title: Congenital rubella syndrome surveillance as a platform for surveillance of other congenital infections, Peru, 2004-2007.
abstract: BACKGROUND
  Rubella during pregnancy can cause serious fetal abnormalities and death. Peru has had integrated measles/rubella surveillance since 2000 but did not implement congenital rubella syndrome (CRS) surveillance until 2004, in accordance with the Pan American Health Organization recommendations for rubella elimination. The article describes the experience from the CRS sentinel surveillance system in Peru.
  
  
  METHODS
  Peru has maintained a national sentinel surveillance system for reporting confirmed and suspected CRS cases since 2004. A surveillance protocol was implemented with standardized case definitions and instruments in the selected sentinel sites. Each sentinel site completes their case investigations and report forms and sends the reports to the Health Region Epidemiology Department, which forwards the data to the national Epidemiology Department. CRS surveillance data were analyzed for the period 2004-2007.
  
  
  RESULTS
  During the period 2004-2007, 16 health facilities, which are located in 9 of the 33 health regions, representing the 3 main geographical areas (coast, mountain, and jungle), were included as sentinel sites for the CRS surveillance. A total of 2061 suspected CRS cases were reported to the system. Of these, 11 were classified as CRS and 23 as congenital rubella infection. Factors significantly associated with rubella vertical transmission were: (1) in the mother, maternal history of rash during pregnancy (odds ratio [OR], 12.0; 95% confidence interval [CI], 3.8-37.8); (2) and in the infant, pigmentary retinopathy (OR, 18.4; 95% CI, 3.2-104.6), purpura (OR, 14.7; 95% CI, 2.8-78.3), and developmental delay (OR, 4.4; 95% CI, 1.75-11.1).
  
  
  CONCLUSIONS
  The surveillance system has been able to identify rubella vertical transmission, reinforcing the evidence that rubella was a public health problem in Peru. This system may serve as a platform to implement surveillance for other congenital infections in Peru.
authors.affiliation: Dirección General de Epidemiología, Ministerio de Salud, Lima, Perú. alwhittvla@yahoo.com
authors.forename: Alvaro
authors.initials: A
authors.lastname: Whittembury
authors.forename: Jorge
authors.initials: J
authors.lastname: Galdos
authors.forename: María
authors.initials: M
authors.lastname: Lugo
authors.forename: Luis
authors.initials: L
authors.lastname: Suárez-Ognio
authors.forename: Ana
authors.initials: A
authors.lastname: Ortiz
authors.forename: Edwin
authors.initials: E
authors.lastname: Cabezudo
authors.forename: Mario
authors.initials: M
authors.lastname: Martínez
authors.forename: Carlos
authors.initials: C
authors.lastname: Castillo-Solórzano
authors.forename: Jon Kim
authors.initials: JK
authors.lastname: Andrus
mesh_terms: D003140:Communicable Disease Control; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D016017:Odds Ratio; D010568:Peru / Q000453:epidemiology; D011159:Population Surveillance; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000517:prevention & control; D012410:Rubella Syndrome, Congenital / Q000453:epidemiology* / Q000517:prevention & control*