Nwanegbo Edward C, Swanson Thor, Vanderpuye Oluseyi, Rios-Bedoya Carlos F
Department of Family and Community Medicine, Texas Tech University and Lamb Health Care Center, Littlefield, TX 79339, USA ; Siouxland Medical Educational Foundation and Siouxland Community Health Center, Sioux City, IA 51104, USA.
Siouxland Medical Educational Foundation and Siouxland Community Health Center, Sioux City, IA 51104, USA.
ISRN Family Med. 2013 Jan 15;2013:602130. doi: 10.5402/2013/602130. eCollection 2013.
Since the introduction of the Rubella vaccine in 1969, prevalence of congenital Rubella syndrome (CRS) has greatly declined in the United States. However, reports of sporadic adult cases of the disease and frequent identification of non-Rubella immune (NRI) women in prenatal units may result in outbreak of CRS in susceptible communities. Identifying populations with high rates of NRI will assist in evidence-based public health intervention that may prevent epidemic of CRS in the United States. Method. This is a retrospective, cross-sectional study involving chart audit of Rubella screening results of 642 women who attended a high-risk prenatal care at a northwestern Iowa clinic between January 1 and December 31, 2007. Results. NRI was found in 6.9% of the study population. The highest prevalence rate of 10.2% was found among adolescents. NRI was highest among Native American women at 17.3%, compared to Whites 7.3%, African Americans 5.9%, and Hispanics 4.6%. Multivariate analysis demonstrated that Native Americans were 2.5 times more likely to be NRI compared to Whites (OR 2.7; 95% CI: 1.1, 6.6). Conclusion. This study demonstrated higher rate of non-Rubella immunity among adolescent pregnant women and supports Rubella booster immunization for all non-pregnant teenage women. The observed high rate of NRI among Native Americans may require further studies and evaluation of Rubella vaccination programs in tribal communities.
自1969年引入风疹疫苗以来，美国先天性风疹综合征（CRS）的患病率大幅下降。然而，该疾病散发性成人病例的报告以及产前单位中频繁发现非风疹免疫（NRI）女性，可能导致易感社区爆发CRS。确定NRI发生率高的人群将有助于开展基于证据的公共卫生干预措施，从而预防美国CRS的流行。方法。这是一项回顾性横断面研究，涉及对2007年1月1日至12月31日期间在爱荷华州西北部一家诊所接受高危产前护理的642名女性的风疹筛查结果进行图表审核。结果。在研究人群中发现NRI的比例为6.9%。青少年中的患病率最高，为10.2%。美国原住民女性中NRI的比例最高，为17.3%，相比之下，白人中的比例为7.3%，非裔美国人为5.9%，西班牙裔为4.6%。多变量分析表明，与白人相比，美国原住民成为NRI的可能性高出2.5倍（比值比2.7；95%置信区间：1.1，6.6）。结论。本研究表明青少年孕妇中非风疹免疫的比例较高，并支持对所有未怀孕的青少年女性进行风疹加强免疫。在美国原住民中观察到的高NRI率可能需要对部落社区的风疹疫苗接种计划进行进一步研究和评估。
