics, King Edward VIII Hospital, Durban.
²² Department of Pediatrics, Inkosi Albert Luthuli Hospital, Durban.
²³ Department of Pediatrics, Grey's Hospital, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
²⁴ Department of Pediatrics, Kimberley Hospital, South Africa.
²⁵ Department of Pediatrics and Neonatology, Dr Harry Surtie Hospital, Upington, South Africa.
²⁶ Department of Pediatrics and Child Health, Mankweng Hospital, University of Limpopo, South Africa.
²⁷ Department of Pediatrics, Mafikeng Provincial Hospital, South Africa.
²⁸ Department of Pediatrics, Klerksdorp Hospital, South Africa.
²⁹ Department of Pediatrics, Job Shimankana Tabane Hospital, Rustenburg, South Africa.
³⁰ Department of Pediatrics, Witbank Hospital, South Africa.
³¹ Department of Pediatrics, Rob Fereirra Hospital, Nelspruit, South Africa.
³² Department of Pediatrics, Dr George Mukhari Hospital, Sefako Makgatho University, Pretoria, South Africa.
³³ Division of Medical Virology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service Tygerberg, South Africa.
³⁴ Division of Epidemiology and Biostatistics, School of Public Health, Johannesburg, South Africa.
³⁵ Chemical Pathology, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

PMID: 30203002
PMCID: PMC6495013
DOI: 10.1093/cid/ciy758

Abstract

Background: Congenital rubella syndrome (CRS) includes disorders associated with intrauterine rubella infection. Incidence of CRS is higher in countries with no rubella-containing vaccines (RCV) in their immunization schedules. In the World Health Organization African region, RCVs are being introduced as part of the 2012-2020 global measles and rubella strategic plan. This study aimed to describe the epidemiology of confirmed CRS in South Africa prior to introduction of RCVs in the immunization schedule.

Methods: This was a descriptive study with 28 sentinel sites reporting laboratory-confirmed CRS cases in all 9 provinces of South Africa. In the retrospective phase (2010 to 2014), CRS cases were retrieved from medical records, and in the prospective phase (2015 to 2017) clinicians at study sites reported CRS cases monthly.

Results: There were 42 confirmed CRS cases in the retrospective phase and 53 confirmed CRS cases in the prospective phase. Most frequently reported birth defects were congenital heart disease and cataracts. The median age of mothers of CRS cases was 21 years in the retrospective phase (range: 11 to 38 years) and 22 years in the prospective phase (range: 15 to 38 years).

Conclusion: Baseline data on laboratory-confirmed CRS will enable planning and monitoring of RCV implementation in the South African Expanded Programme on Immunization program. Ninety-eight percent of mothers of infants with CRS were young women 14-30 years old, indicating a potential immunity gap in this age group for consideration during introduction of RCV.

Keywords: birth defects; congenital rubella syndrome; rubella; rubella-containing vaccines; surveillance.

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References

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Congenital Rubella Syndrome Surveillance in South Africa Using a Sentinel Site Approach: A Cross-sectional Study

Affiliations

Congenital Rubella Syndrome Surveillance in South Africa Using a Sentinel Site Approach: A Cross-sectional Study

Authors

Affiliations

Abstract

References

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LinkOut - more resources

Full Text Sources

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Medical

Miscellaneous