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Purnami N, Rachmadhan HF, Moon IS, Sudaryo MK. A Study Prevalence of Congenital Rubella Syndrome Cases Before and After Rubella Vaccination Campaign. Indian J Otolaryngol Head Neck Surg 2023; 75:2913-2920. [PMID: 37974742 PMCID: PMC10645922 DOI: 10.1007/s12070-023-03882-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/08/2023] [Indexed: 11/19/2023] Open
Abstract
Rubella is a vaccine-preventable disease and is the leading cause of congenital disabilities. This study was performed to identify the congenital rubella syndrome (CRS) patients before and after the Rubella Vaccination Campaign in the Outpatient Unit of the Audiology Department at Dr. Soetomo General Hospital Surabaya. This was a descriptive study that used secondary data from a CRS surveillance case investigation form and medical records from 2015 to 2020 at Dr. Soetomo Hospital. A total of 346 suspected CRS cases were included in this study. According to the final classification, 145 (41.9%) patients had clinical CRS, 65 (18.8%) had confirmed CRS, and 136 (39.3%) had discarded CRS. The majority of the suspected cases were in the < 1-month age group (27.4%). Hearing loss was the most prevalent symptom in both the pre and post-rubella vaccination campaign (RVC) introduction periods campaign among groups. A patient with suspected CRS clinical signs.
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Affiliation(s)
- Nyilo Purnami
- Department of Otorhinolaryngology Head and Neck Surgery (ORL-HNS), Faculty of Medicine Airlangga University, Dr. Soetomo General Academic Hospital Center, Jl. Mayjen Prof. Dr. Moestopo No. 6-8, Airlangga, Kec. Gubeng, Kota SBY, Surabaya, Jawa Timur 60286 Indonesia
| | - Hayyu Fath Rachmadhan
- Department of Otorhinolaryngology Head and Neck Surgery (ORL-HNS), Faculty of Medicine Airlangga University, Dr. Soetomo General Academic Hospital Center, Jl. Mayjen Prof. Dr. Moestopo No. 6-8, Airlangga, Kec. Gubeng, Kota SBY, Surabaya, Jawa Timur 60286 Indonesia
| | - In Seok Moon
- Department of Otorhinolaryngology, Yonsei University, Seoul, South Korea
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Goel V, Mathew S, Gudi N, Jacob A, John O. A scoping review on laboratory surveillance in the WHO Southeast Asia Region: Past, present and the future. J Glob Health 2023; 13:04028. [PMID: 37083001 PMCID: PMC10119808 DOI: 10.7189/jogh.13.04028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
Background The South-East Asia (SEA) region bears a significant proportion of the world's communicable disease burden. The onset of the COVID-19 pandemic has further affected the situation. A well-established laboratory-based surveillance (LBS) can reduce the burden of infectious diseases. In light of this, the review collated the existing literature on LBS system in the region and the modifications adopted by the surveillance systems during the pandemic. Methodology We followed the guidelines for scoping review as prescribed by Arskey and O'Malley. We comprehensively searched three databases (PubMed, Scopus and CINAHL) and supplemented it with grey literature search. The screening of the articles was conducted at the title and abstract followed by full-text screening. This was followed by data extraction using a pre-tested data extraction tool by two independent reviewers. The results were presented narratively. Results Including 75 relevant articles and documents, we compiled a list of surveillance systems. A shift from paper to dual (paper and electronic) modalities was identified across the countries. This largely low- and middle-income countries (LMIC) area face challenges in reporting, resources, and collaboration-related issues. While some countries have well-established National Reference Laboratories; others have more private than public-owned laboratories. Given the COVID-19 pandemic, modifications to the existing laboratory capacities to enable real-time surveillance was identified. Laboratory capacity complemented with genomic surveillance can indubitably aid in disease detection and control. Limitations due to inaccessible government portals, and language barriers are acknowledged. This review identified a comprehensive list of surveillance systems in the region, challenges faced in using these surveillance systems and inform the decision makers about the benefits of integrating fragmented surveillance systems. Conclusion Regionally and nationally integrated genomic and laboratory surveillance systems justify capital investments, as their payoffs rationalise such costs owing to economies of scale over time. Further, as data flows are harmonized and standardized, algorithm- and computing-based pattern recognition methods allow for targeted and accurate disease prediction when integrated with, potentially, climate and weather systems data. Trained human resources are a sine qua non to optimize such investments, but in the medium to long run, such investments will buttress initiatives in other arenas at the regional level.
