Seroprevalence of Rubella in a Group of Moroccan Parturients and Physicians’ Opinions

Document Type : Original Article

Authors

1 National Reference Center in Neonatology and Nutrition, Children’s Hospital, IBN SINA University Hospital Centre, Rabat, Morocco Research Team on Health and Nutrition of Mother and Child, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco

2 Joint Research Unit in Nutrition, Health, and Environment, RDC-Nutrition AFRA/IAEA, Ibn Tofail University-CNESTEN, Rabat-Kenitra, Morocco

3 Research Team on Health and Nutrition of Mother and Child, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco Gynaecology-Obstetrics and Endocrinology Department, Maternity Souissi, IBN SINA University Hospital Center, Rabat, Morocco

4 National Reference Center in Neonatology and Nutrition, Children’s Hospital, IBN SINA University Hospital Centre, Rabat, Morocco 2. Research Team on Health and Nutrition of Mother and Child, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco

Abstract

Background: Rubella is an acute viral disease generally mild in its clinical manifestations. However, it is most serious for pregnant women due to the high frequency of congenital abnormalities that it causes, known as congenital rubella syndrome. This study aimed to determine rubella seroprevalence among a group of Moroccan parturients and survey physicians’ opinions regarding the situation of congenital rubella syndrome in different regions of Morocco.
Methods: We prospectively enrolled 1500 women hospitalized in the Maternity Souissi of Rabat for delivery and 14 pediatricians/neonatologists who were practicing in public and private centers representing different regions of Morocco. Data on rubella serological status were extracted from the medical records of mothers. The physicians involved in this study were visited to answer the survey in person, or they completed the survey by e-mail or phone discussion.
Results: Among enrolled women, and after excluding those who did not bring back evidence of a serological assessment, 222 (17.5%) women performed a rubella serology of which 84.7% were immunized against rubella. The opinion poll of physicians showed an almost absence of reports on congenital rubella syndrome cases. All practitioners surveyed were interested to join the establishment of congenital rubella syndrome reporting system.
Conclusion: To achieve the goals set for congenital rubella syndrome elimination, it is of primary importance to protect women from the childbearing age by vaccination and measures that help avoid any further contact with the virus. There is also a need to expand serological screening to detect and monitor seronegative women. In addition, it is necessary to diagnose and notify new cases of congenital rubella syndrome.
 
 

