Factors Related to the Incidence of Congenital Rubella Syndrome (CRS) in Indonesia

Abstract

Congenital Rubella Syndrome (CRS) is a serious consequence in infants due to Rubella virus infection during early pregnancy which can cause several congenital abnormalities. In 2021, Indonesia became the country that reported the highest cases of CRS in the WHO Southeast Asia region with 229 cases out of a total of 402 cases (57%). There are various factors related to the incidence of CRS including vaccination, health facilities and mother and baby factors. Knowledge on these factors can be applied to improve efforts to prevent and control CRS cases. This study aims to determine the factors related to the incidence of CRS in Indonesia. This was a case-control study using secondary data derived from the 2020-2021 CRS sentinel surveillance reports of the Ministry of Health of the Republic of Indonesia. Based on the results of multivariate analysis using multiple logistic regression, it was revealed that there was one factor related to the incidence of CRS, namely the area of residence with an OR of 2.3 (95% CI: 1.49-3.42). The area of residence outside Java-Bali had a higher risk for the incidence of CRS by 2.3 times compared to the area of residence in Java-Bali. In contrast, other variables such as history of maternal vaccination, history of maternal Rubella infection, maternal age and the child gender were not found to be statistically related to the incidence of CRS. It can be concluded that the area of residence outside Java-Bali was a factor related to the incidence of CRS. Therefore, it is necessary to have an even distribution of Rubella vaccination coverage, strengthen the surveillance system and prepare equal distribution of health facilities to prevent the spread of Rubella cases.