Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
, P.O. Box 8418, Moshi, Tanzania.
Ital J Pediatr. 2017 Jul 21;43(1):63. doi: 10.1186/s13052-017-0379-3.
Childhood rubella infection is a mild, self-limiting illness. Rubella infection among pregnant women however, is a major public health concern. Depending on gestation age, it may result in fetal death, stillbirth or a new-born with congenital rubella syndrome (CRS). Maternal antibodies protect young infants from rubella infection and lifelong immunity is acquired by vaccination or post-rubella infection. This study aims at characterizing rubella infection and its epidemiology in the Kilimanjaro region, prior to the introduction of the rubella vaccine in Tanzania.
This was a population based cross-sectional study, covering all the seven districts in Kilimanjaro region, North-eastern Tanzania. The study population included children of 0 to 36 months of age and their mothers/primary caretakers. A multistage sampling method was used to obtain a representative sample of the children. Interviews were conducted using a structured questionnaire. Dried blood spot (DBS) samples were taken from eligible children. Rubella specific IgG antibodies were detected from eluted serum by enzyme-linked immunosorbent assay (ELISA). Descriptive statistics were used to summarize the data, the difference between groups was tested by Fishers exact test or chi square test as appropriate. Univariate and multivariate analysis was used, with rubella sero-positive groups as dependent variables and the socio-demographic, children, paediatric and parental factors as independent variables, the Odds ratio and their 95% confidence intervals were calculated to assess the strength of association between the dependent and independent variables. A p value less than 0.05 was considered significant.
The overall rubella sero-prevalence was 1.8%. Rural residence was associated with greater risk for rubella infection. Other family characteristic did not predict rubella infection.
This study highlights the low natural immunity to rubella among children prior to the introduction of rubella vaccine in Tanzania. Our research underscores the need for an effective rubella vaccination program to prevent CRS. More epidemiologic and immunologic studies are needed to guide the vaccination deployment and administration strategy in Tanzania.
儿童风疹感染是一种轻度、自限性疾病。然而，孕妇风疹感染是一个主要的公共卫生问题。根据妊娠年龄的不同，它可能导致胎儿死亡、死产或新生儿患有先天性风疹综合征（CRS）。母体抗体可保护幼儿免受风疹感染，且通过接种疫苗或感染后获得终身免疫力。本研究旨在坦桑尼亚引入风疹疫苗之前，描述基利马尼地区风疹感染及其流行病学特征。
这是一项基于人群的横断面研究，涵盖了坦桑尼亚东北部基利马尼地区的所有七个区。研究人群包括 0 至 36 个月大的儿童及其母亲/主要照顾者。采用多阶段抽样方法获得儿童的代表性样本。使用结构化问卷进行访谈。从合格的儿童中采集干血斑（DBS）样本。通过酶联免疫吸附试验（ELISA）从洗脱的血清中检测风疹特异性 IgG 抗体。使用描述性统计来总结数据，使用 Fisher 确切检验或适当的卡方检验检验组间差异。使用单变量和多变量分析，将风疹血清阳性组作为因变量，社会人口统计学、儿童、儿科和父母因素作为自变量，计算优势比及其 95%置信区间，以评估因变量与自变量之间的关联强度。p 值小于 0.05 被认为具有统计学意义。
风疹总血清阳性率为 1.8%。农村居住与风疹感染风险增加相关。其他家庭特征不能预测风疹感染。
本研究强调了在坦桑尼亚引入风疹疫苗之前，儿童对风疹的天然免疫力较低。我们的研究强调需要有效的风疹疫苗接种计划来预防 CRS。需要更多的流行病学和免疫学研究来指导坦桑尼亚的疫苗接种部署和管理策略。
