Nguyen Van Bang1, Nguyen Thi Van Anh2, Vu Thi Tuong Van3, Trieu Thi Hong Thai4, Nguyen Van Thuong5, Gulam Khandeker6, Elizabeth Elliott7,8
1 1. Department of Pediatrics, Hanoi Medical University, Hanoi, Vietnam
2 Department of Medical Education and Skill Laboratory, Hanoi Medical University, Hanoi, Vietnam
3 Department of Microbiology, Bach Mai University Hospital, Hanoi, Vietnam
4 National Hospital of Pediatrics, Hanoi, Vietnam
5 5. Department of Pediatrics, Saint Paul Hospital, Hanoi, Vietnam
6 National Centre for Immunization Research and Surveillance (NCIRS), The Children’s Hospital at Westmead, NSW, Australia 8. Discipline of Pediatrics and Child Health, the Children’s Hospital at Westmead Clinical School, Sydney Medical School, the University of Sydney, NSW, Australia
7 Discipline of Pediatrics and Child Health, the Children’s Hospital at Westmead Clinical School, Sydney Medical School, the University of Sydney, NSW, Australia
8 Australian Pediatric Surveillance Unit (APSU), Sydney, NSW, Australia


Tóm tắt

Congenital rubella syndrome (CRS) is preventable illness but stays frequent in developing countries where rubella vaccination is not incorporated in national program of vaccination. Objectives: This study aimed at obtaining baseline information on acquired immunization status of school girls as well as the rate of susceptibility and rubella infection in pregnant women around a rubella outbreak in Hanoi. Methods@ During and after the rubella outbreak in 2011, sera from 136 school girls were tested for rubella-specifi c IgG (Rs-IgG) and 140 pregnant women were tested for rubella-specifi c IgG and for rubella-specifi c IgM (Rs-IgM) using electro-chemiluminescence immunoassay (ECLIA) (Roche Diagnostic) with cut-off value 10 IU/mL for IgG and 0.3 IU/mL for IgM. During the surveillance period, 113 infants were identifi ed with confi rmed CRS and clinically analyzed. Results: Rs-IgG antibodies was positive in 125/136 (91.9%) school girls and 119/140 (85%) pregnant
women, with strong-to-extreme concentration in 86/136 (63.2%) school girls versus 19/140
(13.6%) in pregnant women (p<0.002). Rs-IgG was negative in 21/140 (15%) and Rs-IgM
antibodies was positive in 27.9% (39/140) pregnant women, of whom 38 (27.1%) a co-existence of Rs-IgG and Rs-IgM were documented. During the surveillance period 113 infants were identifi ed with confi rmed CRS. Clinical manifestations of CRS included low birth weight <2,500g (86%), congenital heart disease (63.7%), hearing impairment (63.7%), ophthalmological involvement (46.9%). Other clinical features included: thrombocytopenia (85%), neonatal purpura (74.3%), splenomegaly (63.7%), hepatomegaly (62.8%) and blueberry muffi n rash (61.1%). During the surveillance period the estimated annual incidence of CRS was 1.13/1,000
live birth (95% CI 0.92-1.34). Conclusion:
This preliminary, baseline per/post epidemic information showed a high rate of acquired
immunization in female adolescents but also high rate of susceptibility and very high rate of
rubella infection in pregnant women, as well as a very high burden of CRS in Vietnam.


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