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

Table 2

Unpublished studies () on congenital rubella syndrome.

Author	Year	Sign	Methods	Included subjects	Results
Tanglao-Salazar 1993 [22]	1993	Hearing loss	Retrospective chart review	Children with hearing impairment	18.4% with maternal history of rubella infection during pregnancy
Rodriguez 1995 [23]	1995	Hearing loss	Retrospective chart review	Children with hearing impairment	13% diagnosed with congenital rubella
Santos-Gonzales and Santiago 2013 [24]	2013	Cataract	Retrospective review of records in pediatric ophthalmology clinic	Children with suspected, probable, or laboratory-confirmed	Out of 23 cases, there were 6 (26%) rubella IgM confirmed, 11 (48%) probable, and 6 (26%) CRS suspected cases. Cataract was seen in 21 (91%) of the cases of CRS. Two patients presented with pigmentary retinopathy
Limgenco 2000 [25]	2000	Pregnancy outcome	Retrospective review	Pregnant women with titers	4 cases of maternal rubella infection, 1 had fetal death in utero, and 3 babies were diagnosed with congenital rubella syndrome

1997 US CDC criteria for CRS include the following. Clinical description: an illness is usually manifesting in infancy resulting from rubella infection in utero and characterized by signs or symptoms from the following categories: (A) cataracts/congenital glaucoma, congenital heart disease (most commonly patent ductus arteriosus, or peripheral pulmonary artery stenosis), loss of hearing, and pigmentary retinopathy; 
(B) purpura, splenomegaly, jaundice, microcephaly, mental retardation, meningoencephalitis, and radiolucent bone disease. Case classification: suspected: a case with some compatible clinical findings but not meeting the criteria for a probable case; probable: a case that is not laboratory confirmed and that has any two complications listed in paragraph (A) of the clinical description or one complication from paragraph (A) and one from paragraph (B) and lacks evidence of any other etiology; confirmed: a clinically compatible case that is laboratory confirmed; infection only: a case that demonstrates laboratory evidence of infection, but without any clinical symptoms or signs. Laboratory confirmation is through viral isolation, rubella IgM, and rubella antibody level that persists at a higher level and for a longer period than expected from passive transfer of maternal antibody.
: toxoplasma, rubella, cytomegalovirus, herpes titers.