Van Bang Nguyen, Van Anh Nguyen Thi, Van Vu Thi Tuong, Thai Trieu Thi Hong, Van Thuong Nguyen, Khandaker Gulam, Elliott Elizabeth
Department of Paediatrics, Hanoi Medical University, Hanoi, Viet Nam; Department of Paediatrics, Bachmai Hospital, Hanoi, Viet Nam.
Department of Medical Education and Skill Laboratory, Hanoi Medical University, Hanoi, Viet Nam.
Vaccine. 2014 Dec 12;32(52):7065-9. doi: 10.1016/j.vaccine.2014.10.087. Epub 2014 Nov 11.
To describe the epidemiology and clinical features of congenital rubella syndrome (CRS) in Hanoi, Vietnam.
Prospective surveillance of CRS between May 2011 and March 2012 in Hanoi, Vietnam. CRS burden was assessed by clinical examination and collection of serum samples from infants in neonatology, cardiology and pediatric departments of two tertiary care hospitals in Hanoi. All infants born during the study period with clinical manifestations of CRS and seropositivity (IgM) for rubella were included in this study.
During the surveillance period 113 infants were identified with confirmed CRS (clinical features and positive rubella IgM). Their mean age at diagnosis was 38.4 days (range 1-152 days) and 61% were female. Clinical manifestations of CRS included low birth weight<2500 g (86.0%), congenital heart disease (63.7%), hearing impairment (63.7%) and ophthalmological abnormalities (46.9%). Other clinical features at birth included: thrombocytopenia (85.0%), neonatal purpura (74.3%), splenomegaly (63.7%), hepatomegaly (62.8%) and blueberry muffin rash (61.1%). Among the mothers of infants with confirmed CRS none had received a rubella vaccine in the past and 88.4% gave a history of rubella contact during the pregnancy under study. In most cases (84.1%) maternal infection occurred in the first trimester. During the surveillance period the estimated annual incidence of CRS was 1.13/1000 live births (95% CI 0.92-1.34).
These preliminary baseline data show a high burden of CRS in Hanoi, Vietnam and the urgent need for universal vaccination. Surveillance to determine and monitor the national burden of CRS is essential.
描述越南河内先天性风疹综合征（CRS）的流行病学特征和临床特点。
于2011年5月至2012年3月在越南河内对CRS进行前瞻性监测。通过临床检查以及从河内两家三级护理医院的新生儿科、心脏科和儿科收集婴儿血清样本，评估CRS负担。本研究纳入了研究期间出生且有CRS临床表现及风疹血清学阳性（IgM）的所有婴儿。
在监测期间，共确诊113例CRS婴儿（具有临床特征且风疹IgM阳性）。其诊断时的平均年龄为38.4天（范围1 - 152天），61%为女性。CRS的临床表现包括低出生体重<2500克（86.0%）、先天性心脏病（63.7%）、听力障碍（63.7%）和眼科异常（46.9%）。出生时的其他临床特征包括：血小板减少（85.0%）、新生儿紫癜（74.3%）、脾肿大（63.7%）、肝肿大（62.8%）和蓝莓松饼样皮疹（61.1%）。在确诊CRS婴儿的母亲中，过去均未接种过风疹疫苗，88.4%的母亲报告在本次研究的孕期有风疹接触史。在大多数情况下（84.1%），母亲感染发生在孕早期。在监测期间，CRS的估计年发病率为1.13/1000活产（95%可信区间0.92 - 1.34）。
这些初步的基线数据显示越南河内CRS负担较重，迫切需要普及疫苗接种。开展监测以确定和监测CRS的全国负担至关重要。
