title: Epidemiology of rubella infection in Cameroon: a 7-year experience of measles and rubella case-based surveillance, 2008-2014.
abstract: The aim of this study was to estimate the proportion of rubella disease in a measles case-based surveillance in Cameroon prior to rubella vaccine introduction into the national immunisation programme.
  
  
  
  This was a cross-sectional study for rubella infection in Cameroon for the period 2008 to 2014.
  
  
  
  Patients suspected with measles from the 10 regions of Cameroon were recruited according to the WHO measles case definition and were tested for rubella IgM antibodies accompanied with the case report/investigation forms.
  
  
  
  All persons with rash and fever within 14 days of onset of rash according to the standard WHO African Regional Office (WHO/AFRO) case definition for a suspected measles case.
  
  
  
  Descriptive analyses and simple logistic regressions were performed. OR were estimated.
  
  
  
  A total of 9907 serum samples from people with fever and rash were received in the laboratory from 2008 to 2014. A total of 7489 (75.59%) measles-negative samples were tested for rubella; 699 (9.3%) were positive for rubella IgM antibodies. Logistic regression analysis was done using IgM antibodies detection as the outcome variable. Age, sex and setting were explanatory variables. Logistic regression analysis revealed that, comparing the proportion of rubella IgM seropositivity status by age, the association to a positive rubella IgM increased with age from 1 to 4 years (OR 7.11; 95% CI 4.35 to 12.41; p<0.0001), through 5 to 9 years (OR 13.07; 95% CI 7.93 to 22.93; p<0.001), to 10 to 14 years of age (OR 13.86; 95% CI 8.06 to 25.12; p<0.001). Persons aged ≥15 years were also more likely to have rubella infection than children under one (OR 3.69; 95% CI 1.85 to 7.48; p=0.0001). There were also significant associations with sex, with males being less associated to a positive rubella serology than females (OR 1.33; 95% CI 1.14 to 1.56; p=0.0001). No statistically significant difference in proportion of rubella cases was observed between urban and rural populations (OR 1.11; 95% CI 0.94 to 1.31; p=0.208).
  
  
  
  This study reveals that rubella virus circulates in Cameroon, with important number of cases in children under 15 years. This finding supports the planned introduction of rubella-containing vaccines into the Expanded Program on Immunization.
authors.affiliation: Immunization, Vaccines and Emergency, World Health Organization Cameroon Country Office, Yaounde, Cameroon.
authors.forename: Marcellin
authors.initials: M
authors.lastname: Nimpa Mengouo
authors.affiliation: Centre for Evidence Based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa valentinengum@yahoo.com.|Department of Microbiology, Haematology, Parasitology and Infectious Disease, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon.
authors.forename: Valantine Ngum
authors.initials: VN
authors.lastname: Ndze
authors.affiliation: Expanded Program on Immunization, Ministry of Public Health, Yaounde, Cameroon.
authors.forename: Frangy
authors.initials: F
authors.lastname: Baonga
authors.affiliation: Expanded Program on Immunization, Ministry of Public Health, Yaounde, Cameroon.
authors.forename: Marie
authors.initials: M
authors.lastname: Kobela
authors.affiliation: Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa.
authors.forename: Charles Shey
authors.initials: CS
authors.lastname: Wiysonge
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000276:immunology; D002163:Cameroon / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D017589:Immunization Programs; D007075:Immunoglobulin M; D007223:Infant; D016015:Logistic Models; D008297:Male; D008457:Measles / Q000453:epidemiology*; D008875:Middle Aged; D012409:Rubella / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D012411:Rubella Vaccine / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M; D012411:Rubella Vaccine
keywords: Cameroon; Rubella; Surveillance