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Affiliation(s)
- Vidushi Goel
- The George Institute for Global Health, New Delhi, India
| | - Silvy Mathew
- The George Institute for Global Health, New Delhi, India
| | - Nachiket Gudi
- Public Health Evidence South Asia, Department of Health Information, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anil Jacob
- The George Institute Services, New Delhi, India
| | - Oommen John
- The George Institute for Global Health, New Delhi, India
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Herini ES, Triono A, Iskandar K, Nuady A, Pujiastuti LH, Marcellus, Nugrahanto AP, Kamal M, Gunadi. Phylogenetic analysis of congenital rubella virus from Indonesia: a case report. BMC Pediatr 2022; 22:713. [PMID: 36513987 PMCID: PMC9745697 DOI: 10.1186/s12887-022-03775-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 11/24/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Rubella is a common inherited infection resulting in congenital cataracts and a significant cause of permanent vision loss in developing countries. In 2016, Indonesia had the highest number of congenital rubella syndrome (CRS) cases globally. Here, we report the first genotype of the rubella virus extracted from the eye lens from a child with congenital cataracts due to CRS. CASE PRESENTATION A female neonate was delivered by an elective caesarean delivery with normal birth weight at term from a 24-year-old mother in the rural setting. The baby presented with bilateral congenital cataracts, small-moderate secundum atrial septal defect, severe supravalvular pulmonary stenosis, and profound bilateral hearing loss. She also had microcephaly and splenomegaly. The patient's serology showed persistent positive IgG for rubella virus at the age of four years and four months. Following extraction during cataract surgery, viral detection of the lenses identified the presence of rubella. Phylogenetic analysis confirmed that the virus was grouped into genotype 1E. CONCLUSIONS Our study reports the first phylogenetic analysis of the rubella virus extracted from the eye lens of a child with CRS in Indonesia. The detection of the rubella virus from eye lenses is remarkably promising. Our findings also emphasize the importance of molecular epidemiology in tracking the origin of rubella infection toward achieving virus eradication.
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Affiliation(s)
- Elisabeth Siti Herini
- grid.8570.a0000 0001 2152 4506Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281 Indonesia
| | - Agung Triono
- grid.8570.a0000 0001 2152 4506Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281 Indonesia
| | - Kristy Iskandar
- grid.8570.a0000 0001 2152 4506Department of Child Health/Genetics Working Group, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/UGM Academic Hospital, Yogyakarta, 55281 Indonesia
| | - Albaaza Nuady
- grid.8570.a0000 0001 2152 4506Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281 Indonesia
| | | | - Marcellus
- grid.8570.a0000 0001 2152 4506Pediatric Surgery Division, Department of Surgery/Genetics Working Group, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281 Indonesia
| | - Andika Priamas Nugrahanto
- grid.8570.a0000 0001 2152 4506Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281 Indonesia
| | - Musthofa Kamal
- World Health Organization (WHO) Indonesia Representative, Jakarta, 12940 Indonesia
| | - Gunadi
- Pediatric Surgery Division, Department of Surgery/Genetics Working Group, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia.
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Priyanka P, Vyas V, Deora S, Nag VL, Singh K. Epidemiology, etiology and clinical associations of congenital heart disease identified during congenital rubella syndrome surveillance. J Trop Pediatr 2022; 68:6777799. [PMID: 36306124 DOI: 10.1093/tropej/fmac089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Congenital heart disease (CHD) is a common congenital malformation. Antenatal rubella infection in the mother and genetic defects are important causes to which CHD are attributed. Exact contribution of antenatal rubella infection or genetic causes to CHD is still unknown. OBJECTIVE To study the epidemiology, etiology and clinical associations of echocardiographically confirmed congenital heart disease in infants in Western Rajasthan enrolled in the congenital rubella syndrome (CRS) surveillance project. To study the utility of clinical diagnostic criteria in identifying congenital rubella infection. METHOD This was a prospective observational study, in which 251 patients with echocardiographically confirmed CHD were enrolled. Detailed clinical evaluation was done in all patients. Rubella serology was done in all patients. Genetic and other testing was done as appropriate. RESULT The hospital-based prevalence of CHD in infants was 1% at our center. Fifty-seven percent of the babies had acyanotic septal heart defects of which ventricular septal defect (VSD) was the most common (35%). Anti-rubella immunoglobulin M (IgM) antibodies were positive in 8.5% of the CHD patients. A clinically identifiable genetic cause was present in 3.6% of the cases. In patients who tested positive for anti-rubella IgM antibodies also, VSD was the most common (33%) CHD followed by Tetralogy of Fallot (13.2%). CONCLUSION CRS contributes to 8.5% of CHD. CRS is associated with a wide spectrum of CHD. The etiology of a large number of CHD remains elusive. Detailed studies on the cause and mechanism of development of CHD need to be undertaken.
