Related Experiment Video
Updated: Mar 8, 2026
An Improved and High Throughput Respiratory Syncytial Virus RSV Micro-neutralization Assay
Published on: January 26, 2019
Hospital-based surveillance of congenital rubella syndrome in Indonesia
Elisabeth Siti Herini1, Gunadi2, Agung Triono3
1Department of Child Health, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Jl. Kesehatan No. 1, Yogyakarta, 55281, Indonesia. herini_es@ugm.ac.id.
Insights
Congenital rubella syndrome (CRS) is a significant concern in Indonesia, with a high incidence of laboratory-confirmed cases among infants. Hearing impairment is the most common defect, underscoring the need for rubella vaccination.
Area of Science:
- Pediatrics
- Virology
- Public Health
Background:
- Congenital rubella syndrome (CRS) causes severe birth defects and pregnancy complications due to maternal rubella infection.
- Rubella vaccination has significantly reduced CRS incidence in developed nations but remains absent in Indonesia.
- High incidence of CRS in Indonesia necessitates urgent public health interventions.
Purpose of the Study:
- To estimate the incidence of CRS in Indonesia.
- To describe the clinical manifestations of CRS in infants at a referral hospital.
- To pilot a CRS surveillance system for broader implementation.
Main Methods:
- A 4-month prospective surveillance study of infants under one year with suspected CRS.
- Laboratory confirmation using rubella-specific IgM or IgG antibody testing.
- Clinical examination and diagnosis categorization (laboratory-confirmed, clinically compatible, discarded).
Main Results:
- Out of 47 suspected cases, 11 (23.4%) were laboratory-confirmed CRS.
- The most frequent defects in confirmed cases included hearing impairment (100%), congenital cataracts (72.7%), and microcephaly (72.7%).
- Congenital heart defects were observed in 45.5% of confirmed CRS cases.
Conclusions:
- The incidence of laboratory-confirmed CRS among Indonesian infants is notably high.
- Hearing impairment is the predominant clinical feature of CRS in this population.
- Implementing rubella vaccination in Indonesia is crucial to prevent CRS and its associated defects.
Abstract:
Congenital rubella syndrome (CRS) has serious consequences, such as miscarriage, stillbirth, and severe birth defects in infants, resulting from rubella virus infection during pregnancy. However, rubella vaccine has not yet been implemented in Indonesia. This study aimed (1) to estimate the incidence of CRS in Indonesia, (2) describe the clinical features of CRS at our referral hospital, and (3) pilot a CRS surveillance system to be extended to other hospitals. We conducted a 4-month prospective surveillance study of infants aged <1 year with suspected CRS in 2013 at an Indonesian hospital. Infants with suspected CRS were examined for rubella-specific IgM antibody or rubella IgG antibody levels. Of 47 suspected cases of CRS, 11/47 (23.4%), 9/47 (19.1%), and 27/47 (57.5%) were diagnosed as laboratory-confirmed, clinically compatible, and discarded CRS, respectively. The most common defects among laboratory-confirmed CRS cases were hearing impairment (100%), congenital cataracts (72.7%), microcephaly (72.7%), and congenital heart defects (45.5%).
Conclusion:
The number of laboratory-confirmed CRS cases among Indonesian infants is high. Furthermore, hearing impairment is the most common clinical feature of CRS in infants. Our findings indicate the importance of implementation of rubella vaccine in Indonesia. Conducting hospital-based surveillance of CRS in other hospitals in Indonesia may be appropriate. What is Known: •Congenital rubella syndrome (CRS) has serious consequences in infants resulting from rubella virus infection during pregnancy. •The incidence of CRS in most developed countries has greatly decreased since implementation of rubella vaccination. •Rubella vaccine has not yet been implemented in many developing countries. What is New: •The number of laboratory-confirmed CRS cases among Indonesian infants was high. •Implementation of rubella vaccine into immunization programs in Indonesia is important because of the high number of CRS cases. •Our study highlights the need for ongoing prospective surveillance of CRS in Indonesia.
