Epidemio-clinical aspects of congenital rubella syndrome in Madagascar

Todisoa N. Andriatahina; Lantonirina Ravaoarisoa; Andrianina H. Ranivoson; Vonintsoa L. Rahajamanana; Zina A. Randriananahirana; Jocelyn Andriamahita; Jean C. Andrianirinarison; Annick L. Robinson

doi:10.18203/2320-6012.ijrms20200031

Authors

Todisoa N. Andriatahina Department of Pediatrics, Regional Health Facility, Moramanga, Madagascar
Lantonirina Ravaoarisoa Ministry of Public Health Madagascar
Andrianina H. Ranivoson Department of Pediatrics, Mother Child Teaching’s Hospital, Antananarivo, Madagascar
Vonintsoa L. Rahajamanana Department of Pediatrics, Mother Child Teaching’s Hospital, Antananarivo, Madagascar
Zina A. Randriananahirana National Institute of Public and Community Health Antananarivo, Madagascar
Jocelyn Andriamahita Department of Pediatrics, Provincial Health Facility, Toliara, Madagascar
Jean C. Andrianirinarison Ministry of Public Health Madagascar
Annick L. Robinson Department of Pediatrics, Mother Child Teaching’s Hospital, Antananarivo, Madagascar

DOI:

https://doi.org/10.18203/2320-6012.ijrms20200031

Keywords:

Epidemiological monitoring, Rubella syndrome congenital, Rubella vaccine, World Health Organization

Abstract

Background: Congenital rubella syndrome is the first congenital defect preventable by vaccination. The purpose of this study was to provide basic information on the extent and epidemiology of congenital rubella syndrome in Madagascar.

Methods: A retrospective and descriptive study from January 2013 to May 2019 was conducted in 8 hospitals in 2 provinces of Madagascar, Antananarivo and Toliara. The study included children who attended the services selected during the study period and who had the following conditions: children aged of 0 to 59 months, regardless of vaccination status, meeting the World Health Organization clinical criteria for congenital rubella syndrome with or without biological confirmation.

Results: Of the 152,304 cases of children of all ages who visited or were hospitalized during the study period, 112 clinically confirmed cases of congenital rubella syndrome were identified. The age group 0 to 11 months involved 60 children (53.6%). Congenital heart disease was found in 83.0% of cases, mental backwardness in 43.7% and microcephaly in 26.8%. Twenty-three among (20.5%) them died. The death was due to cardiac diseases in 16 children.

Conclusions: Findings confirm that the diagnosis of congenital rubella syndrome is underestimated in current pediatric practice in Madagascar. The introduction of the rubella vaccine in the Expanded Program on Immunization and the implementation of an effective and sustainable surveillance system for congenital rubella syndrome in the country is a proved effective tool for the prevention of this disease.

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