Rubella transmission and the risk of congenital rubella syndrome in Liberia: a need to introduce rubella-containing vaccine in the routine immunization program

Abstract Background Rubella is an RNA virus in the genus Rubivirus within the Matonaviridae family. Rubella remains a leading vaccine-preventable cause of birth defects. Most African countries including Liberia do not currently provide rubella-containing vaccine (RCV) in their immunization program. We analyzed the existing surveillance data to describe rubella cases and identify the at-risk population. Methods We conducted a retrospective descriptive statistics on the suspected-measles case-based surveillance data that obtained from the national database. Suspected-measles cases who were negative and indeterminate for measles IgM and tested for rubella IgM were extracted from the database. We used only rubella IgM positive cases to calculate trends and percentages by person, place and time. The cumulative-percent curve was used to visually describe the age distribution of rubella cases. Results During 2017–2018, a total of 2027 suspected-measles cases with known laboratory results were reported; of which, 1307 were tested for rubella IgM. Among tested cases, 472 (36%) were positive, 769 (59%) were negative and 66 (5%) were indeterminate for rubella IgM. Female contributed 269 (57%) of the confirmed rubella cases respectively. The median age was 7 years with an interquartile range of 5–10 years. From the total rubella cases, 6 (1%) were under 1 year, 109 (23%) were 1–4 years, 207 (44%) were 5–9 years, 87 (18%) were 10–14 years and 56 (12%) were more than or equal to 15 years. Women in their reproductive-age contributed 23 (5%) of rubella cases with 17% positivity rate. Two-thirds or 307 (65%) of the cases were reported from February to May which is dry season in Liberia. Conclusions Our analysis revealed that rubella was widely circulating in Liberia. Majority of the cases were reported among children < 15 years. However, rubella was also reported among women of reproductive age and infants < 1 year with no report of congenital rubella syndrome (CRS). Detail investigation of rubella cases among infants of < 1 year and women of reproductive age is important to uncover CRS. Establishment of CRS surveillance and the introduction of RCV in the immunization program are crucial to prevent rubella infection and avert the risk of CRS.

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SINDROM RUBELLA KONGENITAL

AVERROUS: Jurnal Kedokteran dan Kesehatan Malikussaleh ◽

10.29103/averrous.v4i1.808 ◽

2018 ◽

Vol 4 (1) ◽

pp. 93

Author(s):

Julia Fitriany ◽

Yulia Husna

Keyword(s):

Rubella Virus ◽

Rna Virus ◽

Congenital Rubella Syndrome ◽

Congenital Rubella

Congenital Rubella Syndrome (CRS) adalah suatu kumpulan gejala penyakit terdiri dari katarak, penyakit jantung bawaan, gangguan pendengaran, dan keterlambatan perkembangan. Sindrom rubella kongenital disebabkan infeksi virus rubella pada janin selama masa kehamilan akibat ibu tidak mempunyai kekebalan terhadap virus rubella.. Virus rubella ditransmisikan melalui pernapasan yaitu melalui droplet yang dikeluarkan oleh seseorang yang terinfeksi rubella, setelah terkena droplet, virus ini akan mengalami replikasi di nasofaring dan di daerah kelenjar getah bening. Viremia terjadi antara hari ke-5 sampai hari ke-7 setelah terpajan virus rubella. Infeksi rubella menyebabkan kerusakan janin karena proses pembelahan terhambat. Diagnosis dari CRS bisa ditegakkan melalui anamnesis, pemeriksaan fisik dan pemeriksaan pebunjang. Pemeriksaan laboratorium untuk menunjang diagnosis CRS antara lain: isolasi virus, pemeriksaan serologik (ELISA) dan pemeriksaan terhadap RNA virus rubella. Terapi untuk CRS sendiri hanya bersifat suportif untuk defek-defek yang dialami. Penting untuk mencegah CRS adalah dengan vaksin MMR sebelum hami. Prognosis untuk CRS lebih buruk dibandingkan dengan rubella postnatal karena disertai kerusakan organ multiple yang berat.