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Affiliation(s)
- Priyanka Priyanka
- Department of Pediatrics, All India Institute of Medical Science (AIIMS), Jodhpur, India
| | - Varuna Vyas
- Department of Pediatrics, All India Institute of Medical Science (AIIMS), Jodhpur, India
| | - Surender Deora
- Department of Cardiology, All India Institute of Medical Science (AIIMS), Jodhpur, India
| | - Vijaya Lakshmi Nag
- Department of Microbiology, All India Institute of Medical Science (AIIMS), Jodhpur, India
| | - Kuldeep Singh
- Department of Pediatrics, All India Institute of Medical Science (AIIMS), Jodhpur, India
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Congenital Rubella Syndrome Surveillance After Measles Rubella Vaccination Introduction in Yogyakarta, Indonesia. Pediatr Infect Dis J 2021; 40:1144-1150. [PMID: 34609101 DOI: 10.1097/inf.0000000000003290] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Congenital rubella syndrome (CRS) is a fatal disease causing severe congenital defects. Indonesia had the highest CRS cases in the world in 2016 with a commitment to achieve elimination of rubella disease by 2020, through the campaign and introduction of measles rubella (MR) national vaccination program in 2017 and 2018. This study aimed to describe the impact of the national vaccination campaign by conducting surveillance of CRS cases and comparing the incidence of new CRS cases before and after the MR vaccination campaign. METHODS From July 2015 to July 2020, we conducted surveillance of CRS in Yogyakarta. Suspected patients underwent complete clinical examinations. Serology was tested for the presence of IgM and IgG antibodies against rubella. Descriptive analysis was used to characterize the demographic and clinical characteristics of the cases before and after the MR vaccination campaign. RESULTS The study involved 229 infants who were suspected for CRS. Laboratory-confirmed cases were found in 47 of them (20.86%). Most of the laboratory-confirmed cases (55.3%) were reported among 1-5 months old infants. Common clinical features among laboratory-confirmed cases included structural heart defects in 43 (91.4%). There was a significant decrease (60.9%) of CRS incidence from 0.39 per 1000 live births in the precampaign era to 0.08 in the postcampaign era (P = 0.00). CONCLUSION There has been a significant declining number of CRS cases based on pre- and post-MR vaccination campaign in Yogyakarta, Indonesia. An effective surveillance system will help monitor the number of CRS cases.
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Abstract
Congenital hearing loss is the most common birth defect, estimated to affect 2-3 in every 1000 births. Currently there is no cure for hearing loss. Treatment options are limited to hearing aids for mild and moderate cases, and cochlear implants for severe and profound hearing loss. Here we provide a literature overview of the environmental and genetic causes of congenital hearing loss, common animal models and methods used for hearing research, as well as recent advances towards developing therapies to treat congenital deafness. © 2021 The Authors.
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Affiliation(s)
- Justine M Renauld
- Department of Otolaryngology, Head & Neck Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Martin L Basch
- Department of Otolaryngology, Head & Neck Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Department of Genetics and Genome Sciences, Case Western Reserve School of Medicine, Cleveland, Ohio.,Department of Biology, Case Western Reserve University, Cleveland, Ohio.,Department of Otolaryngology, Head & Neck Surgery, University Hospitals, Cleveland, Ohio
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Purnami N, Pontoh V. Correlation immunoglobulin M antibody of rubella with hearing loss in infants suspected congenital rubella syndrome. INDIAN JOURNAL OF OTOLOGY 2021. [DOI: 10.4103/indianjotol.indianjotol_116_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rosalina E, Purnami N. Congenital Rubella Syndrome profile of audiology outpatient clinic in Surabaya, Indonesia. Infect Dis Rep 2020; 12:8762. [PMID: 32874477 PMCID: PMC7447925 DOI: 10.4081/idr.2020.8762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 07/01/2020] [Indexed: 11/23/2022] Open
Abstract
Congenital Rubella Syndrome (CRS) consists of hearing impairment, ophthalmology abnormalities, and congenital heart disease in children, resulting from rubella infection during pregnancy. Rubella vaccine has been implemented as national immunization program in Indonesia since 2017, and needed to be evaluated. This study aimed to report the CRS patients' profile of Audiology Outpatient Clinic in Surabaya. A descriptive study from patient's medical record was conducted in Dr. Soetomo Hospital Surabaya from January 2016 to December 2017. CRS was categorized using World Health Organization classification. Suspected infants with CRS burden were assessed by Otoacoustic Emission and rubella antibody test. Ninety five infants suspected with CRS classified as laboratory- confirmed CRS (58.95%), clinically confirmed CRS (15.79%), and discarded CRS (25.26%). Clinical manifestations included combination of congenital heart disease and hearing impairment (17.89%), congenital heart disease, ophthalmology abnormalities, and hearing impairment (16.84%), and hearing impairment and ophthalmology abnormalities (13.68%). The data show a high burden of CRS in Surabaya. These implies the urgent need for national rubella immunization program.
