Prevalence of eye signs in congenital rubella syndrome in South India: a role for population screening.
OBJECTIVE
Congenital rubella syndrome (CRS) resulting from maternal rubella infection, especially in the first trimester, affects an estimated 100 000 infants each year worldwide. Immunisation has reduced its occurrence in the developed world, though it remains a problem in countries with poor immunisation coverage. This population-based study was aimed at screening children below 5 years of age for ocular signs suspicious of CRS.


METHODS
Suspected CRS cases were recruited from hospital and outreach services of the Aravind Eye Care System over a 24-month period. Clinical confirmation was based on the fulfilment of the World Health Organization (WHO) definition, and laboratory confirmation was based on a positive test for IgM antibody.


RESULTS
Children under 5 years of age (n = 51 548) with ocular complaints were screened for eye signs suspicious of CRS; CRS compatible signs were detected in 1.92% (1090) children. Of these suspects (299), 27.42% were subsequently confirmed clinically according to WHO definition, and (46) 4.2% were serologically (Laboratory) confirmed. Of all the eye signs evaluated for screening, cataracts were the most sensitive (80.43%).


CONCLUSIONS
Cataracts among children have a high sensitivity for detecting CRS in India. It is the only clinical eye finding that has a high enough sensitivity and specificity to be useful as a screening tool for CRS.
Vijayalakshmi
P
P
Aravind Eye Hospital, 1, Annanagar, Madurai 625 020, India. p.vijayalakshmi@aravind.org
Rajasundari
T Amala
TA
Prasad
Noela Marie
NM
Prakash
S Karthik
SK
Narendran
Kalpana
K
Ravindran
Meenakshi
M
Muthukkaruppan
V R
VR
Lalitha
Prajna
P
Brown
David W G
DW
D002386:Cataract / Q000151:congenital / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D002675:Child, Preschool; D003906:Developing Countries; D005124:Eye Abnormalities / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D015828:Eye Infections, Viral / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening; D015995:Prevalence; D012410:Rubella Syndrome, Congenital / Q000175:diagnosis / Q000453:epidemiology*