Rubella and Congenital Rubella Syndrome in the Philippines: A Systematic Review

Table 1

Published studies of serologic surveys and clinical manifestations of congenital rubella syndrome (CRS) in the Philippines.

(a) Serologic surveys ().

Author	Date	Setting	Methods	Inclusion criteria	Confirmatory test	Results
Espiritu-Campos et al. 1973 [12]	1973	Community setting (urban)	Prospective	Male and female volunteers (0–40 years old)	Hemagglutination-Inhibition test	32.2% rubella susceptible
Del Mundo 1973 [10]	1973	Community setting (urban and rural)	Prospective	Male and female volunteers (0–40 years old)	Hemagglutination-Inhibition test	26% rubella susceptible
Chan et al. 1979 [13]	1978	Community setting (urban)	Prospective	Nonpregnant women (6–45 years old)	Hemagglutination-Inhibition test	29.6% were rubella susceptible (38.1% for women ≤ 30 years old, 12.5% for >30 years old)
Alday et al. 1982 [14]	1982	Tertiary hospitals (urban Manila City and rural Las Pinas)	Prospective	Nonpregnant women aged (16–45 years old)	Hemagglutination-Inhibition test	37.3% were rubella susceptible (urban women ≤ 30 years old, 80%; urban women > 30 years old, 20%; and rural women ≤ 30 years old, 64%, rural women > 30 years old, 36%)
Yu et al. 1997 [15]	1997	Tertiary hospital (Cebu City)	Prospective	Pregnant women (17–45 years old)	Microparticle Enzyme Immunoassay (IgG)	10.9% were rubella susceptible

(b) Congenital rubella syndrome ().

Author	Month/year study was conducted	CRS manifestation(s) primarily used to identify cases	Methods	Included subjects	Diagnostic criteria for CRS	Results
Nueva-Espana et al. 1988 [16]	January 1981 to June 1986	Hearing loss	Retrospective review of audiology clinic records and audiologic test	Children 0–16 years old presenting in a tertiary hospital with hearing loss (mean 4.7 years old)	Hearing loss plus maternal history of febrile rash and other signs associated with CRS	17 cases (out of 496) had maternal history of rubella, and only 3 cases of the 17 were diagnosed with CRS
Santos-Cabaero et al. 1998 [17]	January 1990 to December 1994	Cardiac, hearing loss, and cataract	Retrospective review of patient records	Children diagnosed with CRS by physicians	Rubella IgM confirmed CRS cases	Deafness and cataract were the most predominant symptoms with 26 (62%) and 28 (67%) cases, respectively. Other clinical findings included were psychomotor delay (50%), congenital heart disease (45%), neonatal cholestasis (31%), and glaucoma (4 cases or 10%)
Yu and Rameriz 2003 [18]	September to October 2002	Hearing loss	Prospective, cross-sectional study using questionnaire	Students enrolled in a School for the Deaf (mean 14.2 years old)	Hearing loss plus maternal history of rubella	136 (23.5%) deaf students had maternal history of rubella, among which 15 (2.6%) had visual problems and 8 (1.4%) had congenital heart disease
Tecson and Santiago 2004 [19]	January 2000 to August 2003	Cataract	Retrospective review of patient records	Infants 0–12 mos with atraumatic cataract in a tertiary hospital	Congenital cataract with history of maternal measles and heart disease	45 cases (out of 218 cases, or 20.5%) had CRS. 18 cases (out of 218 cases or 8.2%) had suspected CRS; CRS was the most common cause of secondary cataract
Agnas 2005 [20]	January 1995 to December 2002	Cardiac, cataract, and hearing loss	Retrospective review of patient records	Children diagnosed with CRS by physicians	Rubella IgM confirmed CRS cases	Cataract was the most common clinical manifestation, followed by patent ductus arteriosus at 24 (49%) and 15 cases (31%), respectively. The other clinical manifestations were hepatomegaly (10%), jaundice (10%), pulmonary artery stenosis (6%), extrauterine growth retardation (4%), glaucoma (2%), and hemolytic anemia (2%)
Tipayno 2008 [21]	January 1996 to December 2005	Hearing loss	Retrospective review of audiologic records	Patients tested in audiologic clinic of a pediatric specialty tertiary hospital (mean 3.9 years old)	Clinically diagnosed CRS (criteria used for diagnosis not mentioned)	48 patients out of 2,783 (1.7%) physician-diagnosed CRS; 44 patients with CRS (91%) with hearing loss, 80% of which were severe to profound hearing loss