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Affiliation(s)
- Elsa Rosalina
- Faculty of Medicine, Universitas Airlangga, Surabaya
| | - Nyilo Purnami
- Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo Hospital, Surabaya, Indonesia
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Shokri S, Shahkarami MK, Shafyi A, Mohammadi A, Esna-ashari F, Hamta A. Evaluation of the thermal stability of live-attenuated Rubella vaccine (Takahashi strain) formulated and lyophilized in different stabilizers. J Virol Methods 2019; 264:18-22. [DOI: 10.1016/j.jviromet.2018.08.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 07/09/2018] [Accepted: 08/20/2018] [Indexed: 11/26/2022]
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Herini ES, Gunadi, Triono A, Wirastuti F, Iskandar K, Mardin N, Soenarto Y. Clinical profile of congenital rubella syndrome in Yogyakarta, Indonesia. Pediatr Int 2018; 60:168-172. [PMID: 29068106 DOI: 10.1111/ped.13444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 10/09/2017] [Accepted: 10/20/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Congenital rubella syndrome (CRS) has many severe neurological manifestations and other systemic consequences. Although various studies have been done in Indonesia, there are no conclusive results on CRS incidence. The aim of this study was therefore to investigate the incidence, clinical manifestations and outcomes of CRS in Yogyakarta, Indonesia. METHODS A descriptive study involving a review of congenital anomalies associated with CRS was carried out at Dr Sardjito Hospital, Yogyakarta, Indonesia, from July 2008 to June 2013. CRS was categorized according to the World Health Organization (WHO) classification. This study involved children aged <1 year old, and was conducted at the outpatient clinic, pediatric and neonatology wards. RESULTS A total of 201 children met the criteria for suspected CRS during the 5 year study. Of those patients, 6% were classified as having laboratory-confirmed CRS, 21.4% as having clinically compatible CRS, and 72.6% as having discarded CRS (i.e. a suspected case that does not meet the criteria for CRS). The estimated incidence of laboratory-confirmed CRS and laboratory-confirmed and clinically compatible CRS in Yogyakarta, Indonesia during the study period was 0.05:1,000 and 0.25:1,000 live births, respectively. Of the laboratory-confirmed CRS patients, 83.3% of children had congenital heart disease (CHD), 75% had hearing impairment, 66.7% had congenital cataract and 50% had microcephaly. Furthermore, none of the mothers was vaccinated against rubella. CONCLUSIONS The incidence of CRS in infants in Yogyakarta Indonesia is considered high, with most clinical manifestations being CHD, hearing impairment and congenital cataract. This emphasizes the necessity for epidemiological study of CRS in other hospitals and the importance of establishing a national rubella vaccination program in Indonesia.
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Affiliation(s)
- Elisabeth S Herini
- Department of Child Health, Faculty of Medicine, Universitas Gadjah Mada/Dr Sardjito Hospital, Yogyakarta, Indonesia
| | - Gunadi
- Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr Sardjito Hospital, Yogyakarta, Indonesia
| | - Agung Triono
- Department of Child Health, Faculty of Medicine, Universitas Gadjah Mada/Dr Sardjito Hospital, Yogyakarta, Indonesia
| | - Fita Wirastuti
- Department of Child Health, Faculty of Medicine, Universitas Gadjah Mada/UGM Academic Hospital, Yogyakarta, Indonesia
| | - Kristy Iskandar
- Department of Child Health, Faculty of Medicine, Universitas Gadjah Mada/UGM Academic Hospital, Yogyakarta, Indonesia
| | | | - Yati Soenarto
- Department of Child Health, Faculty of Medicine, Universitas Gadjah Mada/Dr Sardjito Hospital, Yogyakarta, Indonesia
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