A rubella serosurvey in postpartum women in the three regions of Peru.
OBJECTIVE
To determine the proportion of postpartum women aged 15-49 in Peru who are susceptible to rubella, in order to help address strategies to eliminate rubella and to prevent congenital rubella syndrome (CRS) in the country.


METHODS
A cross-sectional survey was conducted during March and April 2003 in six main regional hospitals, in the three geographic regions (coast, mountain, and jungle) of Peru. For the postpartum women who provided written informed consent, a questionnaire was administered and a blood specimen was collected. Sera were tested for rubella immunoglobulin G (IgG) antibody, using a commercial enzyme-linked immunosorbent serologic assay (ELISA) kit. Univariate, bivariate, and multivariate analyses were carried out to assess risk factors for susceptibility.


RESULTS
In total, 1 236 postpartum women were enrolled. The overall proportion of IgG-antibody negative women was 12.8% (95% confidence interval (CI): 10.9%-14.6%). Bivariate analysis found the following variables associated with susceptibility: living in the jungle region (odds ratio (OR) = 1.65; 95% CI: 1.13-2.42); age < 19 years (OR = 2.02; 95% CI: 1.35-3.03); being a housewife (OR = 1.69; 95% CI: 1.12-2.55); and having < or = 11 years of education (OR = 2.12; 95% CI :1.20-3.75). Multivariate analysis found the following variables were associated with susceptibility: living in the jungle region (OR = 1.67; 95% CI: 1.13-2.46); age < 19 years (OR = 1.62; 95% CI: 1.07-2.47); having < 4 children born alive (OR = 1.85; 95% CI: 1.00-3.40); and having < or = 11 years of education (OR = 2.07; 95% CI: 1.16-3.71).


CONCLUSIONS
The proportion of postpartum women at the study sites who were found to be susceptible to rubella was 12.8%, placing Peru among the countries facing a moderate level of risk for the occurrence of CRS cases. The findings suggest the need to also provide the rubella vaccine to other population groups, especially women of childbearing age.
Suárez-Ognio
Luis
L
General Office of Epidemiology, Ministry of Health, Lima, Peru. lsuarez@oge.sld.pe
Adrianzén
Ana
A
Ortiz
Ana
A
Martínez
Carlos
C
Whittembury
Alvaro
A
Cabezudo
Edwin
E
de Oliveira
Lucia
L
Siqueira
Marilda M
MM
Castillo-Solórzano
Carlos
C
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003625:Data Collection; D003627:Data Interpretation, Statistical; D004198:Disease Susceptibility; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007258:Informed Consent; D008875:Middle Aged; D016017:Odds Ratio; D010568:Peru; D049590:Postpartum Period; D011247:Pregnancy; D012307:Risk Factors; D012409:Rubella / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D012410:Rubella Syndrome, Congenital / Q000517:prevention & control*; D012412:Rubella virus / Q000276:immunology; D016036:Seroepidemiologic Studies; D012959:Socioeconomic Factors
D000914:Antibodies, Viral; D007074:Immunoglobulin G