Sadighi Jila, Eftekhar Hasan, Mohammad Kazem
Institute for Health Sciences Research, Tehran, Iran.
BMC Infect Dis. 2005 Jun 6;5:44. doi: 10.1186/1471-2334-5-44.
Congenital rubella syndrome (CRS) can be prevented with appropriate vaccination programs. The prevalence rates of rubella and CRS in Iran are unknown; therefore, the risk of exposure in pregnant women is not clear. The prevalence of CRS in the pre-vaccine period can be estimated by evaluating the proportion of children in the population with sensorineural hearing loss attributable to rubella.
This was a case-control study to estimate prevalence of CRS in Tehran (Iran) by evaluating the proportion of children with sensorineural hearing loss attributable to rubella. The study used rubella antibody titer as an indicator, and compared the prevalence of rubella antibody between children with and without sensorineural hearing loss. Using these findings, the proportion of cases of sensorineural hearing loss attributable to rubella was estimated.
A total of 225 children aged 1 to 4 years were entered into the study (113 cases and 112 controls). There was a significant difference between cases and controls with regard to rubella antibody seropositivity (19.5% vs. 8.9%, respectively, odds ratio = 2.47, 95% CI = 1.04-5.97). The proportion of sensorineural hearing loss cases attributable to rubella was found to be 12%, corresponding to a CRS prevalence of 0.2/1000.
The prevalence of CRS was approximately 0.2/1000 before rubella vaccination in Iran, Moreover; the results suggest that implementation of appropriate rubella vaccination programs could potentially prevent about 12% of cases of sensorineural hearing loss in Iranian children. This data could potentially be used as baseline data, which in conjunction with an appropriate method, to establish a surveillance system for rubella vaccination in Iran. An appropriate surveillance system is needed, because the introduction of a rubella vaccine without epidemiological data and an adequate monitoring program could result in the shifting of rubella cases to higher ages, and increasing the incidence of CRS.
先天性风疹综合征（CRS）可通过适当的疫苗接种计划预防。伊朗风疹和CRS的患病率未知；因此，孕妇的暴露风险尚不清楚。通过评估风疹所致感音神经性听力损失儿童在人群中的比例，可以估计疫苗接种前CRS的患病率。
这是一项病例对照研究，通过评估风疹所致感音神经性听力损失儿童的比例来估计德黑兰（伊朗）CRS的患病率。该研究使用风疹抗体滴度作为指标，比较有感音神经性听力损失和无感音神经性听力损失儿童之间风疹抗体的患病率。利用这些结果，估计风疹所致感音神经性听力损失病例的比例。
共有225名1至4岁儿童纳入研究（113例病例和112例对照）。病例组和对照组在风疹抗体血清阳性方面存在显著差异（分别为19.5%和8.9%，优势比=2.47，95%置信区间=1.04-5.97）。发现风疹所致感音神经性听力损失病例的比例为12%，对应CRS患病率为0.2/1000。
伊朗在风疹疫苗接种前CRS的患病率约为0.2/1000。此外，结果表明实施适当的风疹疫苗接种计划可能预防约12%的伊朗儿童感音神经性听力损失病例。这些数据可能用作基线数据，结合适当方法，为伊朗建立风疹疫苗接种监测系统。需要一个适当的监测系统，因为在没有流行病学数据和充分监测计划的情况下引入风疹疫苗可能导致风疹病例年龄上移，并增加CRS的发病率。
