An epidemiological assessment towards elimination of rubella and congenital rubella syndrome in Singapore
An epidemiological assessment towards elimination of rubella and congenital rubella syndrome in Singapore
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DOI：
10.1016/j.vaccine.2015.04.003
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发表时间：
2015-06-17
期刊：
影响因子：
5.5
通讯作者：
Goh, Kee Tai
中科院分区：
文献类型：
--
作者：
Chua, Ying Xian;Ang, Li Wei;Goh, Kee Tai
目的：根据消灭风疹和先天性风疹综合征(CRS)的区域和全球目标，我们根据风疹和先天性风疹综合征的监测报告、全国免疫覆盖率和血清流行率调查，回顾了新加坡的流行病学情况。我们审查的目的是找出目前的差距和为实现世界卫生组织西太平洋区域办事处(WPRO)设定的目标而采取的步骤。方法：对2003年至2013年向新加坡卫生部传染病司通报的风疹临床和实验室确诊病例(包括CRS)的流行病学数据进行整理和分析。风疹疫苗接种范围从国家免疫登记处和健康促进委员会的学校卫生服务处获得。结果：每百万人口中的本土风疹病例发病率从2008年的37.2例下降到2013年的7.6例，2012和2013年没有本土风疹病例。由于风疹感染而进行的治疗性流产已经变得不常见。儿童人群中麻疹、腮腺炎和风疹(MMR)疫苗的年度接种率仍然很高，从93%到96%。18-44岁女性对风疹的总体易感性已从2004年的15.8%大幅下降至2010年的11.0%。2008-2010年新加坡1~17岁儿童风疹免疫球蛋白抗体流行率维持在87.3%。结论：新加坡在消除风疹和CRS方面取得了良好的进展。它已经达到了世卫组织WPRO为2015年设定的目标。为准备核查消除风疹，已实施了一个加强的监测系统，以确保所有报告的病例都得到实验室确认，并对分离的风疹病毒株进行了基因分型，以提供阻断地方性传播的证据。(C)爱思唯尔有限公司出版的2015年。
Objective: In line with regional and global goals for the elimination of rubella and congenital rubella syndrome (CRS), we reviewed the epidemiological situation in Singapore, based on surveillance reports on rubella and CRS, national immunization coverage and seroprevalence surveys. The aim of our review was to identify current gaps and steps taken to achieve the targets set by the World Health Organization (WHO) Western Pacific Regional Office (WPRO).Methods: Epidemiological data on clinical and laboratory-confirmed rubella cases, including CRS, notified to the Communicable Diseases Division, Ministry of Health, Singapore, from 2003 to 2013 were collated and analyzed. Vaccination coverage against rubella was obtained from the National Immunization Registry and School Health Services of the Health Promotion Board. The changing prevalence of rubella was determined from periodic serological surveys.Findings: The incidence of indigenous rubella cases per million population decreased from 37.2 in 2008 to 7.6 in 2013 and there had been no indigenous case of CRS in 2012 and 2013. Therapeutic abortions performed due to rubella infections had become uncommon. The annual measles, mumps, and rubella (MMR) vaccination coverage in childhood population remained high ranging from 93% to 96%. The overall susceptibility to rubella in women aged 18-44 years had reduced significantly from 15.8% in 2004 to 11.0% in 2010. The prevalence of IgG antibody against rubella among Singapore children aged 1-17 years was maintained at 87.3% in 2008-2010.Conclusion: All available data indicated that Singapore has made good progress towards the elimination of rubella and CRS. It has attained the targets set by the WHO WPRO for 2015. In preparation for verification of rubella elimination, an enhanced surveillance system has been implemented to ensure that all reported cases are laboratory confirmed, and genotyping of rubella virus strains isolated is carried out to provide evidence for interruption of endemic transmission. (C) 2015 Published by Elsevier Ltd.