e-Article
Profile of cardiac lesions among laboratory confirmed congenital rubella syndrome (CRS) infants: a nationwide sentinel surveillance, India, 2016–22Research in context
Document Type
article
Author
Pradeep Kumar Gunasekaran; Devika Shanmugasundaram; Sridhar Santhanam; Sanjay Verma; Kuldeep Singh; Bhagirathi Dwibedi; Shally Awasthi; Himabindu Singh; Mahantesh Sangappa; Nivedita Mondal; Priya Sreenivasan; Geetha Saradakutty; Shikha Malik; Manish Jain; Rajlakshmi Viswanathan; Gajanan Sapkal; Shalini Tripathi; Bhupeshwari Patel; Mahendra Kumar Jain; Sanjeev Hanumantacharya Naganur; Arun Baranwal; Manoj K Rohit; Surender Deora; Akhil Sharma; Avinash Anantharaj; Lakshmi Sadasivan Pillai; Amber Kumar; Sabarinathan Ramasamy; Padma Priya Rajendran; Mini P. Singh; Radha Kanta Ratho; Vijaylakshmi Nag; Ravishekhar Gadepalli; Baijayantimala Mishra; Tapas Kumar Som; Amita Jain; Sudha Madhuri Devara; Sudha Rani Vannavada; Ashok Munivenkatappa; Asha Mary Abraham; Rahul Dhodapkar; Syed Ali; Debasis Biswas; Deepashri Pratkeye; Ashish Bavdekar; Jayant Prakash; Jaydeb Ray; Manoj Murhekar; Praveen Kumar; Parul Chawla Gupta; Sanjay Munjal; Naveen Sankhyan; Nabaneeta Dash; Madhu Gupta; Ria Sai; Vishaly Sharma; Neeraj Gupta; Varuna Vyas; Nidhi Kaushal; Suhanimanasa; Niranjan Hunasanahalli Shivanna; Prem Kumar P; Deepa John; Arun Alexander; Nirupama Kasturi; Adhisivam Bethou; Varsha Singh; Nidhi Prasad; Aniruddha Ghosh; Agniva Majumdar; Shanta Dutta
Source
The Lancet Regional Health - Southeast Asia, Vol 16, Iss , Pp 100268- (2023)
Subject
Language
English
ISSN
2772-3682
Abstract
Summary: Background: The phenotypical profile of cardiovascular malformations in patients with congenital rubella syndrome (CRS) is varied. We aimed to describe the profile of cardiac defects among CRS patients detected in the sentinel CRS surveillance in India during 2016–22. Methods: Sentinel sites enrolled infants with suspected CRS based on presence of cardiac defects, hearing impairment, eye signs, or maternal history of febrile rash illness. Suspected CRS cases underwent detailed systemic examination, including echocardiography and serological investigation for rubella. Cardiac defects were categorized as ‘Simple’ or ‘Complex’ as per the National Heart, Lung, and Blood Institute classification. We compared the distribution of cardiac defects among laboratory confirmed CRS cases and seronegative discarded cases. Findings: Of the 4578 suspected CRS cases enrolled by 14 sites, 558 (12.2%) were laboratory confirmed. 419 (75.1%) laboratory confirmed cases had structural heart defects (simple defects: n = 273, 65.2%, complex defects: n = 144, 34.4%), with ventricular septal defect (42.7%), atrial septal defect (39.4%), patent ductus arteriosus (36.5%), and tetralogy of Fallot as the commonest defects (4.5%). Laboratory confirmed CRS cases had higher odds of left to right shunt lesions (OR = 1.58, 95% CI: 1.15–2.17). This was mainly on account of a significant association of PDA with CRS (OR = 1.77, 95% CI: 1.42–2.21). Mortality was higher among CRS patients with complex heart defects (HR = 2.04, 95% CI: 1.26–3.30). Interpretation: Three-fourths of the laboratory confirmed CRS cases had structural heart defects. CRS patients with complex cardiac defects had higher mortality. Detecting CRS infection early and providing timely intervention for cardiovascular defects is critical for the management of CRS patients. Funding: Ministry of Health and Family Welfare, Govt of India, through Gavi, the Vaccine Alliance.