Cargando…

Rubella in Sub-Saharan Africa and sensorineural hearing loss: a case control study

BACKGROUND: Rubella infection can affect several organs and cause birth defects that are responsible for congenital rubella syndrome (CRS). Congenital hearing loss is the most common symptom of this syndrome, occurring in approximately 60% of CRS cases. Worldwide, over 100 000 babies are born with C...

Descripción completa

Detalles Bibliográficos
Autores principales: Caroça, Cristina, Vicente, Vera, Campelo, Paula, Chasqueira, Maria, Caria, Helena, Silva, Susana, Paixão, Paulo, Paço, João
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5286841/
https://www.ncbi.nlm.nih.gov/pubmed/28143602
http://dx.doi.org/10.1186/s12889-017-4077-2
_version_ 1782504075538989056
author Caroça, Cristina
Vicente, Vera
Campelo, Paula
Chasqueira, Maria
Caria, Helena
Silva, Susana
Paixão, Paulo
Paço, João
author_facet Caroça, Cristina
Vicente, Vera
Campelo, Paula
Chasqueira, Maria
Caria, Helena
Silva, Susana
Paixão, Paulo
Paço, João
author_sort Caroça, Cristina
collection PubMed
description BACKGROUND: Rubella infection can affect several organs and cause birth defects that are responsible for congenital rubella syndrome (CRS). Congenital hearing loss is the most common symptom of this syndrome, occurring in approximately 60% of CRS cases. Worldwide, over 100 000 babies are born with CRS every year. There is no specific treatment for rubella, but the disease is preventable by vaccination. Since 1969, the rubella vaccine has been implemented in many countries, but in Africa, only a few countries routinely immunize against rubella. The aim of this study was to estimate the rate of infection from the wild-type rubella virus in São Tomé and Príncipe by determining rubella seroprevalence with a DBS method. The goal of this study was to reinforce the need for implementation of the rubella vaccine in this country. As secondary objectives, the validation of a DBS method was first attempted and an association between seroprevalence and hearing loss was assessed. METHODS: We collected samples from individuals observed during humanitarian missions in São Tomé and Príncipe. All individuals underwent an audiometric evaluation, and a drop of blood was collected for the dried blood spot (DBS). We define two groups: the case group (individuals with unilateral or bilateral hearing loss (HL)) and the control group (individuals with two normal ears). Patients were excluded if they suffered from conductive HL, if they showed evidence of possible causes of HL, if they had developmental delay or if they refused to participate in the study. RESULTS: Among the 315 subjects, we found 64.1% individuals with IgG for the rubella virus, 32.1% without immunity for the rubella virus and 3.8% who were borderline. In the control group, 62.6% were positive for the rubella IgG, whereas in the case group, 72% were positive. Analyzing both groups, with ages ranging from 2 to 14 years of age and from 15 to 35 years of age, we found a seroprevalence of 50.3% to rubella in the younger group and 82.1% in the older group, with a significant difference between cases and control group noted within the younger patients (p = 0.025). CONCLUSIONS: Rubella is a disease that can be prevented. Rubella infections are still very common in São Tomé and Príncipe, and women of child-bearing age are still at risk for rubella infection during pregnancy, justifying the urgency of vaccination against rubella. A statistically significant association between the group of children under 14 years of age with HL and immunity for rubella was observed in this country, although this study did not allow us to establish a cause-effect relationship between rubella infection and SNHL.
format Online
Article
Text
id pubmed-5286841
