Epidemiology of acute rubella infection in Zambia during the pre-vaccination period (2005–2016) as a baseline for monitoring rubella epidemiology in the post-rubella vaccine introduction era
Abstract Background Rubella is highly under reported in Zambia as in most sub-Saharan countries despite being a disease of major public health concern especially among women of childbearing age. In September 2016, Zambia introduced a combined measles-rubella vaccine in children 0–14 years. In this s...
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doaj-38ed09fa2c7e48a399dc039e024a9aec2021-02-07T12:08:59ZengBMCBMC Infectious Diseases1471-23342020-02-012011710.1186/s12879-020-4806-5Epidemiology of acute rubella infection in Zambia during the pre-vaccination period (2005–2016) as a baseline for monitoring rubella epidemiology in the post-rubella vaccine introduction eraMazyanga L. Mazaba0Seter Siziya1Mwaka Monze2Daniel Cohen3The Health Press – Zambia, Zambia National Public Health Institute, Ministry of HealthMichael Chilufya Sata School of Medicine, Copperbelt UniversityVirology Unit, University Teaching Hospital, Ministry of HealthSackler Faculty of Medicine, Tel Aviv UniversityAbstract Background Rubella is highly under reported in Zambia as in most sub-Saharan countries despite being a disease of major public health concern especially among women of childbearing age. In September 2016, Zambia introduced a combined measles-rubella vaccine in children 0–14 years. In this study, we estimated the proportion positive for acute rubella among suspected but negative measles cases between 2005 and 2016 and determined its correlates for monitoring rubella epidemiology post-rubella vaccine introduction. Methods In a retrospective study, 4497 measles IgM negative serum samples from 5686 clinically suspected measles cases were examined for rubella IgM antibodies using the Siemens, Enzygnost® ELISA kit at the national measles laboratory. Data on demographics, year and month of onset were extracted from the surveillance data. Multivariate logistic regression analysis using backward variable selection was conducted to determine independent predictors for acute rubella. The magnitude of association was estimated using adjusted odds ratio with a 95% confidence interval. Results Overall, a proportion of 29.2% (1313/4497) affecting mostly those between 5 and 24 years was determined. Only age, province, month and year were independently associated with acute rubella. The regional proportions varied from 21.8–37.3% peaking in the month of October. Persons in the age group 10–14 years (Adjusted Odds Ratio [AOR] = 2.43; 95% CI [2.01–2.95]) were more likely while those aged < 1 year less likely (AOR = 0.31; 95% CI [021–0.48]) to have acute rubella compared to those aged 25 years or older. Persons in 2010 were less likely (AOR = 0.12; CI [0.05, 0.28]) to have acute rubella compared to those in 2016. While acute rubella was more likely to occur between July and November compared to December, it was less likely to occur between February and May. Conclusions Rubella virus was circulating in Zambia between 2005 and 2016 affecting mostly persons in the age group 5–24 years peaking in the hot dry season month of October. Although vaccination against rubella has been launched, these baseline data are important to provide a reference point when determining the impact of the vaccination program implemented.https://doi.org/10.1186/s12879-020-4806-5RubellaAcuteProportionCorrelatesZambiaPre vaccination era |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mazyanga L. Mazaba Seter Siziya Mwaka Monze Daniel Cohen |
spellingShingle |
Mazyanga L. Mazaba Seter Siziya Mwaka Monze Daniel Cohen Epidemiology of acute rubella infection in Zambia during the pre-vaccination period (2005–2016) as a baseline for monitoring rubella epidemiology in the post-rubella vaccine introduction era BMC Infectious Diseases Rubella Acute Proportion Correlates Zambia Pre vaccination era |
author_facet |
Mazyanga L. Mazaba Seter Siziya Mwaka Monze Daniel Cohen |
author_sort |
Mazyanga L. Mazaba |
title |
Epidemiology of acute rubella infection in Zambia during the pre-vaccination period (2005–2016) as a baseline for monitoring rubella epidemiology in the post-rubella vaccine introduction era |
title_short |
Epidemiology of acute rubella infection in Zambia during the pre-vaccination period (2005–2016) as a baseline for monitoring rubella epidemiology in the post-rubella vaccine introduction era |
title_full |
Epidemiology of acute rubella infection in Zambia during the pre-vaccination period (2005–2016) as a baseline for monitoring rubella epidemiology in the post-rubella vaccine introduction era |
title_fullStr |
Epidemiology of acute rubella infection in Zambia during the pre-vaccination period (2005–2016) as a baseline for monitoring rubella epidemiology in the post-rubella vaccine introduction era |
title_full_unstemmed |
Epidemiology of acute rubella infection in Zambia during the pre-vaccination period (2005–2016) as a baseline for monitoring rubella epidemiology in the post-rubella vaccine introduction era |
title_sort |
epidemiology of acute rubella infection in zambia during the pre-vaccination period (2005–2016) as a baseline for monitoring rubella epidemiology in the post-rubella vaccine introduction era |
publisher |
BMC |
series |
BMC Infectious Diseases |
issn |
1471-2334 |
publishDate |
2020-02-01 |
description |
Abstract Background Rubella is highly under reported in Zambia as in most sub-Saharan countries despite being a disease of major public health concern especially among women of childbearing age. In September 2016, Zambia introduced a combined measles-rubella vaccine in children 0–14 years. In this study, we estimated the proportion positive for acute rubella among suspected but negative measles cases between 2005 and 2016 and determined its correlates for monitoring rubella epidemiology post-rubella vaccine introduction. Methods In a retrospective study, 4497 measles IgM negative serum samples from 5686 clinically suspected measles cases were examined for rubella IgM antibodies using the Siemens, Enzygnost® ELISA kit at the national measles laboratory. Data on demographics, year and month of onset were extracted from the surveillance data. Multivariate logistic regression analysis using backward variable selection was conducted to determine independent predictors for acute rubella. The magnitude of association was estimated using adjusted odds ratio with a 95% confidence interval. Results Overall, a proportion of 29.2% (1313/4497) affecting mostly those between 5 and 24 years was determined. Only age, province, month and year were independently associated with acute rubella. The regional proportions varied from 21.8–37.3% peaking in the month of October. Persons in the age group 10–14 years (Adjusted Odds Ratio [AOR] = 2.43; 95% CI [2.01–2.95]) were more likely while those aged < 1 year less likely (AOR = 0.31; 95% CI [021–0.48]) to have acute rubella compared to those aged 25 years or older. Persons in 2010 were less likely (AOR = 0.12; CI [0.05, 0.28]) to have acute rubella compared to those in 2016. While acute rubella was more likely to occur between July and November compared to December, it was less likely to occur between February and May. Conclusions Rubella virus was circulating in Zambia between 2005 and 2016 affecting mostly persons in the age group 5–24 years peaking in the hot dry season month of October. Although vaccination against rubella has been launched, these baseline data are important to provide a reference point when determining the impact of the vaccination program implemented. |
topic |
Rubella Acute Proportion Correlates Zambia Pre vaccination era |
url |
https://doi.org/10.1186/s12879-020-4806-5 |
work_keys_str_mv |
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