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      Effectiveness of immunization activities on measles and rubella immunity among individuals in East Sepik, Papua New Guinea: A cross-sectional study

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          Highlights

          • •

            Measles and rubella are endemic in Papua New Guinea.

          • •

            The target age group had low anti-measles and anti-rubella IgG prevalence.

          • •

            The target group for immunization had higher measles and rubella IgG prevalence.

          • •

            The immunization program should be intensified to eliminate measles and rubella.

          Abstract

          Objectives

          This study aimed to assess measles and rubella immunity by measuring virus-specific immunoglobulin G (IgG) prevalence among individuals and evaluate the effectiveness of recent supplementary immunization activities (SIAs) by comparing the antibody positivity rates of the SIA target age groups in 2015 with those in 2019 as measles and rubella are endemic in Papua New Guinea.

          Methods

          A cross-sectional study. The measles- and rubella-specific IgG levels of patients aged ≥1 year at two clinics in East Sepik province, Papua New Guinea were assessed with commercially available virus-specific IgG EIA kits.

          Results

          In total, 297 people participated in the study and 278 samples with sufficient volume, relevant information, and age inclusion criteria were analyzed. The overall IgG prevalence rates were 62.6% for measles and 82.0% for rubella. The age groups targeted in the 2019 SIAs had a higher IgG prevalence than those targeted in the 2015 SIAs for both the infectious diseases. Moreover, the IgG prevalence for rubella was higher than measles in these groups.

          Conclusions

          The anti-measles and anti-rubella IgG prevalence in the target groups were lower than those required for herd immunity. The immunization program should be emphasized to eliminate measles and rubella. Further population-based studies are warranted.

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          Most cited references24

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          Measles vaccines: WHO position paper – April 2017.

          (2017)
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            Evaluation of nationwide supplementary immunization in Lao People's Democratic Republic: Population-based seroprevalence survey of anti-measles and anti-rubella IgG in children and adults, mathematical modelling and a stability testing of the vaccine

            Masahiko Hachiya, Shinsuke Miyano, Yoshio Mori … (2018)
            Background Measles outbreaks have occurred in some countries despite supplementary immunization activities (SIA) using measles-containing vaccine with high vaccination coverage. We conducted a cross-sectional seroprevalence survey to estimate population immunity in Lao People's Democratic Republic where repeated mass immunization has failed to eliminate measles. Methods and findings In this nationwide multistage cluster sampling survey conducted in 2014 based on probability proportionate to size sampling, blood samples were collected from 2,135 children and adults living in 52 randomly selected villages. Anti-measles and anti-rubella IgG were measured, and IgG prevalence was calculated. We applied mathematical modelling to estimate the number of cases of congenital rubella syndrome (CRS) in 2013 that were averted by the 2011 SIA. A stability testing was applied to the MR vaccine at 4°C, 25°C, and 35°C to examine stability differences between measles and rubella vaccine components. Measles IgG prevalence was significantly lower in the target age groups (5–21 years) of the 2011 SIA using a combination vaccine for measles and rubella vaccine (MR vaccine) than in young adults (22–39 years) (86.8% [95% CI: 83.0–90.6] vs. 99.0% [98.3–99.8]; p<0.001), whereas rubella IgG prevalence was significantly higher (88.2% [84.5–91.8] vs. 74.6% [70.7–78.5]; p<0.001). In the SIA target age groups, prevalence of measles IgG, but not rubella IgG, increased with age. CRS cases prevented in 2013 ranged from 16 [0–50] to 92 [32–180] if the force of infection had remained unchanged or had been reduced by 75%, respectively. In freeze-dried conditions, the measles vaccine component was more heat sensitive than the rubella component. Conclusions Inconsistent IgG prevalence between measles and rubella in Lao PDR can be partly explained by different stability of the measles and rubella vaccine components under heat exposure. Suboptimal vaccine handling may cause insufficient immunogenicity for measles, which subsequently leads to an outbreak despite high SIA coverage, while direct evidence is lacking. Temperature monitoring of the vaccine should be conducted.
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              Serological makers of rubella infection in Africa in the pre vaccination era: a systematic review

