{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:14:16Z","timestamp":1772165656117,"version":"3.50.1"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T00:00:00Z","timestamp":1580688000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T00:00:00Z","timestamp":1580688000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rubella is highly under reported in Zambia as in most sub-Saharan countries despite being a disease of major public health concern especially among women of childbearing age. In September 2016, Zambia introduced a combined measles-rubella vaccine in children 0\u201314\u2009years. In this study, we estimated the proportion positive for acute rubella among suspected but negative measles cases between 2005 and 2016 and determined its correlates for monitoring rubella epidemiology post-rubella vaccine introduction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a retrospective study, 4497 measles IgM negative serum samples from 5686 clinically suspected measles cases were examined for rubella IgM antibodies using the Siemens, Enzygnost\u00ae ELISA kit at the national measles laboratory. Data on demographics, year and month of onset were extracted from the surveillance data. Multivariate logistic regression analysis using backward variable selection was conducted to determine independent predictors for acute rubella. The magnitude of association was estimated using adjusted odds ratio with a 95% confidence interval.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, a proportion of 29.2% (1313\/4497) affecting mostly those between 5 and 24\u2009years was determined. Only age, province, month and year were independently associated with acute rubella. The regional proportions varied from 21.8\u201337.3% peaking in the month of October. Persons in the age group 10\u201314\u2009years (Adjusted Odds Ratio [AOR]\u2009=\u20092.43; 95% CI [2.01\u20132.95]) were more likely while those aged &lt;\u20091\u2009year less likely (AOR\u2009=\u20090.31; 95% CI [021\u20130.48]) to have acute rubella compared to those aged 25\u2009years or older. Persons in 2010 were less likely (AOR\u2009=\u20090.12; CI [0.05, 0.28]) to have acute rubella compared to those in 2016. While acute rubella was more likely to occur between July and November compared to December, it was less likely to occur between February and May.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Rubella virus was circulating in Zambia between 2005 and 2016 affecting mostly persons in the age group 5\u201324\u2009years peaking in the hot dry season month of October. Although vaccination against rubella has been launched, these baseline data are important to provide a reference point when determining the impact of the vaccination program implemented.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-020-4806-5","type":"journal-article","created":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T12:05:03Z","timestamp":1580731503000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Epidemiology of acute rubella infection in Zambia during the pre-vaccination period (2005\u20132016) as a baseline for monitoring rubella epidemiology in the post-rubella vaccine introduction era"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5465-5710","authenticated-orcid":false,"given":"Mazyanga L.","family":"Mazaba","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seter","family":"Siziya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mwaka","family":"Monze","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,2,3]]},"reference":[{"issue":"45","key":"4806_CR1","doi-asserted-by":"publisher","first-page":"1256","DOI":"10.15585\/mmwr.mm6645a4","volume":"66","author":"GB Grant","year":"2017","unstructured":"Grant GB, Reef SE, Patel M, Knapp JK, Dabbagh A. Progress in rubella and congenital rubella syndrome control and elimination - worldwide, 2000-2016. MMWR Morb Mortal Wkly Rep. 2017;66(45):1256\u201360.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"Suppl 1","key":"4806_CR2","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1093\/infdis\/jir108","volume":"203","author":"JL Goodson","year":"2011","unstructured":"Goodson JL, Masresha B, Dosseh A, Byabamazima C, Nshimirimana D, Cochi S, Reef S. Rubella epidemiology in Africa in the prevaccine era, 2002-2009. J Infect Dis. 2011;203(Suppl 1):215\u201325.","journal-title":"J Infect Dis"},{"issue":"4","key":"4806_CR3","doi-asserted-by":"publisher","first-page":"e012959","DOI":"10.1136\/bmjopen-2016-012959","volume":"7","author":"M Nimpa Mengouo","year":"2017","unstructured":"Nimpa Mengouo M, Ndze VN, Baonga F, Kobela M, Wiysonge CS. Epidemiology of rubella infection in Cameroon: a 7-year experience of measles and rubella case-based surveillance, 2008\u20132014. BMJ Open. 2017;7(4):e012959.","journal-title":"BMJ Open"},{"key":"4806_CR4","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1186\/s12889-015-1642-4","volume":"15","author":"S Chimhuya","year":"2015","unstructured":"Chimhuya S, Manangazira P, Mukaratirwa A, Nziramasanga P, Berejena C, Shonhai A, et al. Trends of rubella incidence during a 5-year period of case based surveillance in Zimbabwe. BMC Public Health. 