Estimates of the global burden of Congenital Rubella Syndrome, 1996-2019

• Published in: International journal of infectious diseases Vol. 137; pp. 149 - 156
• Main Authors: Vynnycky, Emilia, Knapp, Jennifer K., Papadopoulos, Timos, Cutts, Felicity T., Hachiya, Masahiko, Miyano, Shinsuke, Reef, Susan E.
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01-12-2023; Elsevier
• Subjects: Congenital Rubella Syndrome; Mathematical modeling; Measles-rubella vaccine; Rubella; Seroprevalence; Measles-rubella vaccine; Rubella; Congenital Rubella Syndrome; Mathematical modeling; Seroprevalence
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2023.09.003

•Many countries introduced rubella-containing vaccination (RCV) after 2010.•The global Congenital Rubella Syndrome (CRS) incidence fell by 66% during 2010-2019.•By 2019, 32,000 (95% confidence intervals: 13,000-60,000) babies were born annually with CRS globally.•The biggest reductions were in South-East Asia and the Western Pacific region.•Further declines in CRS incidence need continued high coverage and RCV in all nations.
Many countries introduced rubella-containing vaccination (RCV) after 2011, following changes in recommended World Health Organization (WHO) vaccination strategies and external support. We evaluated the impact of these introductions.
We estimated the country-specific, region-specific, and global Congenital Rubella Syndrome (CRS) incidence during 1996-2019 using mathematical modeling, including routine and campaign vaccination coverage and seroprevalence data.
In 2019, WHO African and Eastern Mediterranean regions had the highest estimated CRS incidence (64 [95% confidence intervals (CI): 24-123] and 27 [95% CI: 4-67] per 100,000 live births respectively), where nearly half of births occur in countries that have introduced RCV. Other regions, where >95% of births occurred in countries that had introduced RCV, had a low estimated CRS incidence (<1 [95% CI: <1 to 8] and <1 [95% CI: <1 to 12] per 100,000 live births in South-East Asia [SEAR] and the Western Pacific [WPR] respectively, and similarly in Europe and the Americas). The estimated number of CRS births globally declined by approximately two-thirds during 2010-2019, from 100,000 (95% CI: 54,000-166,000) to 32,000 (95% CI: 13,000-60,000), representing a 73% reduction since 1996, largely following RCV introductions in WPR and SEAR, where the greatest reductions occurred.
Further reductions can occur by introducing RCV in remaining countries and maintaining high RCV coverage.