สถาบันวิจัยวิทยาศาสตร์สาธารณสุข

National Institute of Health of Thailand

Developing Rubella Vaccination Policy in Nepal—Results From Rubella Surveillance and Seroprevalence and Congenital Rubella Syndrome Studies

Authors : Shyam Raj Upreti,1 Kusum Thapa,2 Yasho Vardan Pradhan,1 Geeta Shakya,1 Yuddha Dhoj Sapkota,3 Abhijeet Anand,4 Thomas Taylor,4 Ondrej Mach,4 Susan Reef,4 Sirima Pattamadilok,5 Jayantha Liyanage,6 Patrick O'Connor,6 Tika Sedai,7 Sagar Ram Bhandary,7 Jeffrey Partridge,7 and William Schluter7

 

Affiliations : 

1 Department of Health Services, Ministry of Health and Population
2 Paropakar Mother and Womens Hospital, Ministry of Health and Population
3 Nepal Netra Jyoti Sangh, Kathmandu, Nepal
4 Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia
5 Rubella Virus Laboratory, National Institute of Health, Nonthaburi, Thailand
6 Immunization and Vaccine Development, The World Health Organization, Regional Office for South East Asia, New Delhi, India
7 Programme for Immunization Preventable Diseases, The World Health Organization, Country Office for Nepal

Source :

The Journal of Infectious Diseases 2011;204:S433–S438

Language : Thai

Abstract :

 
 

      Background. The Government of Nepal is interested in preventing congenital rubella syndrome (CRS). Surveillance data were analyzed and studies conducted to assess the burden of rubella and CRS and aid in developing a rubella vaccination strategy.
      Methods. (1) Analysis of rubella cases reported through measles surveillance, 2004 - 2009; (2) in 2008, rubella seroprevalence among women 15 to 39 years of age was evaluated; and (3) in 2009, children attending a school for the deaf were examined for ocular defects associated with CRS.
      Results. From 2004-2009, there were 3,710 confirmed rubella cases and more than 95% of these cases were less than 15 years of age. Of 2,224 women of childbearing age (WCBA) tested for anti-rubella IgG, 2,020 (90.8%) were seropositive. Using a catalytic infection model, approximately 1,426 infants were born with CRS (192/100,000 live births) in 2008. Among 243 students attending a school for the deaf, 18 (7.4%) met the clinical criteria for CRS.
      Conclusions. Rubella and CRS were documented as significant public health problems in Nepal. A comprehensive approach is necessary, including introducing rubella vaccine in the routine program, assuring immunity among WCBA, strengthening routine immunization, integrating rubella surveillance with measles casebased surveillance, and establishing CRS surveillance.