Association between parity and rubella seropositivity among older reproductive-age women
Date of Award
Master of Medicine (MMed)
Obstetrics and Gynaecology (East Africa)
Background: Rubella virus when it infects a non-pregnant adult or child usually causes a mild febrile rash illness. However, infection in the first 12 weeks of pregnancy causes miscarriages, stillbirths or foetal anomalies known as congenital rubella syndrome (CRS). Factors associated with rubella immunity include age and parity. No studies have been done to isolate the association of parity independent of age.
Objectives: To determine the seroprevalence of rubella IgG antibodies among nulliparous and multiparous women of the same age-group attending various clinics in Aga Khan University Hospital, Nairobi,
Design: A cross-sectional study of women attending a tertiary hospital, Nairobi, Kenya.
Subjects and methods: Eligible participants were multiparous and nulliparous women aged between 30 and 34 years, recruited sequentially. The rubella IgG antibody was tested using a commercial ELISA Kit. Fischer exact test and Chi square was used to compare the two groups. Logistic regression was used to explore the association.
Results: A total of 300 women who fulfilled the inclusion criteria were enrolled into the study. There was no difference in seropositivity between the multiparous (87%) and the nulliparous group (88%), P=0.81. The overall rubella seroprevalence was 87%. Variation in seropositivity was noted from place of birth, ranging from 82% in Coast to 100% in Western province, though the difference was not statistically significant (P=0.81). None of the socio-demographic and obstetrical factors included in the study questionnaire were associated with seronegativity for rubella in the univariate and multivariate analysis.
Conclusions: Thirteen percent of the participants were seronegative, translating to a significant number of women in childbearing age susceptible to rubella virus and subsequent CRS. Seronegativity did not correlate with the socio-demographic and obstetrical factors. Regular rubella testing and promotion of wider coverage of vaccination recommended, since there seems to be no benefit in targeting one group over the other.
Awadh, I. S. (2014). Association between parity and rubella seropositivity among older reproductive-age women (Unpublished master's dissertation). Aga Khan University, East Africa.