Congenital rubella syndrome (CRS) in Vietnam 2011-2012-CRS epidemic after rubella epidemic in 2010-2011
Congenital rubella syndrome (CRS) in Vietnam 2011-2012-CRS epidemic after rubella epidemic in 2010-2011
复制标题
DOI：
10.1016/j.vaccine.2015.06.035
复制
发表时间：
2015-07-17
期刊：
影响因子：
5.5
通讯作者：
Tran Hien Nguyen
中科院分区：
文献类型：
--
作者：
Toda, Kohei;Reef, Susan;Tran Hien Nguyen
背景：风疹在越南呈地方性流行，每4 - 5年发生一次流行。2011年，越南经历了全国性的大规模风疹流行。在风疹流行期间，国家医院的新生儿科或心内科发现并报告了许多患有先天性风疹综合征（CRS）的婴儿。为了解CRS的负担，国家扩大免疫规划（NEPI）建立了CRS哨点监测系统。
方法：河内和胡志明市的三家国家儿科医院被选为CRS哨点监测点。采集婴儿的血液样本进行风疹特异性IgM检测，并在国家麻疹和风疹实验室进行酶联免疫吸附测定（ELISA）检测。
结果：2011年1月至2012年12月，共发现并报告了424例疑似CRS婴儿。其中406例（96%）获得了样本，284例（70%）为IgM阳性，包括279例实验室确诊的CRS和5例先天性风疹感染（CRI）。13例经临床确诊，127例（30%）被排除。共有292例婴儿被确诊为CRS。在292例CRS婴儿中，69%的母亲在孕期有“发热和皮疹”病史，其中85%发生在孕早期。最常见的临床缺陷是先天性心脏病和白内障。然而，81.9%的婴儿有主要和次要体征及症状的组合。在确诊为CRS的足月婴儿中，有114例（39%）观察到低出生体重。
结论：新建立的CRS哨点监测系统记录了越南CRS的重大负担，并为政策制定者将含风疹疫苗（RCV）引入越南提供了证据。本报告强调了风疹流行国家迅速建立CRS监测的重要性，以支持将RCV纳入常规的扩大免疫规划（EPI）免疫接种。（C）2015爱思唯尔有限公司。保留所有权利。
Background: Rubella is endemic in Vietnam with epidemics occurring every 4-5 years. In 2011, Vietnam experienced the large nationwide rubella epidemic. During the rubella epidemic, many infants born with congenital rubella syndrome (CRS) were identified and reported from the neonatal units or cardiology departments of the national hospitals. To understand the burden of CRS, National Expanded Program on Immunization (NEPI) established sentinel CRS surveillance system.Method: Three national paediatric hospitals in Hanoi and Ho Chi Minh City (HCMC) were selected as CRS sentinel surveillance sites. Blood specimens from the infants were collected for rubella specific IgM and ELISA testing was performed at the national measles and rubella laboratory.Results: From January 2011 to December 2012, 424 infants with suspected CRS were identified and reported. Among them 406 (96%) had specimens obtained, 284 (70%) cases were IgM positive including 279 laboratory confirmed CRS and 5 Congenital Rubella Infection (CRI). 13 cases were clinically confirmed and 127 (30%) were discarded. Total 292 infants were confirmed as CRS. Of the 292 infants with CRS, 69% of mothers had a history of "fever and rash" during pregnancy, of which 85% was in the first trimester. The most common clinical defects were congenital heart disease and cataract(s). However, 81.9% of the infants had a combination of major and minor signs and symptoms. Low birth weight in full term infants with confirmed CRS was observed in 114 infants (39%).Conclusions: The newly established CRS sentinel surveillance system documented the significant burden of CRS in Vietnam and provided evidence to the policy makers for the introduction of rubella containing vaccine (RCV) into Vietnam. This report highlights the importance of countries with rubella epidemic to establish CRS surveillance rapidly in order to support the introduction of RCV into the routine Expanded Programme on Immunization (EPI) immunization. (C) 2015 Elsevier Ltd. All rights reserved.