Study stresses the importance of access to vaccination

Development of congenital rubella in infants causes severe disability, study finds. Disabilities could be avoided through increasing access to rubella vaccination for mothers and their children (Lawn et al., 2000).

What was the context of the research

Due to immunizations, congenital rubella has nearly been eradicated in developed countries. However, in lower income countries such as Ghana, there is limited access to the rubella vaccine and therefore, it has not been eradicated. Congenital rubella leads to hearing impairments, blindness, and in some cases death. The morbidity and mortality of congenital rubella in children in developing countries often go unrecorded due to lack of research. In this study, researchers aimed to determine the impact congenital rubella had in Kumasi, Ghana.

What were the methods of the research

Cases of congenital rubella were surveyed in Kumasi, Ghana by analyzing past hospital records and current cases of infants under the age of two. Additionally, pregnant mothers were screened for rubella by drawing their blood. There were 18 cases of infants that met the criteria of either having two of the following: congenital cataracts, congenital heart disease, auditory impairment. In other cases, the infant may have had one of the following: hepatomegaly, microcephaly, severe developmental delay, weight below the third percentile, or thrombocytopenia. Additionally, the researchers conducted a prospective study on 6 infants to determine the outcome of the disorder.

What did the study find

The mean age of onset was 5.8 months (range 2-12 months). It was found that congenital rubella affected about 0.8 cases per 1,000 live births. However, this rate is likely lower than what it actually is. We must conduct more research to really understand the true prevalence of the disorder. For the six infants that were prospectively studied, two of them died. One died from cardiac failure and lower respiratory tract infection (LRTI), and the other died from a LRTI, as well. Children with congenital rubella struggle to thrive and gain weight. Mother’s reported issues during pregnancy such as febrile illness (fever), a rash, and malaria.

LRTI: lower respiratory tract infection
*all cases showed failure to thrive (under third percentile for age) and developmental delay

What were the conclusions of the study/what do they recommend

In developing countries, there are diseases that impact a large population of people, and therefore take priority in public health concerns. Illnesses like congenital rubella do not affect as many people and tend to be overlooked. Congenital rubella can be prevented through vaccinations, and with access to immunizations, it can be eradicated. The burden of congenital rubella - which causes blindness, deafness, mental retardation, and cardiac defects is very high. Therefore, it is important to spread awareness about the severity and prevalence of it, so that it can be managed.

Keywords

Congenital rubella, immunizations, vaccines, Ghana, developmental delays, mental retardation, heart defects, blindness, deafness

Links

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1446363/

Citation

Lawn, J. E., Reef, S., Baffoe-Bonnie, B., Adadevoh, S., Caul, E. O., & Griffin, G. E. (2000). Unseen blindness, unheard deafness, and unrecorded death and disability: congenital rubella in Kumasi, Ghana. American Journal of Public Health, 90(10), 1555-61.