title: Seroprevalence of rubella in the cord blood of pregnant women and congenital rubella incidence in Nha Trang, Vietnam.
abstract: To investigate susceptibility to and factors associated with rubella infection among pregnant mothers and to estimate the burden of congenital rubella infection (CRI) in Vietnam where rubella-containing vaccine (RCV) is not included in the routine immunization program, we conducted a prospective cohort study in Nha Trang, Vietnam between 2009 and 2010. Rubella-specific immunoglobulin-M and immunoglobulin-G were investigated in cord blood samples by enzyme immunoassay. Corresponding clinical-epidemiological data were analyzed and the national congenital rubella syndrome (CRS) incidence was estimated using modeling. We enrolled 1988 pairs of mothers aged 17-45 years and their newborn babies. No mothers had received RCV. Multivariate analysis revealed that mothers aged 17-24 (aOR 2.5, 95% CI: 1.7-3.8) or 25-34 (1.4, 1.0-2.1) years were more likely to be susceptible than those aged 35-45 years. Overall 28.9% (574/1988, 95% CI: 26.9-30.9%) of mothers were seronegative. The CRI rate was 151 (95% CI: 0-322) per 100,000 live births. Modeling estimated that 3788 babies (95% CI: 3283-4143) were born with CRS annually in Vietnam with an overall CRS incidence of 234 (95% CI: 207-262) cases per 100,000 live births. A substantial proportion of women of childbearing age (WCBA) are at risk of rubella infection during pregnancy and this can result in a high frequency of miscarriage or burden of CRS across Vietnam. Prompt introduction of RCV into national immunization program with catch-up vaccination to children and WCBA will reduce CRI in Vietnam.
authors.affiliation: Department of Molecular Microbiology and Immunology, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. Electronic address: masami5008@gmail.com.
authors.forename: Masami
authors.initials: M
authors.lastname: Miyakawa
authors.affiliation: Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Sakamoto, Nagasaki, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshino
authors.affiliation: Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Sakamoto, Nagasaki, Japan.
authors.forename: Lay Myint
authors.initials: LM
authors.lastname: Yoshida
authors.affiliation: Modelling & Economics Unit, Public Health England, Colindale Ave, London, Greater London, UK; Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, England, United Kingdom.
authors.forename: Emilia
authors.initials: E
authors.lastname: Vynnycky
authors.affiliation: Department of Molecular Microbiology and Immunology, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Motomura
authors.affiliation: Khanh Hoa Provincial Public Health Service, Nha Trang, Viet Nam.
authors.forename: Le Huu
authors.initials: le H
authors.lastname: Tho
authors.affiliation: National Institute of Hygiene and Epidemiology, Yecxanh, Hai Ba Trung, Ha Noi, Viet Nam.
authors.forename: Vu Dinh
authors.initials: VD
authors.lastname: Thiem
authors.affiliation: Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Sakamoto, Nagasaki, Japan.
authors.forename: Koya
authors.initials: K
authors.lastname: Ariyoshi
authors.affiliation: National Institute of Hygiene and Epidemiology, Yecxanh, Hai Ba Trung, Ha Noi, Viet Nam.
authors.forename: Dang Duc
authors.initials: DD
authors.lastname: Anh
authors.affiliation: Department of Molecular Microbiology and Immunology, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. Electronic address: hiromori@nagasaki-u.ac.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Moriuchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D005260:Female; D005312:Fetal Blood / Q000821:virology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D015994:Incidence; D007231:Infant, Newborn; D008875:Middle Aged; D008954:Models, Biological; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D011446:Prospective Studies; D012409:Rubella / Q000453:epidemiology; D012410:Rubella Syndrome, Congenital / Q000453:epidemiology*; D012411:Rubella Vaccine / Q000008:administration & dosage; D016036:Seroepidemiologic Studies; D014744:Vietnam / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012411:Rubella Vaccine
keywords: Congenital rubella syndrome; Cord blood; IgG; IgM; Incidence; Modeling; Seroprevalence; Women of childbearing age