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Prevalence and determinants of anemia among women of reproductive age in developing countries of Asia and Africa: A systematic review protocol

10.21203/rs.3.rs-24100/v1 ◽

2020 ◽

Author(s):

Savera Savera ◽

Sumera Aziz Ali

Keyword(s):

Systematic Review ◽

Developing Countries ◽

English Language ◽

Reproductive Age ◽

Evidence Based ◽

Women Of Reproductive Age ◽

African Countries ◽

Cross Sectional ◽

Review Protocol ◽

Detailed Search

Abstract Background The burden of anemia among women of reproductive age (WRA) is significantly higher in developing countries. Studies have been conducted to estimate the prevalence and magnitude of anemia among women of reproductive age and its associated factors mainly in African and Asian countries. However, findings from the existing literature are not synthesized in a systematic way to make evidence-based decisions. Given the high burden of anemia in Asian and African countries and an enormous amount of literature on the prevalence and determinants of anemia, there is a need to undertake a systematic review on prevalence and determinants of anemia among WRA in developing countries of Asia and Africa. Hence, the objective of this study is to conduct a systematic review on the prevalence and determinants of anemia among WRA in developing countries of Asia and Africa. This synthesis of literature will help to understand the determinants of anemia to design targeted and context-based interventions primarily for WRA. In addition, this systematic review will also assist policymakers, stakeholders and managers to make informed and evidence-based decisions mainly in developing countries of Asia and Africa.Methods The review will focus on assessing the burden of anemia and its determinants in the developing countries of Asia and Africa. PubMed, CINAHL Plus, Science Direct, Medline and Cochrane will be explored using a detailed search strategy. A study will be considered eligible, if it will be a primary epidemiological research conducted through quantitative observational study designs (cross-sectional, case-control or cohort studies) on prevalence and determinants or only determinants of anemia among WRA (15-49 years) in the developing country of Africa or Asia and published in the English language in a peer-reviewed local or international journal from 2000 to 2020.Discussion This systematic review will provide an opportunity to critically appraise and synthesize the findings from individual studies on the prevalence and determinants of anemia to finally generate a summary. These aggregated findings, in turn, can guide practice and inform policymakers to make evidence-based decisions to address the problem of anemia among women of reproductive age. The results of the review will be disseminated through presentations and peer-reviewed publications.

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Congenital Rubella Syndrome Based on Serologic and RNA Virus Examination

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v13i2.673 ◽

2017 ◽

Vol 13 (2) ◽

pp. 63

Author(s):

Kadek Kadek ◽

S Darmadi

Keyword(s):

Rna Virus ◽

Ductus Arteriosus ◽

First Trimester ◽

Latex Agglutination ◽

Congenital Rubella Syndrome ◽

Congenital Glaucoma ◽

Pulmonary Artery Stenosis ◽

Congenital Rubella ◽

Laboratory Confirmation ◽

Loss Of Hearing

Rubella infection with occurs during pregnancy, especially during the first trimester often caused by Congenital Rubella Syndrome (CRS). CRS can resulting abortions, miscarriages, stillbirth, and severe birth defects. The baby diagnosed with CRS when characterized by signs or symptoms from the following two categories A (Cataracts/congenital glaucoma, congenital heart disease (most commonly patent ductus arteriosus or peripheral pulmonary artery stenosis), loss of hearing, pigmentary retinopathy) or one categorie A and one catagorie B (Purpura, splenomegaly, jaundice, microencephaly, mental retardation, meningoencephalitis, radiolucent bone disease. Laboratory confirmation can be obtained by any of the following: virus isolation, serologi test (pasif hemaglutination, latex agglutination test, hemaglutination inhibisi, Flouresence immunoassay, Enzyme immunoassay), RNA test.

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Congenital Rubella Syndrome profile of audiology outpatient clinic in Surabaya, Indonesia

Infectious Disease Reports ◽

10.4081/idr.2020.8762 ◽

2020 ◽

Author(s):

