TEPHINET, SAFETYNET Support Efforts to Combat Congenital Rubella Syndrome in the Philippines
On September 27 and 28, 2022, the South Asia Field Epidemiology and Technology Network (SAFETYNET) held a training on data collection for a retrospective study that is being conducted as a part of efforts to better understand the burden of Congenital Rubella Syndrome (CRS) in the Philippines. A secondary aim of the study is to demonstrate the feasibility of prospective surveillance for CRS through sentinel sites. The project was initiated in 2021, with data collection beginning at the end of 2022, enabled by the aforementioned training.
Rubella, also known as German measles, is carried by a virus that results in a mild, febrile rash when symptomatic. Congenital Rubella Syndrome (CRS) is an illness that results from maternal infection with the rubella virus during pregnancy. In the Philippines, rubella cases are thought to be underreported as surveillance is solely based on the testing of measles-negative cases. Reported rubella cases have fluctuated, beginning with 926 in 2011 to 382 in 2020. In 2017 and 2020, outbreaks of rubella occurred with 2,111 and 382 reported cases, respectively. While there is currently no CRS surveillance in the Philippines, a retrospective study of hospital records from 2010 to 2014 identified 18 confirmed and 210 probable cases.1 The aforementioned data collection training and retrospective study supported by TEPHINET, SAFETYNET, and Centers for Disease Control and Prevention (CDC), will be used to advocate for establishment of CRS surveillance, strengthen rubella surveillance, and improve immunization coverage.
In collaboration with CDC and SAFETYNET, TEPHINET provided project management guidance by developing the budget and participating in oversight of the training schedule and its deliverables. In discussions prior to the training, TEPHINET, CDC, and SAFETYNET discussed the technical goals for the training, which included development of proficient data collection skills among hospital-designated trainees and increased investment of the local and national government in CRS as a pervasive public health issue.
One representative from CDC, Laura Zimmerman, traveled to the Philippines to observe the training, provide background information on rubella and present on the current state of epidemiology and CRS in the region. Following presentations from Dr. Zimmerman, Dr. Ian Gonzales, a Philippines FETP fellow, provided guidance on how to use the data collection form created by SAFETYNET to representatives from the six different sites where the study is being conducted. Dr. Agnes Serra, Chief of the Epidemiology Bureau of the Applied Epidemiology and Health Management Division in the Philippines, attended the training and gave closing remarks. Given that the ultimate goal of the study is increased investment from the Philippines government, Dr. Serra’s presence and engagement was a welcome event.
Since the training was conducted, data collection has begun at three of the six sites across the country, with one nearing completion. Data collection at the remaining three sites is slated to begin during the second quarter of 2023, with two sites having recently received ethics board approval and one awaiting approval. All sites will conclude data collection in August 2023. TEPHINET is continuing to monitor data collection, advocating for expedited ethics board approval when possible, and engaging in the development of next steps once data collection has concluded.
1 World Health Organization: Regional Office for the Western Pacific. (2015). Regional framework for implementation of the Global Vaccine Action Plan in the Western Pacific. Manila, Philippines: WHO Regional Office for the Western Pacific. https://www.who.int/publications/i/item/9789290617099