Reduction in Rubella Virus Active Cases among Children and Adolescents after Rubella Vaccine Implementation in Tanzania: A Call for Sustained High Vaccination Coverage
Fausta Michael,
Mariam M. Mirambo,
Dafrossa Lyimo,
Furaha Kyesi,
Delfina R. Msanga,
Georgina Joachim,
Honest Nyaki,
Richard Magodi,
Delphius Mujuni,
Florian Tinuga,
Ngwegwe Bulula,
Bonaventura Nestory,
Dhamira Mongi,
Ahmed Makuwani,
Betina Katembo,
William Mwengee,
Alex Mphuru,
Nassor Mohamed,
David Kayabu,
Helmut Nyawale,
Eveline T. Konje,
Stephen E. Mshana
Affiliations
Fausta Michael
Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania
Mariam M. Mirambo
Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania
Dafrossa Lyimo
Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania
Furaha Kyesi
Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania
Delfina R. Msanga
Department of Pediatrics and Child Health, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania
Georgina Joachim
Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania
Honest Nyaki
Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania
Richard Magodi
Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania
Delphius Mujuni
Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania
Florian Tinuga
Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania
Ngwegwe Bulula
Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania
Bonaventura Nestory
Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania
Dhamira Mongi
Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania
Ahmed Makuwani
Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania
Betina Katembo
National Public Health Laboratory, Dar es Salaam P.O. Box 9083, Tanzania
William Mwengee
World Health Organization, Country Office, Dar es Salaam P.O. Box 9292, Tanzania
Alex Mphuru
United Nations Children’s Fund (UNICEF), Country Office, Dar es Salaam P.O. Box 4076, Tanzania
Nassor Mohamed
Immunization Center, John Snow Inc. (JSI), 2733 Crystal Dr 4th Floor, Arlington, VA 22202, USA
David Kayabu
Management and Development for Health (MDH), Dar es Salaam P.O Box 79810, Tanzania
Helmut Nyawale
Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania
Eveline T. Konje
Department of Epidemiology and Biostatistics, School of Public Health, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania
Stephen E. Mshana
Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania
Rubella virus (RV) infection in susceptible women during the first trimester of pregnancy is associated with congenital Rubella syndrome (CRS). In countries where a vaccination program is implemented, active case surveillance is emphasized. This report documents the magnitude of active cases before and after vaccine implementation in Tanzania. A total of 8750 children and adolescents with signs and symptoms of RV infection were tested for Rubella IgM antibodies between 2013 and 2019 using enzyme immunoassay followed by descriptive analysis. The median age of participants was 3.8 (IQR: 2–6.4) years. About half (4867; 55.6%) of the participants were aged 1–5 years. The prevalence of RV active cases was 534 (32.6%, 95% CI: 30.2–34.9) and 219 (3.2%, 95% CI: 2.7–3.6) before and after vaccine implementation, respectively. Before vaccination, the highest prevalence was recorded in Pemba (78.6%) and the lowest was reported in Geita (15.6%), whereas, after vaccination, the prevalence ranged between 0.5% in Iringa and 6.5% in Pemba. Overall, >50% of the regions had a >90% reduction in active cases. The significant reduction in active cases after vaccine implementation in Tanzania underscores the need to sustain high vaccination coverage to prevent active infections and eventually eliminate CRS, which is the main goal of Rubella vaccine implementation.
