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. 2023 May 9;9(5):e15965.
doi: 10.1016/j.heliyon.2023.e15965. eCollection 2023 May.

Congenital rubella syndrome surveillance in India, 2016-21: Analysis of five years surveillance data

Devika Shanmugasundaram  1 , Sanjay Verma  2 , Kuldeep Singh  3 , Bhagirathi Dwibedi  4 , Shally Awasthi  5 , S Mahantesh  6 , Himabindu Singh  7 , Sridhar Santhanam  8 , Nivedita Mondal  9 , Geetha S  10 , Priya Sreenivasan  10 , Shikha Malik  11 , Manish Jain  12 , Rajlakshmi Viswanathan  13 , Shalini Tripathi  5 , Bhupeshwari Patel  11 , Gajanan Sapkal  13 , R Sabarinathan  1 , Mini P Singh  2 , R K Ratho  2 , Vijaylakshmi Nag  3 , Ravishekhar Gadepalli  3 , Tapas Kumar Som  4 , Baijayantimala Mishra  4 , Amita Jain  5 , M Ashok  13 , Devara Sudha Madhuri  7 , V Sudha Rani  7 , Asha Mary Abraham  8 , Deepa John  8 , Rahul Dhodapkar  9 , A Syed Ali  10 , Debasis Biswas  11 , Deepashri Pratyeke  12 , Ashish Bavdekar  14 , Jayant Prakash  15 , Varsha Singh  15 , Nidhi Prasad  15 , Jaydeb Ray  16 , Agniva Majumdar  17 , Shanta Dutta  17 , Nivedita Gupta  18 , Manoj Murhekar  1 ; CRS Surveillance Group; Akhil Sharma  5 , Aniruddha Ghosh  16 , Arun Alexander  9 , Arun Baranwal  2 , Avinash Anantharaj  9 , Adhisivam Bethou  9 , Dolat S Shekhawat  3 , G Kiruthika  1 , Jagat Ram  2 , Madhu Gupta  2 , Mamatha Gowda  9 , Manoj K Rohit  2 , Nabaneeta Dash  2 , Naveen Sankhyan  2 , Nidhi Kaushal  3 , Niranjan Hunasanahalli Shivanna  6 , Nirupama Kasturi  9 , P Prem Kumar  6 , Parul Chawla Gupta  2 , Pradeep Kumar Gunasekaran  3 , Pratibha Singh  3 , Praveen Kumar  2 , Sanjay Kumar Munjal  2 , Siddharth Agarwal  5 , Suhani Manasa  6 , Suruchi Shukla  5 , Urvashi Nehra  2 , Valsan P Verghese  8 , Varuna Vyas  3 , Vikas Gupta  11
Affiliations

Congenital rubella syndrome surveillance in India, 2016-21: Analysis of five years surveillance data

Devika Shanmugasundaram et al. Heliyon. .

Abstract

Background: In India, facility-based surveillance for congenital rubella syndrome (CRS) was initiated in 2016 to estimate the burden and monitor the progress made in rubella control. We analyzed the surveillance data for 2016-2021 from 14 sentinel sites to describe the epidemiology of CRS.

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.

Keywords: Congenital Rubella Syndrome; India; Surveillance.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Trend graph of rubella positivity among suspected CRS case-patients, 2017-21.
Fig. 2
Fig. 2
Nomogram for predicting the probability of CRS case-patients.
See this image and copyright information in PMC

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