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Motaze NV, Manamela J, Smit S, Rabie H, Harper K, duPlessis N, Reubenson G, Coetzee M, Ballot D, Moore D, Nuttall J, Linley L, Tooke L, Kriel J, Hallbauer U, Sutton C, Moodley P, Hardie D, Mazanderani AH, Goosen F, Kyaw T, Leroux D, Hussain A, Singh R, Kelly C, Ducasse G, Muller M, Blaauw M, Hamese M, Leeuw T, Mekgoe O, Rakgole P, Dungwa N, Maphosa T, Sanyane K, Preiser W, Cohen C, Suchard M. Congenital Rubella Syndrome Surveillance in South Africa Using a Sentinel Site Approach: A Cross-sectional Study. Clin Infect Dis 2020; 68:1658-1664. [PMID: 30203002 PMCID: PMC6495013 DOI: 10.1093/cid/ciy758] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 08/31/2018] [Indexed: 11/12/2022] Open
Abstract
Background 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. Methods 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. Results 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). Conclusion 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.
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Affiliation(s)
- Nkengafac Villyen Motaze
- 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
| | - Jack Manamela
- National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Sheilagh Smit
- National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Helena Rabie
- Department of Pediatrics, Tygerberg Hospital, Stellenbosch University, South Africa
| | - Kim Harper
- Department of Pediatrics, Frere Hospital, East London, South Africa
| | - Nicolette duPlessis
- Department of Pediatrics, Kalafong Hospital, University of Pretoria, South Africa
| | - Gary Reubenson
- Department of Pediatrics and Child Health, Empilweni Service and Research Unit, Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Melantha Coetzee
- Department of Paediatrics and Child Health, Steve Biko Academic Hospital, University of Pretoria, South Africa
| | - Daynia Ballot
- Department of Pediatrics and Child Health, Charlotte Maxeke Academic Hospital, Johannesburg
| | - David Moore
- Department of Pediatrics and Child Health, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | - James Nuttall
- Department of Pediatrics, Red Cross War Memorial Children's Hospital, South Africa
| | - Lucy Linley
- Department of Pediatrics, Mowbray Maternity Hospital, South Africa
| | - Lloyd Tooke
- Department of Pediatrics, Groote Schuur Hospital, University of Cape Town, South Africa
| | - Jeannette Kriel
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Ute Hallbauer
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Christopher Sutton
- Department of Pediatrics and Child Health, Polokwane Hospital, University of Limpopo, South Africa
| | - Pravi Moodley
- Department of Virology, Inkosi Albert Luthuli Central Hospital, University of Kwazulu-Natal, South Africa
| | - Diana Hardie
- Division of Medical Virology, Groote Schuur Hospital, University of Cape Town, South Africa
| | - Ahmad Haeri Mazanderani
- National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Felicity Goosen
- Department of Pediatrics, Cecilia Makiwane Hospital, East London, South Africa
| | - Thanda Kyaw
- Department of Virological Pathology, Dr George Mukhari Academic Hospital, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Dave Leroux
- Department of Pediatrics, New Somerset Hospital, University of Cape Town, South Africa
| | - Akhtar Hussain
- Department of Pediatrics, Prince Mshiyeni Memorial Hospital, Durban
| | - Radhika Singh
- Department of Pediatrics, King Edward VIII Hospital, Durban
| | | | - Graham Ducasse
- Department of Pediatrics, Grey's Hospital, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | | | - Magdaleen Blaauw
- Department of Pediatrics and Neonatology, Dr Harry Surtie Hospital, Upington, South Africa
| | - Mohlabi Hamese
- Department of Pediatrics and Child Health, Mankweng Hospital, University of Limpopo, South Africa
| | - Tumelo Leeuw
- Department of Pediatrics, Mafikeng Provincial Hospital, South Africa
| | - Omphile Mekgoe
- Department of Pediatrics, Klerksdorp Hospital, South Africa
| | - Philemon Rakgole
- Department of Pediatrics, Job Shimankana Tabane Hospital, Rustenburg, South Africa
| | - Norman Dungwa
- Department of Pediatrics, Witbank Hospital, South Africa
| | - Thulisile Maphosa
- Department of Pediatrics, Rob Fereirra Hospital, Nelspruit, South Africa
| | - Kgomotso Sanyane
- Department of Pediatrics, Dr George Mukhari Hospital, Sefako Makgatho University, Pretoria, South Africa
| | - Wolfgang Preiser
- Division of Medical Virology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service Tygerberg, South Africa
| | - Cheryl Cohen
- National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa.,Division of Epidemiology and Biostatistics, School of Public Health, Johannesburg, South Africa
| | - Melinda Suchard
- National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa.,Chemical Pathology, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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