Murdoch Childrens Research Institute, Royal Children’s Hospital, Melbourne, Australia
Curtin University, School of Public Health, Perth, Western Australia, Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Australia
Infect Disord Drug Targets. 2020;20(3):284-290. doi: 10.2174/1871526518666181004092758.
Congenital Rubella Syndrome (CRS) is the leading cause of vaccine-preventable congenital anomalies. Comprehensive country-level data on the burden of CRS in low and middle-income countries, such as Bangladesh, are scarce. This information is essential for assessing the impact of rubella vaccination programs. We aim to systematically review the literature on the epidemiology of CRS and estimate the burden of CRS in Bangladesh.
We conducted a systematic review of existing literature and transmission modelling of seroprevalence studies to estimate the pre-vaccine period burden of CRS in Bangladesh. OVID Medline (1948 - 23 November 2016) and OVID EMBASE (1974 - 23 November 2016) were searched using a combination of the database-specific controlled vocabulary and free text terms. We used an age-stratified deterministic model to estimate the pre-vaccination burden of CRS in Bangladesh.
Ten articles were identified, published between 2000 and 2014, including seven crosssectional studies, two case series and one analytical case-control study. Rubella seropositivity ranged from 47.0% to 86.0% among all age population. Rubella sero-positivity increased with age. Rubella seropositivity among women of childbearing age was 81.0% overall. The estimated incidence of CRS was 0·99 per 1,000 live births, which corresponds to approximately 3,292 CRS cases annually in Bangladesh.
The estimated burden of CRS in Bangladesh during the pre-vaccination period was high. This will provide important baseline information to assess the impact and cost-effectiveness of routine rubella immunisation, introduced in 2012 in Bangladesh.
先天性风疹综合征（CRS）是可通过疫苗预防的先天性畸形的主要原因。在孟加拉国等中低收入国家，有关 CRS 负担的综合国家级数据非常匮乏。这些信息对于评估风疹疫苗接种规划的影响至关重要。我们旨在系统地回顾有关 CRS 流行病学的文献，并估计孟加拉国 CRS 的负担。
我们对现有文献进行了系统回顾，并对血清阳性率研究进行了传播建模，以估计孟加拉国疫苗接种前 CRS 的负担。我们使用 OVID Medline（1948 年至 2016 年 11 月 23 日）和 OVID EMBASE（1974 年至 2016 年 11 月 23 日）数据库，采用数据库特定的受控词汇和自由文本术语相结合的方法进行检索。我们使用年龄分层确定性模型来估计孟加拉国疫苗接种前 CRS 的负担。
共确定了 10 篇文章，发表于 2000 年至 2014 年期间，其中包括 7 项横断面研究、2 项病例系列研究和 1 项分析性病例对照研究。所有年龄人群的风疹血清阳性率范围为 47.0%至 86.0%。风疹血清阳性率随年龄增长而增加。育龄妇女的风疹血清阳性率总体为 81.0%。估计 CRS 的发病率为每 1000 例活产儿 0.99 例，相当于孟加拉国每年约有 3292 例 CRS 病例。
在疫苗接种前时期，孟加拉国 CRS 的估计负担很高。这将为评估 2012 年在孟加拉国引入的常规风疹免疫接种的影响和成本效益提供重要的基线信息。