Elsa Rosalina ◽

Nyilo Purnami

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Hearing Impairment ◽

Outpatient Clinic ◽

Congenital Heart ◽

Clinical Manifestations ◽

Congenital Rubella Syndrome ◽

World Health ◽

Immunization Program ◽

Congenital Rubella

Congenital Rubella Syndrome (CRS) consists of hearing impairment, ophthalmology abnormalities, and congenital heart disease in children, resulting from rubella infection during pregnancy. Rubella vaccine has been implemented as national immunization program in Indonesia since 2017, and needed to be evaluated. This study aimed to report the CRS patients’ profile of Audiology Outpatient Clinic in Surabaya. A descriptive study from patient’s medical record was conducted in Dr. Soetomo Hospital Surabaya from January 2016 to December 2017. CRS was categorized using World Health Organization classification. Suspected infants with CRS burden were assessed by Otoacoustic Emission and rubella antibody test. Ninety five infants suspected with CRS classified as laboratory- confirmed CRS (58.95%), clinically confirmed CRS (15.79%), and discarded CRS (25.26%). Clinical manifestations included combination of congenital heart disease and hearing impairment (17.89%), congenital heart disease, ophthalmology abnormalities, and hearing impairment (16.84%), and hearing impairment and ophthalmology abnormalities (13.68%). The data show a high burden of CRS in Surabaya. These implies the urgent need for national rubella immunization program.

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Consumption of Dietary Folate Estimates and Its Implication for Reproductive Outcome among Women of Reproductive Age in Kersa: Cross-Sectional Survey

10.21203/rs.3.rs-601866/v1 ◽

2021 ◽

Author(s):

Nega Assefa ◽

Yasir Y Abdullahi ◽

Aklilu Abrham ◽

Elena C Hemler ◽

Isabel Madzorera ◽

...

Keyword(s):

Dietary Intake ◽

Dietary Diversity ◽

Reproductive Age ◽

Leafy Vegetables ◽

Folate Intake ◽

Women Of Reproductive Age ◽

African Countries ◽

Cross Sectional ◽

Eastern Ethiopia ◽

Dietary Folate

Abstract Background: Dietary folate inadequacy is one the most common micronutrient deficiencies that causes neural tube defect (NTD) among infants in Sub-Saharan African countries. This study aims to determine the dietary intake of folate among women of reproductive age (WRA) of Kersa, Eastern Ethiopia.Methods: A cross-sectional study took place among voluntary women that were selected from 1140 random households. Using a validated Food Frequency Questionnaire, participants weekly dietary intake history of Ethiopian foods and dietary folate intake was worked out. Statistical analysis was done at 95% confidence interval. Modified Poisson regression was used to identify factors that associated with dietary folate consumptionResult: The estimated median usual intake of folate was 170 ug/d (IQR: 118.3; 252.2) and about 33% WRA had low folate intake and 73.9% were at risk for folate inadequacy. From the reported food groups, Beans and Peas, Starchy staples, and Vitamin-A rich dark-green leafy vegetables were the top three ranked foods that contributed much of the dietary folate. The following conditions were statistically related with dietary folate inadequacy; women’s age, being in poor wealth index, low dietary diversity, having seasonal employment, and reliance on market food source.Conclusions: We found that women’s dietary intake of folate in Kersa is very low and cannot protect their offspring from having NTD. They could also potentially be predisposed poor health outcomes. Diversifying and fortification Ethiopian wheats and salts could decrease the burden of folate deficiency in the country.

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Congenital rubella - a familiar stranger (case study)

Neonatology surgery and perinatal medicine ◽

10.24061/2413-4260.iii.2.8.2013.17 ◽

2013 ◽

Vol 3 (2(8)) ◽

pp. 131-135

Author(s):

G.V. Vaschilin ◽

L.A. Gagalovska ◽

M.M. Gnativ ◽

N.G. Tandura ◽

T.D. Zagorulko ◽

...

Keyword(s):

Birth Defects ◽

Congenital Heart Defects ◽

Gestational Age ◽

Congenital Heart ◽

Rna Virus ◽

Heart Defects ◽

Congenital Rubella Syndrome ◽

Congenital Rubella ◽

Fetal Infection

Rubella is an acute contagious viralexanthemа. Its an agent RNA virus – has teratogenic effect.The disease may be severe, light and asymptomatic inpregnant women. Transplacental contamination is possiblein any of the disease forms. Contamination during the firsteight weeks of pregnancy leads to fetal infection in 30-80%of cases. With higher gestational age the risk of congenitalrubella reduces. The major birth defects because of rubellaare congenital heart defects, eye defects and deafness.Prevention of congenital rubella syndrome is possible onlyby vaccination.

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Fortified Foods Are Major Contributors to Apparent Intakes of Vitamin A and Iodine, but Not Iron, in Diets of Women of Reproductive Age in 4 African Countries

Journal of Nutrition ◽

10.1093/jn/nxaa167 ◽

2020 ◽

Vol 150 (8) ◽

pp. 2183-2190

Author(s):

Valerie M Friesen ◽

Mduduzi N N Mbuya ◽

Grant J Aaron ◽

Helena Pachón ◽

Olufemi Adegoke ◽

...

