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[Determining factors of rubella in the 10 to 14 year-old population in Mexico]
R Tapia-Conyer1, J Sepúlveda, B Salvatierra
1Unidad de Investigación Clínica en Enfermedades Infecciosas y Parasitarias, Instituto Mexicano del Seguro Social.
Abstract:
The clinical and epidemiological importance of rubella relates to its teratogenic effects. When this disease occurs in children, adolescents and adults, it is usually benign. On the other hand, these age groups are source of disease transmission to pregnant women. The serology studies on rubella carried in Mexico prior to 1974, detected seropositivity levels from 87.1 to 97.7 percent in children younger than 14 years of age. In contrast, the National Seroepidemiology Survey (NSS) (1988) reported a much lower seropositivity (69.3%) in children of the same age group, and a rate of 80 percent in women of reproductive age. This situation is a particular problem for Mexico where a high proportion of the pregnancies occur during adolescence. While previous research has commented on descriptive measures of seroprevalences in women, this study, which is based on a logistic regression model, has the purpose of identifying the factors associated with the immunological status of girls between 10 and 14 years of age. The variable which showed the most evident relation to the antibody levels for rubella was years of schooling. The odds ratios (OR) for seropositivity among those who finished secondary schooling was 2.05 times (CI 1.28-2.56) that of the illiterate group. Other statistically significant variables were related to residence, urban vs rural (OR = 1.69; CI 1.48-2.12) and age, 10 vs 14 years (OR = 1.93; CL 1.69-2.42). Based on the multivariate model, it was observed that the girls with a greater risk of seropositivity were those who live in urban areas, attend secondary school, and are 14 years of age, with an OR = 4.05 (G = 6,756.4 and 5,580 gl; p less than .001). The study concludes with the following considerations: the immunological levels of girls from 10 to 14 years of age are low, and the results of the NSS suggest that Mexican public health authorities should evaluate the policy of vaccination against rubeola in the population potentially at risk, and that the factors associated with the disease, in descending order, are: years of schooling, age, and place of residence. It is also necessary to carry out analytic studies which will identify the risks and the etiology of congenital malformations which are likely to have been associated with the occurrence of rubeola virus during pregnancy.
Insights
Rubella (German measles) poses teratogenic risks to pregnant women. In Mexico, girls aged 10-14 show low immunity, with schooling, urban residence, and age being key risk factors for rubella seropositivity.
Area of Science:
- Epidemiology
- Immunology
- Public Health
Context:
- Rubella's teratogenic effects underscore its clinical and epidemiological importance, particularly concerning pregnant women.
- Previous seroprevalence studies in Mexico indicated high rubella immunity in children, but a 1988 survey revealed lower rates (69.3%) in children and 80% in women of reproductive age.
- A significant proportion of pregnancies in Mexico occur during adolescence, increasing the risk of congenital rubella syndrome.
Purpose:
- To identify factors associated with rubella immunological status in girls aged 10-14 years in Mexico.
- To analyze the relationship between seropositivity and variables such as education, residence, and age using a logistic regression model.
Summary:
- Years of schooling was the most significant factor associated with rubella antibody levels; secondary schooling increased odds of seropositivity (OR=2.05).
- Urban residence (OR=1.69) and older age within the group (14 vs. 10 years, OR=1.93) were also significant risk factors.
- A multivariate model identified girls in urban areas, attending secondary school, and aged 14 as having the highest risk of seropositivity (OR=4.05).
Impact:
- The study highlights low rubella immunity in Mexican girls aged 10-14, suggesting a need to re-evaluate vaccination policies for at-risk populations.
- Identified key risk factors—education, age, and residence—for rubella seropositivity, informing targeted public health interventions.
- Emphasizes the necessity for further analytical studies to understand the risks and etiology of congenital malformations linked to maternal rubella infection.