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-52868412017-02-06 Rubella in Sub-Saharan Africa and sensorineural hearing loss: a case control study Caroça, Cristina Vicente, Vera Campelo, Paula Chasqueira, Maria Caria, Helena Silva, Susana Paixão, Paulo Paço, João BMC Public Health Research Article BACKGROUND: Rubella infection can affect several organs and cause birth defects that are responsible for congenital rubella syndrome (CRS). Congenital hearing loss is the most common symptom of this syndrome, occurring in approximately 60% of CRS cases. Worldwide, over 100 000 babies are born with CRS every year. There is no specific treatment for rubella, but the disease is preventable by vaccination. Since 1969, the rubella vaccine has been implemented in many countries, but in Africa, only a few countries routinely immunize against rubella. The aim of this study was to estimate the rate of infection from the wild-type rubella virus in São Tomé and Príncipe by determining rubella seroprevalence with a DBS method. The goal of this study was to reinforce the need for implementation of the rubella vaccine in this country. As secondary objectives, the validation of a DBS method was first attempted and an association between seroprevalence and hearing loss was assessed. METHODS: We collected samples from individuals observed during humanitarian missions in São Tomé and Príncipe. All individuals underwent an audiometric evaluation, and a drop of blood was collected for the dried blood spot (DBS). We define two groups: the case group (individuals with unilateral or bilateral hearing loss (HL)) and the control group (individuals with two normal ears). Patients were excluded if they suffered from conductive HL, if they showed evidence of possible causes of HL, if they had developmental delay or if they refused to participate in the study. RESULTS: Among the 315 subjects, we found 64.1% individuals with IgG for the rubella virus, 32.1% without immunity for the rubella virus and 3.8% who were borderline. In the control group, 62.6% were positive for the rubella IgG, whereas in the case group, 72% were positive. Analyzing both groups, with ages ranging from 2 to 14 years of age and from 15 to 35 years of age, we found a seroprevalence of 50.3% to rubella in the younger group and 82.1% in the older group, with a significant difference between cases and control group noted within the younger patients (p = 0.025). CONCLUSIONS: Rubella is a disease that can be prevented. Rubella infections are still very common in São Tomé and Príncipe, and women of child-bearing age are still at risk for rubella infection during pregnancy, justifying the urgency of vaccination against rubella. A statistically significant association between the group of children under 14 years of age with HL and immunity for rubella was observed in this country, although this study did not allow us to establish a cause-effect relationship between rubella infection and SNHL. BioMed Central 2017-02-01 /pmc/articles/PMC5286841/ /pubmed/28143602 http://dx.doi.org/10.1186/s12889-017-4077-2 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Caroça, Cristina
Vicente, Vera
Campelo, Paula
Chasqueira, Maria
Caria, Helena
Silva, Susana
Paixão, Paulo
Paço, João
Rubella in Sub-Saharan Africa and sensorineural hearing loss: a case control study
title Rubella in Sub-Saharan Africa and sensorineural hearing loss: a case control study
title_full Rubella in Sub-Saharan Africa and sensorineural hearing loss: a case control study
title_fullStr Rubella in Sub-Saharan Africa and sensorineural hearing loss: a case control study
title_full_unstemmed Rubella in Sub-Saharan Africa and sensorineural hearing loss: a case control study
title_short Rubella in Sub-Saharan Africa and sensorineural hearing loss: a case control study
title_sort rubella in sub-saharan africa and sensorineural hearing loss: a case control study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5286841/
https://www.ncbi.nlm.nih.gov/pubmed/28143602
http://dx.doi.org/10.1186/s12889-017-4077-2
work_keys_str_mv AT carocacristina rubellainsubsaharanafricaandsensorineuralhearinglossacasecontrolstudy
AT vicentevera rubellainsubsaharanafricaandsensorineuralhearinglossacasecontrolstudy
AT campelopaula rubellainsubsaharanafricaandsensorineuralhearinglossacasecontrolstudy
AT chasqueiramaria rubellainsubsaharanafricaandsensorineuralhearinglossacasecontrolstudy
AT cariahelena rubellainsubsaharanafricaandsensorineuralhearinglossacasecontrolstudy
AT silvasusana rubellainsubsaharanafricaandsensorineuralhearinglossacasecontrolstudy
AT paixaopaulo rubellainsubsaharanafricaandsensorineuralhearinglossacasecontrolstudy
AT pacojoao rubellainsubsaharanafricaandsensorineuralhearinglossacasecontrolstudy