Related Experiment Video
Updated: Jul 15, 2026
An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection
Published on: December 10, 2013
Rubella seroprevalence using residual samples from the South African measles surveillance program: a cross-sectional
N V Motaze1,2, L Makhathini1, S B Smit1
1A Division of the National Health Laboratory Service, Centre for Vaccines and Immunology, National Institute for Communicable Diseases , Johannesburg, South Africa.
Insights
South Africa has not yet introduced rubella-containing vaccines (RCV). High rubella susceptibility is found in children under 16, with about 20% of adults aged 16-49 also susceptible, informing RCV introduction strategies.
Area of Science:
- Immunology
- Vaccinology
- Public Health
Background:
- South Africa has not incorporated rubella-containing vaccines (RCV) into its routine immunization program.
- Assessing population immunity is crucial for effective vaccine introduction strategies.
- Understanding rubella antibody seroprevalence and immunity gaps is essential for public health planning.
Purpose of the Study:
- To determine the seroprevalence of rubella antibodies in South Africa across all age groups.
- To identify and characterize immunity gaps related to rubella in the South African population.
- To inform the strategic introduction of rubella-containing vaccines (RCV) in South Africa.
Main Methods:
- Utilized residual serum samples from the national measles surveillance program (2016-2018).
- Employed a commercial enzyme-linked immunosorbent assay (ELISA) to detect rubella immunoglobulin G (IgG) antibodies.
- Conducted logistic regression analysis to identify factors associated with rubella susceptibility (IgG negative), including age, sex, and province.
Main Results:
- Analyzed 6057 samples, revealing high rubella susceptibility in children aged 0-11 months (81.9%) and 1-5 years (71.5%).
- Susceptibility decreased with age, with 40.9% in 6-10 year olds and 31.25% in 11-15 year olds.
- Approximately 19.9% of individuals aged 16-49 years remained susceptible to rubella. Age and province of residence were significant predictors of susceptibility.
Conclusions:
- The majority of individuals susceptible to rubella in South Africa are children under 16 years old.
- A notable proportion (around 20%) of adults aged 16-49 years also exhibit rubella susceptibility.
- These findings highlight critical immunity gaps that must be addressed during the introduction of rubella-containing vaccines (RCV).
Abstract:
Introduction: South Africa is yet to introduce rubella-containing vaccines (RCV) into its routine immunization schedule. Selecting the target population when introducing RCV should take into account the ages of susceptible individuals in the population. We aimed to determine the seroprevalence of antibodies to rubella and characterize immunity gaps among individuals of all ages in South Africa. Methods: We tested for rubella immunoglobulin G (IgG) antibodies with a commercial enzyme-linked immunosorbent assay. We used residual samples collected from 2016 through 2018 as part of the national measles surveillance program. We only tested samples that were negative for measles and rubella immunoglobulin M (IgM) and explored the association between rubella susceptibility (IgG negative) and predictor variables (year of sample collection, age, sex, and province of residence) using logistic regression analysis. Results: We obtained results for 6057 records. Rubella susceptibility was highest among Individuals aged zero to 11 months (81.9%), followed by children 1 to 5 years old (71.5%), 6 to 10 y old (40.9%) and 11 to 15 y old (31.25) while the smallest proportion of susceptible individuals was among those 16 to 49 y old (19.9%). Females were less likely to be susceptible to rubella compared to males (OR = 0.79 (95%CI: 0.71-0.87), P < .001) in unadjusted analysis but this effect was not observed after adjusting for age and province. In multivariable logistic regression, age (OR = 6.24 (4.52-8.63), P < .001) and province of residence (OR = 0.97 (95%CI: 0.95-0.99), P = .01) were associated with rubella susceptibility. Conclusion: In the absence of rubella vaccination in the Expanded Program on Immunization in South Africa, the bulk of individuals susceptible to rubella are children under 16 y old. About 20% of individuals 16 to 49 y old are susceptible to rubella. This susceptibility gap must be born in mind during RCV introduction.