Keyword(s):

Vitamin A ◽

Food Consumption ◽

Food Samples ◽

Reproductive Age ◽

Nutrient Intakes ◽

Women Of Reproductive Age ◽

African Countries ◽

Fortified Foods ◽

Cross Sectional ◽

Equivalent Method

ABSTRACT Background Food fortification is implemented to increase intakes of specific nutrients in the diet, but contributions of fortified foods to nutrient intakes are rarely quantified. Objectives We quantified iron, vitamin A, and iodine intakes from fortified staple foods and condiments among women of reproductive age (WRA). Methods In subnational (Nigeria, South Africa) and national (Tanzania, Uganda) cross-sectional, clustered household surveys, we assessed fortifiable food consumption. We estimated daily nutrient intakes from fortified foods among WRA by multiplying the daily apparent fortifiable food consumption (by adult male equivalent method) by a fortification content for the food. Two fortification contents were used: measured, based on the median amount quantified from individual food samples collected from households; and potential, based on the targeted amount in national fortification standards. Results for both approaches are reported as percentages of the estimated average requirement (EAR) and recommended nutrient intake (RNI). Results Fortified foods made modest contributions to measured iron intakes (0%–13% RNI); potential intakes if standards are met were generally higher (0%–65% RNI). Fortified foods contributed substantially to measured vitamin A and iodine intakes (20%–125% and 88%–253% EAR, respectively); potential intakes were higher (53%–655% and 115%–377% EAR, respectively) and would exceed the tolerable upper intake level among 18%–56% of WRA for vitamin A in Nigeria and 1%–8% of WRA for iodine in Nigeria, Tanzania, and Uganda. Conclusions Fortified foods are major contributors to apparent intakes of vitamin A and iodine, but not iron, among WRA. Contributions to vitamin A and iodine are observed despite fortification standards not consistently being met and, if constraints to meeting standards are addressed, there is risk of excessive intakes in some countries. For all programs assessed, nutrient intakes from all dietary sources and fortification standards should be reviewed to inform adjustments where needed to avoid risk of low or excessive intakes.

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Assessment of universal access to comprehensive sexual and reproductive health services in Egypt

African Evaluation Journal ◽

10.4102/aej.v3i2.147 ◽

2015 ◽

Vol 3 (2) ◽

Cited By ~ 1

Author(s):

Doaa Oraby

Keyword(s):

Reproductive Health ◽

Health Services ◽

Sexual And Reproductive Health ◽

Universal Access ◽

Married Women ◽

Reproductive Age ◽

World Health ◽

Reproductive Health Services ◽

Women Of Reproductive Age ◽

African Countries

In 2005, a World Health Organization resolution called for health systems to move towards universal coverage, such that everyone would have access to promotive, preventive, curative and rehabilitative health interventions at an affordable cost. Responding to this call, a new target for achieving universal access to reproductive health was integrated within the revised millennium development goals framework. Forty-eight African countries adopted the Maputo Plan of Action committing to the goal of universal access to comprehensive sexual and reproductive health services in Africa by 2015. The aim of this study was to assess Egypt’s commitment to implementing the Maputo Plan of Action. This was achieved through soliciting information relating to the extent of Egypt’s progress towards the achievement of universal access to sexual and reproductive health and rights information and services. In late 2009, a qualitative study was conducted. It included in-depth interviews with 20 physicians and 10 key informants in addition to 8 focus group discussions with sub-segments of 65 beneficiaries, including married women of reproductive age, married men and youth of both sexes. The study revealed that public sector, non-governmental organisations and private sector organisations delivering sexual and reproductive health services functioned in isolation from each other. Delivered services focused mainly on family planning and maternity care and targeted married women of reproductive age. Scaling up universal access to sexual and reproductive health services requires programmes to expand beyond the maternal and child health delivery model targeted solely at married women with children.

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EDUCATIONAL EMPOWERMENT AND USE OF ANTENATAL SERVICES

Journal of University Medical & Dental College ◽

10.37723/jumdc.v10i4.71 ◽

2019 ◽

Vol 10 (4) ◽

pp. 11-15

Author(s):

Muhammad Siddique Khan Qadr ◽

Huda Abbas ◽

Wajahat Hussain et al.

