Mirambo Mariam M, Aboud Said, Groß Uwe, Majigo Mtebe, Mushi Martha F, Mshana Stephen E
Department of Microbiology and Immunology, Weill Bugando School of Medicine, Mwanza, Tanzania.
Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Int J Prev Med. 2017 Jan 23;8:3. doi: 10.4103/2008-7802.198914. eCollection 2017.
The World health organization advocates assessment of the burden of rubella and congenital rubella syndrome (CRS) by seroepidemiological surveys and surveillance programs in all countries without vaccination programs. Due to scarcity of data in developing countries, this study was conducted to assess the seromakers for natural rubella infection in Tanzania during prevaccination era so as to ascertain the gaps for future research and prevention strategies.
A cross-sectional study was conducted between September and October 2014. Indirect enzyme-linked immunosorbent assay was used to detect rubella IgG and IgM antibodies. STATA version 11 was used to perform data analysis.
Of 723 enrolled participants, 368 (50.8%) and 94 (13%) were positive for specific IgG and IgM rubella antibodies, respectively. On multivariable logistic regression analysis, significant determinants of rubella IgG seropositivity were increase in age (odds ratios [OR]: 1.24, 95% confidence interval [CI]: 1.18-1.29, < 0.001), low socioeconomic status (SES) (OR: 2.38, 95% CI: 1.1.23-4.50, = 0.010), and absence of rash (OR: 4.34, 95% CI: 1.1.17-15.3, = 0.027), while only the presence of rashes was significant determinant of rubella IgM seropositivity (OR: 2.5, 95%; 1.07-5.98, = 0.034). Significantly higher mean IgG titers were observed in population ≥10 years ( < 0.001), those residing in urban and peri-urban areas ( < 0.001), those from employed mothers ( = 0.018), and those with no current history of fever ( = 0.018).
The prevalence of specific rubella IgG antibodies in Tanzania is high and is associated with increase in age, absence of rash, and low SES. Results suggest a need to reconsider upper age limit for vaccination campaigns in developing countries. Screening and vaccinating women may be cost-effective campaign to prevent CRS in developing countries.
世界卫生组织倡导在所有未实施疫苗接种计划的国家，通过血清流行病学调查和监测项目来评估风疹及先天性风疹综合征（CRS）的负担。由于发展中国家数据匮乏，开展本研究以评估坦桑尼亚疫苗接种前时代自然风疹感染的血清学标志物，从而确定未来研究和预防策略的差距。
于2014年9月至10月进行了一项横断面研究。采用间接酶联免疫吸附试验检测风疹IgG和IgM抗体。使用STATA 11版进行数据分析。
在723名纳入研究的参与者中，分别有368名（50.8%）和94名（13%）风疹特异性IgG和IgM抗体呈阳性。多变量逻辑回归分析显示，风疹IgG血清阳性的显著决定因素包括年龄增加（比值比[OR]：1.24，95%置信区间[CI]：1.18 - 1.29，P < 0.001）、社会经济地位（SES）低（OR：2.38，95% CI：1.23 - 4.50，P = 0.010）以及无皮疹（OR：4.34，95% CI：1.17 - 15.3，P = 0.027），而只有皮疹的出现是风疹IgM血清阳性的显著决定因素（OR：2.5，95%；1.07 - 5.98，P = 0.034）。在年龄≥10岁的人群中（P < 0.001）、居住在城市和城郊地区的人群中（P < 0.001）、母亲有工作的人群中（P = 0.018）以及目前无发热病史的人群中（P = 0.018），观察到的平均IgG滴度显著更高。
坦桑尼亚风疹特异性IgG抗体的患病率较高，且与年龄增加、无皮疹和低SES相关。结果表明，有必要重新考虑发展中国家疫苗接种运动的年龄上限。对女性进行筛查和接种疫苗可能是发展中国家预防CRS的具有成本效益的运动。
