The burden of congenital rubella syndrome in the Philippines: results from a retrospective assessment

Authors

  • Anna Lena Lopez Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines Manila, Philippines
  • Peter Francis Raguindin Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines Manila, Philippines
  • Jose Jonas Del Rosario Philippine Children’s Medical Center, Quezon City, Philippines; Department of Pediatrics, College of Medicine, University of the Philippines Manila, Philippines
  • Ramon V. Najarro Department of Pediatrics, Vicente Sotto Memorial Medical Center, Cebu City, Philippines
  • Eleanor Du Department of Pediatrics, Southern Philippines Medical Center, Davao City, Philippines
  • Josephine Aldaba Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines Manila, Philippines
  • Aida M. Salonga Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines Manila, Philippines
  • Andrea Kristina Monzon-Pajarillo Department of Ophthalmology, College of Medicine, University of the Philippines Manila, Philippines
  • Alvina Pauline Santiago Department of Ophthalmology, College of Medicine, University of the Philippines Manila, Philippines
  • Alan C. Ou World Health Organization Representative’s Office, Manila, Philippines; Centers for Disease Control and Prevention, Global Immunization Division, Atlanta, GA, USA
  • Maria Joyce Ducusin Department of Health, Philippines

DOI:

https://doi.org/10.5365/wpsar.2017.8.1.006

Abstract

Introduction: In line with the regional aim of eliminating rubella and congenital rubella syndrome (CRS), the Philippines introduced rubella-containing vaccines (RCV) in the national routine immunization program in 2010. We attempted to estimate the burden of CRS in the country prior to nationwide programmatic use.

Methods: We performed a retrospective chart review in four tertiary hospitals. Children born between January 1, 2009 and December 31, 2014 identified as possible CRS cases based on the presence of one or more potential manifestations of CRS documented in hospital or clinic charts were reviewed.  Laboratory-confirmed cases meeting the clinical case definition of CRS were confirmed CRS cases.  Cases that met the clinical case definition of CRS but without laboratory confirmation were considered as probable CRS cases.

Results: We identified 18 confirmed and 201 probable cases in this review. Depending on the hospital, the estimated incidence of CRS ranged from 30 to 233 cases per 100,000 live births. The estimated national burden of CRS was 20-31 cases per 100,000 annually.

Discussion: This is the first attempt to assess the national CRS burden.  Prospective surveillance for CRS and further strengthening of the ongoing measles-rubella surveillance are necessary to establish accurate estimates of the burden of CRS and the impact of programmatic RCV use in the future. 

Author Biographies

Anna Lena Lopez, Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines Manila, Philippines

Director, Institute of Child Health and Human Development Research Associate Professor  

Peter Francis Raguindin, Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines Manila, Philippines

University Researcher, Institute of Child Health and Human Development

Jose Jonas Del Rosario, Philippine Children’s Medical Center, Quezon City, Philippines; Department of Pediatrics, College of Medicine, University of the Philippines Manila, Philippines

Head, Section of Pediatric Cardiology

Ramon V. Najarro, Department of Pediatrics, Vicente Sotto Memorial Medical Center, Cebu City, Philippines

Chairman, Department of Pediatrics

Eleanor Du, Department of Pediatrics, Southern Philippines Medical Center, Davao City, Philippines

Head, Section of Pediatric Endocrinology, Department of Pediatrics

Josephine Aldaba, Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines Manila, Philippines

University Researcher, Institute of Child Health and Human Development

Aida M. Salonga, Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines Manila, Philippines

Past Director, Institute of Child Health and Human Development

 

Andrea Kristina Monzon-Pajarillo, Department of Ophthalmology, College of Medicine, University of the Philippines Manila, Philippines

Clinical Associate Professor, Department of Ophthalmology

Alvina Pauline Santiago, Department of Ophthalmology, College of Medicine, University of the Philippines Manila, Philippines

Clinical Associate Professor, Department of Ophthalmology

Alan C. Ou, World Health Organization Representative’s Office, Manila, Philippines; Centers for Disease Control and Prevention, Global Immunization Division, Atlanta, GA, USA

Medical Officer, Center for Global Health, Global Immunization Division, Centers for Disease Control and Prevention

Maria Joyce Ducusin, Department of Health, Philippines

OIC-Director III Women, Men & Children Health & Development Division  Disease Prevention and Control Bureau Department of Health

References

McLean H, Redd SB, Abernathy E, Icenogle JP, Wallace G. Rubella. In: Roush SW, Baldy LM, eds. Vaccine Preventable Diseases Surveillance Manual. Atlanta, Georgia: Centers for Disease Control and Prevention 2012.

McLean H, Redd SB, Abernathy E, Icenogle JP, Wallace G. Congenital Rubella Syndrome. In: Roush SW, ed. Vaccine Preventable Diseases Surveillance Manual. Atlanta, Georgia: Centers for Disease Control and Prevention; 2012.

Robertson SE, Featherstone DA, Gacic-Dobo M, Hersh BS. Rubella and congenital rubella syndrome: global update. Rev Panam Salud Publica. 2003;14(5):306-315.

Lawn JE, Reef S, Baffoe-Bonnie B, Adadevoh S, Caul EO, Griffin GE. Unseen blindness, unheard deafness, and unrecorded death and disability: Congenital rubella in Kumasi, Ghana. Am J Pub Health. 2000;90(10):1555-1561.

