Strategies to eradicate rubella in the English-speaking Caribbean

Abstract

OBJECTIVE: This report presents the strategies used to eradicate rubella in the Caribbean region and the challenges faced by that effort. METHODS: Using the surveillance system for measles cases that was instituted in all countries in the Caribbean Community (CARICOM), 12 countries confirmed cases of rubella between 1992 and 1996. Rubella infections occurred in epidemic proportions in 6 countries during that period. RESULTS: On the basis of the rubella prevalence data, rubella-congenital rubella syndrome (CRS) cost-benefit analysis, and cost-effectiveness of the mass campaign, the Council for Human and Social Development of CARICOM resolved, on April 21, 1998, that every effort would be made to eradicate rubella, as well as to prevent the occurrence of new cases of CRS by the end of 2000. Using the Pan American Health Organization's template for measles eradication, CARICOM proposed and implemented the main strategies for rubella and CRS eradication, and rubella mass campaigns were conducted in 18 countries. The target population, which included males and females (aged 20-40 years), was approximately 2.2 million. CONCLUSION: The major challenges for rubella eradication are attaining high vaccine coverage in the adult population and maintaining an effective surveillance system able to detect rubella activity.

Rubella natural immunity among adolescent girls in Tanzania: the need to vaccinate child bearing aged women

“…Reduction in CRS cases will save the Tanzanian government a significant amount of money that will be used in lifetime treatment of these cases. It has been observed that the lifetime treatment of CRS can cost between 14,000USD and 200,000USD [ 28 – 30 ].…”

Identification of Serologic Markers for School-Aged Children With Congenital Rubella Syndrome

“…Estimating the CRS burden and the costs of long-term care for children born with disabilities due to CRS should be considered in countries planning to introduce RCV [34]. The immunoblot method described could be used to estimate the proportion of disabilities due to CRS among a group (or groups) of children with a specific disability or disabilities, such as hearing impairment.…”

The Expanded Program on Immunization in the English- and Dutch-speaking Caribbean (1977–2016): reasons for its success

“…The elimination of these diseases was achieved through collective efforts, including coordinated “catch-up” and “follow-up” mass vaccination campaigns, and the strengthening of routine or “keep-up” vaccination of various targeted age groups, including adult males, who were reached at their places of leisure, and work, including the agricultural fields (Figure 3). These efforts were supported by strong active surveillance for suspected cases, using standardized case definitions, in both public and private surveillance sites (including hotels), as well as laboratory diagnosis done centrally at CAREC (15). Training of private-sector health care workers in the principles of surveillance for vaccinepreventable diseases and reporting requirements was also carried out.…”