The Burden of Disease from Congenital Rubella Syndrome in Lesotho

Background: Congenital rubella syndrome (CRS) causes severe birth defects and is preventable. In line with the global vision for measles and rubella elimination, Lesotho introduced the measles-rubella (MR) vaccine into the routine immunization schedule in February 2017. The aim of the study was to show the burden of CRS in Lesotho before the introduction of the rubella vaccine. Methods: This was a cross-sectional descriptive study. Data was extracted from several sources at Queen Mamohato Memorial Hospital including inpatient, outpatient, electronic and laboratory records as well as expert interviews. Files of infants less than 12 months with CRS during the period January 2012 to December 2016 were selected. Results: There were five laboratory and 4 clinically confirmed CRS cases. One case also had Cytomegalovirus (CMV) co-infection. Mohales’ Hoek district had the highest number of cases (33.3%). Six of the districts had at least one case of CRS within the study period. There were no cases in 4 districts. Most (56%) of the CRS cases were reported in 2015. We were unable to determine the incidence of CRS in Lesotho in this study. Conclusion: The detection of 9 CRS cases in Lesotho over the period under review is of high public health importance.There is an immunity gap among mothers of child bearing age which shows an opportunity for future immunization. Prospective CRS case-based surveillance would be useful in determining accurate estimates of the burden of CRS and the impact of the introduction of rubella-containing vaccine into the routine immunization schedule.