title: Seroprevalence of measles and rubella antibodies in pregnant women Haiti, 2012.
abstract: BACKGROUND
  Haiti had set a national goal to eliminate measles and rubella, as well as congenital rubella syndrome (CRS) by 2010. A 2007-2008 nationwide measles and rubella vaccination campaign targeting 1-19 years, however, reached only 79% of the target population. To assess whether population immunity was adequate to support elimination, we conducted a national serosurvey.
  
  
  METHODS
  We systematically selected 740 serum specimens collected from pregnant women in a 2012 national antenatal HIV sentinel serosurvey across four age strata: 15-19, 20-24, 25-29 and 30-39 years. Sera were tested for measles and rubella specific immunoglobulin G antibodies (IgG) using commercial immunoassays. We classified sera as seropositive, seronegative or indeterminate per manufacturer's instructions, and analyzed seroprevalence according to age strata, and rural or urban residence. We assessed immunity by estimating antibody concentrations in international units per milliliter (IU/mL) for seropositive and indeterminate sera. Measles IgG concentrations >0.12 IU/mL and rubella IgG concentrations >10 IU/mL were considered clinically protective.
  
  
  RESULTS
  Of 740 sera, 696 (94.1%) were seropositive and 20 (2.7%) were indeterminate for measles IgG; overall 716 (96.8%) sera had IgG concentrations >0.12 IU/mL. For rubella IgG, 691 (93.4%) sera were seropositive and 1 (0.1%) was indeterminate; a total of 687 (92.8%) had IgG concentrations >10 IU/mL. Measles seropositivity varied across age strata (p=0.003); seropositivity increased from 88.6% among 15-19 year olds to 98.4% among 30-39 year olds (Cochran-Armitage trend tes t ≤ 0.0001). Rubella seropositivity did not differ across age strata. There were no statistically significant differences in measles or rubella seropositivity by urban versus rural residence.
  
  
  CONCLUSIONS
  Despite previous low vaccination coverage for measles, results from this serosurvey indicate high levels of measles and rubella seropositivity in pregnant women, and contribute to the evidence for measles, rubella and CRS elimination from Haiti by the target date.
authors.affiliation: Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service program, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: dfitter@cdc.gov.
authors.forename: David L
authors.initials: DL
authors.lastname: Fitter
authors.affiliation: National Public Health Laboratory, Ministry of Public Health and Population, Haiti.
authors.forename: Renette
authors.initials: R
authors.lastname: Anselme
authors.affiliation: Comprehensive Family Immunization, Pan American Health Organization, Port-au-Prince, Haiti.
authors.forename: Gilson
authors.initials: G
authors.lastname: Paluku
authors.affiliation: Comprehensive Family Immunization, Pan American Health Organization, San Jose, Costa Rica.
authors.forename: Gloria
authors.initials: G
authors.lastname: Rey
authors.affiliation: Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Brendan
authors.initials: B
authors.lastname: Flannery
authors.affiliation: Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Rania A
authors.initials: RA
authors.lastname: Tohme
authors.affiliation: Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Marston
authors.affiliation: Global Program, National Alliance of State and Territorial AIDS Directors, Washington, DC, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Griswold
authors.affiliation: National Public Health Laboratory, Ministry of Public Health and Population, Haiti.
authors.forename: Jacques
authors.initials: J
authors.lastname: Boncy
authors.affiliation: Haiti Country Office, US Centers for Disease Control and Prevention, Port-au-Prince, Haiti.
authors.forename: John F
authors.initials: JF
authors.lastname: Vertefeuille
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood / Q000276:immunology*; D005260:Female; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D008457:Measles / Q000453:epidemiology* / Q000276:immunology*; D022542:Measles-Mumps-Rubella Vaccine / Q000276:immunology; D011247:Pregnancy; D012409:Rubella / Q000453:epidemiology* / Q000276:immunology*; D016036:Seroepidemiologic Studies; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D022542:Measles-Mumps-Rubella Vaccine
keywords: IgG antibody; Measles; Rubella; Seroprevalence; Vaccine