2015;15:294.","journal-title":"BMC Public Health"},{"issue":"1","key":"4806_CR5","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1186\/s12879-016-1842-2","volume":"16","author":"A Farra","year":"2016","unstructured":"Farra A, Pagonendji M, Manikariza A, Rawago D, Ouambita-Mabo R, Guifara G, Gouandjika-Vasilache I. Epidemiology of primary rubella infection in the Central African Republic: data from measles surveillance, 2007-2014. BMC Infect Dis. 2016;16(1):505.","journal-title":"BMC Infect Dis"},{"issue":"1","key":"4806_CR6","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1093\/clinids\/11.1.116","volume":"11","author":"NE Gomwalk","year":"1989","unstructured":"Gomwalk NE, Ahmad AA. Prevalence of rubella antibodies on the African continent. Rev Infect Dis. 1989;11(1):116\u201321.","journal-title":"Rev Infect Dis"},{"key":"4806_CR7","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1016\/0035-9203(77)90044-X","volume":"71","author":"HA Odelola","year":"1977","unstructured":"Odelola HA, Fabiyi A, Familusi JB. Distribution of rubella antibodies in Nigeria. Trans R Soc Trop Med Hyg. 1977;71:425\u20136.","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"4806_CR8","first-page":"168","volume":"15","author":"PAK Addy","year":"1976","unstructured":"Addy PAK, Abedmadzor F. Rubella in Ghana: seroepidemiological studies of healthy urban female Ghanians. Ghanian Med J. 1976;15:168\u201372.","journal-title":"Ghanian Med J"},{"key":"4806_CR9","first-page":"394","volume":"51","author":"WHO","year":"1976","unstructured":"WHO. Seroepidemiology of rubella. Wkly Epidemiol Rec. 1976;51:394\u20136.","journal-title":"Wkly Epidemiol Rec"},{"issue":"4","key":"4806_CR10","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1111\/j.1365-3156.2006.01577.x","volume":"11","author":"J Barreto","year":"2006","unstructured":"Barreto J, Sacramento I, Robertson SE, Langa J, de Gourville E, Wolfson L, et al. Antenatal rubella serosurvey in Maputo. Mozambique Trop Med Int Health. 2006;11(4):559\u201364.","journal-title":"Mozambique Trop Med Int Health"},{"issue":"6","key":"4806_CR11","first-page":"931","volume":"58","author":"M Clarke","year":"1980","unstructured":"Clarke M, Schild GC, Boustred J. McGregor lA, Williams K. epidemiological studies of rubella virus in a tropical African community. 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Version 1.3, August 2011."},{"key":"4806_CR15","unstructured":"Alberts B, Johnson A, Lewis J, Raff M, Roberts K, Walter P. Molecular Biology of the Cell. 4th edition. New York: Garland Science; 2002. B Cells and Antibodies. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK26884\/."},{"key":"4806_CR16","unstructured":"WHO [Regional Office for Africa]. Guidelines for measles surveillance Revised December 2004. http:\/\/www.measlesrubellainitiative.org\/wp-content\/uploads\/2013\/06\/Guidelines-surveillance.pdf. Accessed 10 Oct 2018."},{"key":"4806_CR17","unstructured":"Siemens.Enzygnost\u00ae. Anti-Rubella Virus\/IgM handbook, July 2011."},{"key":"4806_CR18","unstructured":"CDC. Manual for the surveillance of vaccine-preventable diseases. Centers for Disease Control and Prevention. Atlanta, GA 2012; Chapter 14. http:\/\/www.cdc.gov\/vaccines\/pubs\/surv-manual\/index.html. Accessed 10 Oct 2018."},{"key":"4806_CR19","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1186\/s13104-015-1711-x","volume":"8","author":"MM Mirambo","year":"2015","unstructured":"Mirambo MM, Majigo M, Aboud S, Gro\u00df U, Mshana SE. Serological makers of rubella infection in Africa in the pre vaccination era: a systematic review. BMC Res Notes. 2015;8:716.","journal-title":"BMC Res Notes"},{"issue":"1","key":"4806_CR20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.11648\/j.ajhr.20150301.11","volume":"3","author":"AKM Kamruzzaman","year":"2015","unstructured":"Kamruzzaman AKM, Jahan MS, Rahman MR, Khatun M. Impact of climate change on the outbreak of infectious diseases among children in Bangladesh. Am J Health Res. 2015;3(1):1\u20137.","journal-title":"Am J Health Res"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-020-4806-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12879-020-4806-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-020-4806-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T19:28:43Z","timestamp":1612207723000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-020-4806-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,3]]},"references-count":20,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["4806"],"URL":"https:\/\/doi.org\/10.1186\/s12879-020-4806-5","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.2.9744\/v4","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.2.9744\/v1","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.2.9744\/v3","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.2.9744\/v2","asserted-by":"object"}]},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,3]]},"assertion":[{"value":"15 May 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 January 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 February 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The data used in this analysis were de-identified in respect to study participants. Ethical approval was granted by ERES Converge IRB ref.: 2016-Sept-001. Furthermore, as required by law in Zambia, permission to carry out the research was granted by the National Health Research Authority ref.: MH\/101\/23\/20\/1. The Provincial (Copperbelt and Lusaka), District Medical Officers (Ndola and Lusaka) and Senior Medical Superintendents of Ndola Teaching Hospital, Arthur Davison Children\u2019s Hospital and University Teaching Hospital also granted permission to carry out the study.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"There are no competing interests among the authors. All authors have approved the submission and declared that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"101"}}