Incidence of rubella in a state in North-western Nigeria: a call for action

Abstract

IntroductionRubella cases are often under-reported, especially in many developing countries, owing to inadequate attention and weak funding of elimination strategies, despite being an epidemic-prone disease. Based on available data, this paper, therefore, seeks to bring the attention of public health practitioners, researchers and policy makers to threats of rubella in our environment, and also recommend measures to mitigate the threats.MethodsThe authors conducted a retrospective cross-sectional study in which the laboratory results of febrile-rash-illness cases in Kebbi State, Northwest Nigeria, from January 1, 2014 to December 31, 2015 were analysed, using descriptive statistics and chi-square test. We obtained the data set through the routine Integrated Disease Surveillance System and Response being conducted in Nigeria.ResultsA total of 413 febrile-rash-illness cases were reported and investigated in Kebbi State from 2014 to 2015, 5 (3.5%) tested positive for rubella IgM in 2014 while 7(2.6%) tested positive in 2015. There was no statistically significant difference in the incidence of rubella between 2014 and 2015 (p> 0.05). Rubella infection was mainly found in children less than 5 years of age with peak incidence period during the hot season (between February and April). There was no significant sex bias in this study. However, our practice experiences in this environment suggest a systematic under-reporting and under-diagnosis of febrile- rash-illnesses.ConclusionThere was no statistically significant difference in the incidence of rubella in children in our setting for the 2-years studied. However, there is a potential for increase in the transmission of the disease due to non-availability of routine childhood vaccination against rubella and the systematic under-reporting of suspected cases and weak laboratory support. In order to better appreciate the burden of rubella infection, there may be a need to undertake a prevalence survey, and simultaneously, strengthening case-based surveillance in Northwestern Nigeria. Further, WHO should support national government in accelerating the introduction of rubella-containing vaccine to stem the potential spread of this infectious disease.

Characteristics of Rubella Epidemic in Tuzla Canton

“…Study from Kenya recorded 32% of cases under 5 years and 80% were younger than 10 years [22]. While in Nigeria, the most patients were reported among children younger than 5 years (58.3%), followed by children aged 5-9 years (41.7%), while none were reported age ≥10 years [23]. In Ethiopia, the age of confirmed cases is from 1 month to 42 years, with a mean age of 7.3 years; Three-quarters of all confirmed cases were younger than 10 years [24].…”

“…Studies in other countries which have not yet introduced rubella vaccine in routine immunization programs have shown widespread transmission of the virus. Studies from Nigeria, Kenya, and Ethiopia most affected were in March and April [22][23][24].…”

“…This difference is due to an earlier commitment to re-vaccinate female children in the age of 14 that was done by administering a single dose of vaccine against rubella [11]. In a study in Nigeria, there were no differences in morbidity between male and female; both groups had 50% of cases [23]. In Kenya, 54% of all cases were women [22].…”

Adult Males and Females in Osogbo, Osun State, Nigeria Manifest Extremely Low Level of Rubella Virus Susceptibility: Herd Immunity Implication

“…In conclusion, the very low level of susceptibility to rubella viral infection was apparently due to natural infection at childhood or later age as there is no prevention or routine vaccination policy to reduce rubella in Nigeria [2]. The rubella herd immunity therefore was responsible for absence of report of rubella outbreak in Osogbo in spite of epidemic-prone nature of the disease.…”

“…Rubella is a self-limiting, mild viral infection primarily of childhood but can affect adolescents/young adults and it is typically characterized by fever and skin rash [1,2]. It is caused by Rubella virus (RV), an enveloped virus with positive sense single stranded RNA genome belonging to the Genus Rubivirus in the family Togaviridae [3].…”