Rubella surveillance during pregnancy in Tunisia : between recommendations and practice

Abstract

Our study aims to evaluate the rubella surveillance strategy during pregnancy and to evaluate the gap between national recommendations and our practice. Methods : It’s about all sera withdrawn in pregnant women and screened for rubella during 2012. Rubella Serology (IgM and IgG) was conducted by a micro-particular assay with a chimi Flex technology (ARCHITECT-ABBOT). Avidity index was realized by ELISA (Euro-Immun) in every serum presenting both IgM and IgG. Results : Our study included 3893 women with an age average of 28 years (16-46). An old immunity and an absence of contact were noted respectively in 91 and 8.8%. Almost 80% of non-immunized women were aged over 25 years. More than 60% of tests were done at a stage superior to 12 week of amenorrhea and serology was controlled in only 6.4% of non immunized women. Serology was determined in a stage inferior to 8 week of amenorrhea in only 12 % of immunized women. Twenty Two patients exhibited a primary infection profile (stage between 8 and 18 week of amenorrhea). Avidity index was low in 6 % of cases. A sero-conversion was confirmed in one case. Conclusion: Our study shows that rubella surveillance during pregnancy is still not well assured.