Thant KZ, Oo WM, Myint TT, et al. Active surveillance for congenital rubella syndrome in Yangon, Myanmar. Bull World Health Org. 2006;84(1):12-20.

World Health Organization. Rubella vaccine: WHO position paper. Weekly Epidemiol Rev. 2011;86:301-316.

Vynnycky E, Adams EJ, Cutts FT, et al. Using Seroprevalence and Immunisation Coverage Data to Estimate the Global Burden of Congenital Rubella Syndrome, 1996-2010: A Systematic Review. PLoS One. 2016;11(3):e0149160.

World Health Organization. Expanded Program for Immunization: Regional Framework for Implementation of the Global Vaccine Action Plan in the Western Pacific - 65th session of the World Health Organization Regional Committee for the Western Pacific Manila, Philippines: World Health Organization; October 16 2014. WPR/RC65.R5.

World Health Organization. 24th Meeting of the Technical Advisory Group on Immunization and Vaccine Preventable Diseases in the Western Pacific Region. Manila: Western Pacific Regional Office;2015.

Department of Vaccines and Biologicals. WHO-recommended standards for surveillance of selected vaccine-preventable diseases. Geneva, Switzerland: World Health Organization; 2008.

Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine Preventable Diseases. Washington D.C.: Public Health Foundation; 2015.

Reef S, Plotkin S, Cordero JF, et al. Preparing for elimination of congenital rubella syndrome (CRS): Summary of a workshop on CRS elimination in the United States. Clin Infect Dis. 2000;31:85-95.

Wolff SM. The ocular manifestation of congenital rubella: A prospective study of 328 cases of congenital rubella. J Pediatr Ophthalmol Strabismus. 1973;10:101-141.

Bloom S, Rguig A, Berraho A, et al. Congenital rubella syndrome burden in Morocco: a rapid retrospective assessment. The Lancet. 2005;365(9454):135-141.

PhilHealth. Stats & Charts 1st Semester 2015. 2015; http://www.philhealth.gov.ph/about_us/statsncharts/snc2015_1st.pdft/. Accessed 15 May, 2016.

Philippine Statistics Authority. Live Births: Philippines 2014. 2015; https://psa.gov.ph/content/live-births-philippines-2014. Accessed April 2, 2016.

Adam O, Ali AK, Hubschen JM, Muller CP. Identification of congenital rubella syndrome in Sudan. BMC infectious diseases. 2014;14:305.

Toda K, Reef S, Tsuruoka M, et al. Congenital rubella syndrome (CRS) in Vietnam 2011-2012--CRS epidemic after rubella epidemic in 2010-2011. Vaccine. 2015;33(31):3673-3677.

Lopez AL, Raguindin PFN, Silvestre MA, Fabay XCJ, Vinarao AB, Manalastas R. Rubella and Congenital Rubella Syndrome in the Philippines: A Systematic Review. International Journal of Pediatrics. 2016;2016:8.

Vynnycky E, Adams E, Cutts F, et al. Using Seroprevalence and Immunisation Coverage Data to Estimate the Global Burden of Congenital Rubella Syndrome, 1996-2010: A Systematic Review. PLoS One. 2016;11(3).

Family Health Office - Expanded Program for Immunization. The Philippine Immunization Program Strategic Plan for 2015-2019. Manila: Department of Health, Republic of the Philippines;2015.

WHO-UNICEF. WHO and UNCEF estimates of national immunization coverage. 2016; https://data.unicef.org/wp-content/uploads/country_profiles/Philippines/Immunization_phl.pdf. Accessed 30 November, 2016.

World Health Organization and Department of Health. Health Service Delivery Profile: Philippines. 2012; http://www.wpro.who.int/health_services/health_service_delivery_profiles/en/. Accessed Dec 5, 2015.

Chiong C, Ostrea E, Jr., Reyes A, Llanes EG, Uy ME, Chan A. Correlation of hearing screening with developmental outcomes in infants over a 2-year period. Acta Otolaryngol. 2007;127(4):384-388.

Chiong CM, Villanueva EM. Cochlear implantation in chronic otitis media. Acta Med Philipp. 2012;46(3):21-26.

Epidemiology Bureau. Measles-Rubella Cases, Morbidity Week 42 Measles-Rubella Cases, Monthly Report 2016; http://www.doh.gov.ph/sites/default/files/statistics/MEASLESRUBELLA42_compressed.pdf. Accessed 29 December, 2016.

WHO. Introducing rubella vaccine into National Immunization Programmes. 2015; http://www.who.int/immunization/documents/who_ivb_15.07/en/. Accessed 24 October, 2016.

Published

13-06-2017

How to Cite

1.
Lopez AL, Raguindin PF, Del Rosario JJ, Najarro RV, Du E, Aldaba J, Salonga AM, Monzon-Pajarillo AK, Santiago AP, Ou AC, Ducusin MJ. The burden of congenital rubella syndrome in the Philippines: results from a retrospective assessment. Western Pac Surveill Response J [Internet]. 2017 Jun. 13 [cited 2024 Apr. 30];8(2). Available from: https://ojs.wpro.who.int/ojs/index.php/wpsar/article/view/528

Issue

Section

Original Research