Keyword(s):

Health Workers ◽

Age Distribution ◽

Educational Status ◽

Cross Sectional Study ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Cross Sectional ◽

Ethical Approval ◽

One Year ◽

Antenatal Services

ABSTRACT:OBJECTIVE: The single most important factor that has long-lasting impact on lives of women is education. The study was conducted to determine the eﬀect of women and partner's education on utilization of antenatal services in the urban slums.STUDY DESIGN AND SUBJECTS: This descriptive cross sectional study was conducted in urban slums of Bahawalpur City from January 2018 to December 2018 after taking ethical approval from hospital ethical committee. Women of reproductive age n=377, between 15 to 49 years, having at least one alive child less than one year of age and irrespective of current pregnancy were included in the study. Out of selected slum area sample was drawn by non-probability consecutive method. The preformed, pretested questionnaire with the help of lady health workers of the areas was used for collection of data. RESULTS: Mean age of the respondents was 28.26 ± 6.03 years. The age distribution showed that 31.1% respondents belonged to 30-34 years age group followed by 29.7% in 25-29 years, 19.1% in 20-24 years. The utilization of antenatal services was poor in 41.1% (n=155), fair in 24.9% (n=94) and good in 34.0% (n=128) women. The utilization of antenatal services was signiﬁcantly higher in literate group (p <0.001). Regarding husband's educational status the wives of educated husbands had better utilization (p <0.001). The use of antenatal services among wives of uneducated and primary educated husbands was 67.8% and 61.5% respectively. The 52.1% women having graduate and above educational level of husband had good antenatal care use. CONCLUSION: Educational status signiﬁcantly aﬀect the utilization of antenatal services.

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Mixed effects analysis of factors associated with health insurance coverage among women in sub-Saharan Africa

PLoS ONE ◽

10.1371/journal.pone.0248411 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0248411

Author(s):

Hubert Amu ◽

Abdul-Aziz Seidu ◽

Ebenezer Agbaglo ◽

Robert Kokou Dowou ◽

Edward Kwabena Ameyaw ◽

...

Keyword(s):

Health Insurance ◽

Formal Education ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Reproductive Age ◽

Sub Saharan Africa ◽

Health Coverage ◽

Women Of Reproductive Age ◽

African Countries ◽

Sub Saharan

Introduction In the pursuit of achieving the Sustainable Development Goal targets of universal health coverage and reducing maternal mortality, many countries in sub-Saharan Africa have implemented health insurance policies over the last two decades. Given that there is a paucity of empirical literature at the sub-regional level, we examined the prevalence and factors associated with health insurance coverage among women in in sub-Saharan Africa. Materials and methods We analysed cross-sectional data of 307,611 reproductive-aged women from the most recent demographic and health surveys of 24 sub-Saharan African countries. Bivariable and multivariable analyses were performed using chi-square test of independence and multi-level logistic regression respectively. Results are presented as adjusted Odds Ratios (aOR) for the multilevel logistic regression analysis. Statistical significance was set at p<0.05. Results The overall coverage of health insurance was 8.5%, with cross-country variations. The lowest coverage was recorded in Chad (0.9%) and the highest in Ghana (62.4%). Individual-level factors significantly associated with health insurance coverage included age, place of residence, level of formal education, frequency of reading newspaper/magazine and watching television. Wealth status and place of residence were the contextual factors significantly associated with health insurance coverage. Women with no formal education were 78% less likely to be covered by health insurance (aOR = 0.22, 95% CI = 0.21–0.24), compared with those who had higher education. Urban women, however, had higher odds of being covered by health insurance, compared with those in the rural areas [aOR = 1.20, 95%CI = 1.15–1.25]. Conclusion We found an overall relatively low prevalence of health insurance coverage among women of reproductive age in sub-Saharan Africa. As sub-Saharan African countries work toward achieving the Sustainable Development Goal targets of universal health coverage and lowering maternal mortality to less than 70 deaths per 100,000 live births, it is important that countries with low coverage of health insurance among women of reproductive age integrate measures such as free maternal healthcare into their respective development plans. Interventions aimed at expanding health insurance coverage should be directed at younger women of reproductive age, rural women, and women who do not read newspapers/magazines or watch television.

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