              Mariam M. Mirambo, Mtebe Majigo, Said Aboud … (2015)
              Background Rubella infections in susceptible women during early pregnancy often results in congenital rubella syndrome (CRS). World Health Organisation (WHO) recommends that countries without vaccination programmes to assess the burden of rubella infection and CRS. However; in many African countries there is limited data on epidemiology of rubella infection and CRS. This review was undertaken to assess the serological markers and genotypes of rubella virus on the African continent in order to ascertain the gap for future research. Findings A systematic search of original literatures from different electronic databases using search terms such as ‘rubella’ plus individual African countries such as ‘Tanzania’, ‘Kenya’, ‘Nigeria’ etc. and different populations such as ‘children’, ‘pregnant women’ etc. in different combinations was performed. Articles from countries with rubella vaccination programmes, outbreak data and case reports were excluded. Data were entered in a Microsoft Excel sheet and analyzed. A total of 44 articles from 17 African countries published between 2002 and 2014 were retrieved; of which 36 were eligible and included in this review. Of all population tested, the natural immunity of rubella was found to range from 52.9 to 97.9 %. In these countries, the prevalence of susceptible pregnant women ranged from 2.1 to 47.1 %. Rubella natural immunity was significantly higher among pregnant women than in general population (P < 0.001). Acute rubella infection was observed to be as low as 0.3 % among pregnant women to 45.1 % among children. All studies did not ascertain the age-specific prevalence, thus it was difficult to calculate the rate of infection with increase in age. Only two articles were found to report on rubella genotypes. Of 15 strains genotyped; three rubella virus genotypes were found to circulate in four African countries. Conclusion Despite variations in serological assays, the seroprevalence of IgG rubella antibodies in Africa is high with a substantial number of women of childbearing age being susceptible to rubella infection. Standardized sero-epidemiological data in various age groups as well as CRS data are important to implement cost-effective vaccination campaigns and control strategies. Electronic supplementary material The online version of this article (doi:10.1186/s13104-015-1711-x) contains supplementary material, which is available to authorized users.
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                Author and article information

                Contributors
                Yasunori Ichimura
                Journal
                Journal ID (nlm-ta): IJID Reg
                Journal ID (iso-abbrev): IJID Reg
                Title: IJID Regions
                Publisher: Elsevier
                ISSN (Electronic): 2772-7076
                Publication date PMC-release: 03 March 2022
                Publication date Collection: June 2022
                Publication date (Electronic): 03 March 2022
                Volume: 3
                Pages: 84-88
                Affiliations
                [a ]Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
                [b ]Department of Tropical Medicine and Parasitology, Juntendo University, Tokyo, Japan
                [c ]Center for Health Research and Diagnostics, Divine Word University, Madang, Papua New Guinea
                [d ]Wewak General Hospital, Wewak, East Sepik, Papua New Guinea
                [e ]Department of Virology III, National Institute of Infectious Diseases, Tokyo, Japan
                Author notes
                [* ]Corresponding author: Yasunori Ichimura, Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655 JAPAN, Phone: 81-3-3202-7181 (ext. 2733), Fax: 81-3-3205-7860. yichimura@ 123456it.ncgm.go.jp
                Article
                Publisher Item ID: S2772-7076(22)00028-5
                DOI: 10.1016/j.ijregi.2022.03.001
                PMC ID: 9216679
                PubMed ID: 35755474
                SO-VID: a2a7f2c0-4865-4fc3-b548-906d46a6827d
                Copyright © © 2022 The Authors
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 10 January 2022
                Date revision received : 28 February 2022
                Date accepted : 1 March 2022
                Categories
                Subject: Original Report

                Keywords: immunoglobulin g,seroprevalence,immunization,vaccine-preventable diseases,measles,rubella
                Data availability:
                Keywords: immunoglobulin g, seroprevalence, immunization, vaccine-preventable diseases, measles, rubella

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