Title : Seroprevalence of rubella virus infection among antenatal care clients of Halaba Town public health facilities, southern Ethiopia
Abstract:
Background: During pregnancy, the risk of rubella virus infection leads to serious implications for maternal and child health; the worst outcomes of pregnancy, spontaneous abortion and stillbirth, are common causes of CRS. The use of Rubella Containing Vaccine (RCV) against it has not yet been introduced into routine national child immunization services in Ethiopia. We sought to establish seroprevalence and identify risk factors of rubella in pregnant women in Southern Ethiopia in order to formulate targeted interventions for maternal-child health services.
Methods: A facility-based cross-sectional study design was conducted at public health facilities in Halaba Town, southern Ethiopia from March to April, 2021. Samples were collected from 299 consecutive pregnant women attending ANC services and tested for anti-rubella IgG and IgM antibodies using commercially available ELISA kit after administration of a structured questionnaire concerning sociodemographic and reproductive histories. We used binary logistic regression to assess risk factors associated with antibody positivity.
Results:
- Immunity and Exposure: 88.6% (n = 265) of pregnant women had positive anti-rubella IgG antibodies in their serum, suggesting previous natural exposure and immunity.
- Current or Recent Infection: Of the 299 participants, 5.0% (n = 15) were positive for anti-rubella IgM antibody (current/recent infection) while 11.4% remained fully susceptible.
- Key Risk Predictors: Pregnancy in the first trimester carried an extremely high odds of having recent rubella virus infection compared to later trimesters; (cOR) = 4.26, 95% CI (1.47-12.4, p=0.008).
- Sociodemographic Variables: Urban residence ((cOR) = 4.06, 95% CI (1.94-8.47)) and occupation of housewife ((cOR) =2.94, 95% CI (1.07-8.04)) were found to be significantly associated with high IgG seropositivity.
Conclusion: High rubella virus endemism was established in southern Ethiopia. There was a frightening presence of a pocket of recent rubella virus infection within the sensitive early stages of pregnancy. Over one in ten of our pregnant mothers studied remained unprotected against the virus, thus we call for immediate introduction of RCV into childhood immunization services and implementation of special interventions aimed at women of childbearing age for the eventual eradication of CRS.
Keywords: Rubella virus, Seroprevalence, Pregnant women, Congenital Rubella Syndrome, Ethiopia.