Keywords


  1. Best JM. Rubella. Semin Fetal Neonatal Med. 2007; 12(3):182‑92.
  2. Woolf SH, Battista RN, Anderson GM, Logan AG, Wang E. Assessing the clinical effectiveness of preventive maneuvers: Analytic principles and systematic methods in reviewing evidence and developing clinical practice recommendations A report by the Canadian task force on the periodic health examination. J Clin Epidemiol. 1990; 43(9):891‑905.
  3. Duszak RS. Congenital rubella syndrome—major review. Optometry. 2009; 80(1):36‑43.
  4. Caidi H, Abernathy ES, Benjouad A, Smit S, Bwogi J, Nanyunja M, et al. Phylogenetic analysis of rubella viruses found in Morocco, Uganda, Cote d’Ivoire and South Africa from 2001 to 2007. J Clin Virol. 2008; 42(1):86‑90.
  5. Kassa ZY, Hussen S, Asnake S. Sero-prevalence of rubella among pregnant women in Sub-Saharan Africa: a meta-analysis. Hum Vaccines Immunother. 2020; 16(10):2472‑8.
  6. Cutts FT, Robertson SE, Diaz-Ortega JL, Samuel R. Control of rubella and congenital rubella syndrome (CRS) in developing countries, Part 1: Burden of disease from CRS. Bull World Health Organ. 1997; 75(1):55-68.
  7. Roadmap to elimination standard measles and rubella surveillance = Feuille de route pour une surveillance de la rougeole et de la rubéole. Available at : https://apps.who.int/iris/handle/10665/254754 .
  8. Andrus JK, de Quadros CA, Solórzano CC, Periago MR, Henderson DA. Measles and rubella eradication in the Americas. Vaccine. 2011; 29(4):91-6.
  9. Gilbert NL, Rotondo J, Shapiro J, Sherrard L, Fraser WD, Ward BJ. Seroprevalence of rubella antibodies and determinants of susceptibility to rubella in a cohort of pregnant women in Canada, 2008-2011. Vaccine. 2017; 35(23):3050‑5.
  10. Dontigny L, Arsenault MY, Martel MJ, Biringer A, Cormier J, Delaney M, et al. Rubéole au cours de
    la grossesse. J Obstet Gynaecol Can. 2008; 30(2):159‑66.
  11. Public Health Agency of Canada. Surveillance of Rubella [Internet]. Government of Canada. 2016 [cited 2021 Sep 13]. Available from : https://www.canada. ca/en/public-health/services/diseases/rubella/surv
    eillance-rubella.html
  12. Adamo G, Sturabotti G, D’andrea E, Baccolini V, Romano F, Iannazzo S, et al. The end of measles and congenital rubella: an achievable dream. Ann Ig. 2017; 29(1):1‑26.
  13. Béraud G, Abrams S, Beutels P, Dervaux B, Hens N. Resurgence risk for measles, mumps and rubella in France in 2018 and 2020. Euro Surveill. 2018; 23(25):1-11.
  14. Grant GB, Desai S, Dumolard L, Kretsinger K, Reef SE. Progress toward rubella and congenital rubella syndrome control and elimination—Worldwide, 2000–2018. Morb Mortal Wkly Rep. 2019; 68(39):855-59.
  15. Bloom S, Rguig A, Berraho A, Zniber L, Bouazzaoui N, Zaghloul K, et al. Congenital rubella syndrome burden in Morocco: a rapid retrospective assessment. Lancet. 2005; 365(9454):135‑41.
  16. Zahir H, Arsalane L, Elghouat G, Mouhib H, Elkamouni Y, Zouhair S. Seroprevalence of rubella in pregnant women in Southern Morocco. Pan Afr Med J. 2020; 35(1):1-3.
  17. Direction de la Population. Programme National d’Immunisation, Aspects pratiques de la vaccination Manuel de formation [Internet]. 2013 [cited 2021 Oct 22]. Available from: https://www.sante.gov.ma/Documents/Manuel_PNI_29Juin2013_VersionImprime_SIPAMA.pdf
  18. Service de la Protection de la Santé de l’Enfant / Division de la Santé Maternelle et Infantile / Direction de la Population. PROGRAMME NATIONAL D’IMMUNISATION. 2012 [Internet]. Available from : https://fr.slideshare.net/MehdiRazzok/programme-national-dimmunisation
  19. Miller E, Cradock-Watson JE, Pollock TM. Consequences of confirmed maternal rubella at successive stages of pregnancy. Lancet. 1982; 320(8302):781‑4.
  20. Banatvala JE, Brown DW. Rubella. Lancet. 2004; 363(9415):1127‑37.
  21. Robertson SE, Featherstone DA, Gacic-Dobo M, Hersh BS. Rubella and congenital rubella syndrome: global update. Rev Panam Salud Publica. 2003; 14:306‑15.
  22. Mangtani P, Evans SJ, Lange B, Oberle D, Smith J, Drechsel-Baeuerle U, et al. Safety profile of rubella vaccine administered to pregnant women: A systematic review of pregnancy related adverse events following immunisation, including congenital rubella syndrome and congenital rubella infection in the foetus or infant. Vaccine. 2020; 38(5):963‑78.
  23. Robertson SE, Featherstone DA, Gacic-Dobo M, Hersh BS. Rubella and congenital rubella syndrome: global update. Rev Panam Salud Publica. 2003; 14(5):306‑15.
  24. Karakoc GB, Altıntas DU, Kılınc B, Karabay A, Mungan NO, Yılmaz M, et al. Seroprevalence of rubella in school girls and pregnant women. Eur J Epidemiol. 2003; 18(1):81‑4.
  25. Bulletin officiel n° 2853 du 5/07/1967 (5 juillet 1967). Décret royal n° 554-65 du 17 rebia I 1387 (26 juin 1967) portant loi rendant obligatoire la déclaration de certaines maladies et prescrivant des mesures prophylactiques propres à enrayer ces [Internet]. [cited 2019 Oct 20]. Available at : https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiN6_Lap4X6AhUIgP0HHVeKAb4QFnoECAYQAQ&url=https%3A%2F%2Fwww.ilo.org%2Fwcmsp5%2Fgroups%2Fpublic%2F---ed_protect%2F---protrav%2F---ilo_aids%2Fdocuments%2Flegaldocument%2Fwcms_127078.pdf&usg=AOvVaw21ThfKiwl9_tIeYbsFgcHQ
  26. Bo Belefquih B, Kasouati J, Doblali T, Touil N, Tagajdid MR, Kabbaj H, et al. Rubella seroprevalence in pregnant women at the military teaching hospital, Rabat, Morocco. Int J Gynecol Obstet. 2013; 120(2):191‑2.
  27. Caidi H, Bloom S, Azilmaat M, Benjouad A, Reef S, El Aouad R. Rubella seroprevalence among women aged 15-39 years in Morocco. East Mediterr Health J. 2009; 15(3):526‑31.
  28. Martínez-Quintana E, Castillo-Solórzano C, Torner N, Rodríguez-González F. Congenital rubella syndrome: a matter of concern. Rev Panam Salud Pública. 2015; 37(3):179‑86.
  29. Boucoiran I, Castillo E. No 368 - La rubéole durant la grossesse. J Obstet Gynaecol Can. 2018; 40(12):1657‑68.
  30. Sbiti M, Lahmadi K, Louzi L. Rubella immune status in pregnant women in central Morocco. JSM Microbiol. 2017; 5(2):1041.
  31. Chaabouni M, Messadi F, Fki L, Hammami A, Karray H. Rubella seroprevalence in Tunisian childbearing women two years after vaccination program Pathol Biol (Paris). 2012; 60(3):170‑3.
  32. White SJ, Boldt KL, Holditch SJ, Poland GA, Jacobson RM. Measles, mumps, and rubella. Clin Obstet Gynecol. 2012; 55(2):1-10.
  33. Global measles and rubella strategic plan: 2012–2020. 2022. Available at : http://apps.
    who.int/iris/ bitstream/10665/44855/1/9789241
    503396%5Feng.pdf
  34. Cerase V, Rebière I. La rubéole chez la femme enceinte et le nouveau-né en France en 1996. J de Pediatrie et de Pueric. 1998; 11(7):435–9.