National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa.
Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.
Clin Infect Dis. 2019 May 2;68(10):1658-1664. doi: 10.1093/cid/ciy758.
Congenital rubella syndrome (CRS) includes disorders associated with intrauterine rubella infection. Incidence of CRS is higher in countries with no rubella-containing vaccines (RCV) in their immunization schedules. In the World Health Organization African region, RCVs are being introduced as part of the 2012-2020 global measles and rubella strategic plan. This study aimed to describe the epidemiology of confirmed CRS in South Africa prior to introduction of RCVs in the immunization schedule.
This was a descriptive study with 28 sentinel sites reporting laboratory-confirmed CRS cases in all 9 provinces of South Africa. In the retrospective phase (2010 to 2014), CRS cases were retrieved from medical records, and in the prospective phase (2015 to 2017) clinicians at study sites reported CRS cases monthly.
There were 42 confirmed CRS cases in the retrospective phase and 53 confirmed CRS cases in the prospective phase. Most frequently reported birth defects were congenital heart disease and cataracts. The median age of mothers of CRS cases was 21 years in the retrospective phase (range: 11 to 38 years) and 22 years in the prospective phase (range: 15 to 38 years).
Baseline data on laboratory-confirmed CRS will enable planning and monitoring of RCV implementation in the South African Expanded Programme on Immunization program. Ninety-eight percent of mothers of infants with CRS were young women 14-30 years old, indicating a potential immunity gap in this age group for consideration during introduction of RCV.
先天性风疹综合征（CRS）包括与宫内风疹感染相关的疾病。在免疫计划中没有含风疹疫苗（RCV）的国家，CRS 的发病率较高。在世卫组织非洲区域，正在将 RCV 作为 2012-2020 年全球麻疹和风疹战略计划的一部分引入。本研究旨在描述南非在免疫计划中引入 RCV 之前 CRS 的流行病学情况。
这是一项描述性研究，有 28 个哨点报告了南非所有 9 个省的实验室确诊 CRS 病例。在回顾性阶段（2010 年至 2014 年），从病历中检索到 CRS 病例，在前瞻性阶段（2015 年至 2017 年），研究地点的临床医生每月报告 CRS 病例。
在回顾性阶段有 42 例确诊的 CRS 病例，在前瞻性阶段有 53 例确诊的 CRS 病例。报告的最常见出生缺陷是先天性心脏病和白内障。CRS 病例母亲的中位年龄在回顾性阶段为 21 岁（范围：11 至 38 岁），在前瞻性阶段为 22 岁（范围：15 至 38 岁）。
实验室确诊的 CRS 的基线数据将为南非扩大免疫规划计划中 RCV 的实施规划和监测提供依据。98%的 CRS 婴儿的母亲是 14-30 岁的年轻女性，这表明在引入 RCV 时需要考虑该年龄组的潜在免疫空白。
