Abstract
Introduction: Primary rubella leads to serious consequences in pregnant women such as abortion, stillbirth and severe birth defect. Vaccination is the best strategy to give acquired immunity and to prevent the disease. However, screening women at reproductive age for rubella is not routinely used in many resource-limited countries like Sudan and data on prevalence of the disease lacks accurate information.
Aim: We aimed to determine anti-Rubella IgM and IgG antibody profile of infertile women in Sudan to assess possible association of rubella with women infertility.
Materials and Methods: This was a cross-sectional study conducted during April-July 2016 where a total number of 184 serum specimens were collected. Specimens included 92 sera of infertile women collected in antenatal care hospital for fertility in Khartoum and 92 sera collected from healthy pregnant women, as controls. Sera were screened for anti-Rubella IgM and IgG antibodies using ELISA kits (Fortress Diagnostics, UK).
Results: Socio-demographic and clinical information were obtained from infertile women using a structured questionnaire and were analysed using Pearson's Chi-square test by SPSS program version 16. Seropositivities of anti-Rubella antibodies among infertile women were found to be 75% (69/92) for IgM and 94.5% (87/92) for IgG. These values increased with age; however, there were no statistical differences among the different age groups. Interestingly, all infertile women at the age above 46 years demonstrated presence of IgM and IgG, accounting 100% seropositivity. A statistically significant difference was observed in the seropositivity of anti-Rubella IgM antibodies among infertile women of different duration of marriage (p-value=0.025). Among pregnant women (control group), 14.1% (13/92) and 92.40% (85/92) were positive for anti-Rubella IgM and IgG antibodies, respectively.
Conclusion: The high anti-Rubella IgG antibody titres among the two cohorts in the absence of routine vaccination in the country suggest high endemicity and sustained transmission. Additionally, the higher IgM antibody titers among the infertile women suggest potential role of rubella to impair women fertility. Further studies are needed to determine high risk population and the need for an immunization policy for rubella in Sudan.