Seroprevalence and Risk Factors Associated with Rubella Virus Infection in Pregnancy and New Born Infants at Kerugoya Level 5 County Hospital, Kenya
Ndathi, Grace Nyawira
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Infection with Rubella virus is a public health concern because it may lead to serious consequences such as Congenital Rubella Syndrome (CRS) during early pregnancy. Introduction of the rubella virus vaccine in developed countries has since informed the need to assess the prevalence of rubella in the African countries and determine whether it is necessary to introduce a vaccine. This study, therefore, was carried out to determine the seroprevalence of the rubella infection in expectant women and their newborn infants. In addition, it assessed the risk factors that predispose pregnant women to rubella virus. This hospital-based cross-sectional survey was carried at Kerugoya level 5 County Hospital using the simple random technique. The study was done from April to June 2016. The study recruited 200 pregnant mothers due for delivery. Two (2 mls) of blood was collected from mothers and cord blood from their newborn infants. Blood was centrifuged to obtain serum which was used for the analysis. Samples were transported to the hospital laboratory where they were stored at -200C until the time of analysis. The samples were screened for rubella antibodies (IgG and IgM) using enzyme immunoassay method to determine the prevalence. Questionnaires were used to collect qualitative data. Data collected from the laboratory analysis and questionnaires were analyzed for association and differences using analytical software. Majority (53%) of the study participants were young adults, who were below 30 years. The highest proportion of mothers (60%) had attained secondary education. Some of the mothers (31.5%) were in small-scale enterprises. Most mothers were having a monthly income of less than US$ 100 per month. Most of the mothers had a household with more than 3 habitable rooms and no more than 3 members. Majority of the participating mothers had no knowledge about rubella. Association between active rubella infection among infants and the education level of the mother was statistically significant with a p- value p= 0.02, df= 2. The proportion of mothers who were rubella IgG positive was significantly dependent on the occupation of the mother p=0.03, df = 4. IgM rubella infection among mothers had a significant relationship with the mothers’ income bracket p=0.004, df = 3. There was a high prevalence of rubella IgG antibodies in pregnant women (91%) and their infants (95%) with a small proportion being unprotected to rubella infection (9%) and (5%) respectively. The prevalence of rubella IgM antibodies in pregnant mothers was (3.5%) while prevalence in infants was (2.5%). The major risk factors for rubella infection includes: Education level, occupation and level of income of the mothers. Vertical transmission rate was at (43%) which is of concern as it may cause CRS in the affected infants. Systematic rubella surveillance should be done routinely in the ante-natal clinic to enhance better health of the mother and avoid rubella transmission to the foetus. The current introduction of rubella vaccine in routine childhood immunization programme is justified. However women of child bearing age should also be included. This will ensure healthy pregnancy and delivery of healthy infants in Kenya.