Profile of cardiac lesions among laboratory confirmed congenital rubella syndrome (CRS) infants: a nationwide sentinel surveillance, India, 2016–22Research in context
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 sit...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-09-01
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| Series: | The Lancet Regional Health - Southeast Asia |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772368223001282 |
| _version_ | 1827860159194464256 |
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| 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 |
| author_facet | 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 |
| author_sort | Pradeep Kumar Gunasekaran |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-12T13:19:15Z |
| format | Article |
| id | doaj.art-37c303da5fb94582a7e70a6a38597279 |
| institution | Directory Open Access Journal |
| issn | 2772-3682 |
| language | English |
| last_indexed | 2024-03-12T13:19:15Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health - Southeast Asia |
| spelling | doaj.art-37c303da5fb94582a7e70a6a385972792023-08-26T04:44:23ZengElsevierThe Lancet Regional Health - Southeast Asia2772-36822023-09-0116100268Profile of cardiac lesions among laboratory confirmed congenital rubella syndrome (CRS) infants: a nationwide sentinel surveillance, India, 2016–22Research in contextPradeep Kumar Gunasekaran0Devika Shanmugasundaram1Sridhar Santhanam2Sanjay Verma3Kuldeep Singh4Bhagirathi Dwibedi5Shally Awasthi6Himabindu Singh7Mahantesh Sangappa8Nivedita Mondal9Priya Sreenivasan10Geetha Saradakutty11Shikha Malik12Manish Jain13Rajlakshmi Viswanathan14Gajanan Sapkal15Shalini Tripathi16Bhupeshwari Patel17Mahendra Kumar Jain18Sanjeev Hanumantacharya Naganur19Arun Baranwal20Manoj K Rohit21Surender Deora22Akhil Sharma23Avinash Anantharaj24Lakshmi Sadasivan Pillai25Amber Kumar26Sabarinathan Ramasamy27Padma Priya Rajendran28Mini P. Singh29Radha Kanta Ratho30Vijaylakshmi Nag31Ravishekhar Gadepalli32Baijayantimala Mishra33Tapas Kumar Som34Amita Jain35Sudha Madhuri Devara36Sudha Rani Vannavada37Ashok Munivenkatappa38Asha Mary Abraham39Rahul Dhodapkar40Syed Ali41Debasis Biswas42Deepashri Pratkeye43Ashish Bavdekar44Jayant Prakash45Jaydeb Ray46Manoj Murhekar47Praveen KumarParul Chawla GuptaSanjay MunjalNaveen SankhyanNabaneeta DashMadhu GuptaRia SaiVishaly SharmaNeeraj GuptaVaruna VyasNidhi Kaushal SuhanimanasaNiranjan Hunasanahalli ShivannaPrem Kumar PDeepa JohnArun AlexanderNirupama KasturiAdhisivam BethouVarsha SinghNidhi PrasadAniruddha GhoshAgniva MajumdarShanta DuttaAll India Institute of Medical Sciences, Jodhpur, IndiaICMR – National Institute of Epidemiology, Chennai, IndiaChristian Medical College, Vellore, IndiaPostgraduate Institute of Medical Education and Research, Chandigarh, IndiaAll India Institute of Medical Sciences, Jodhpur, IndiaAll India Institute of Medical Sciences, Bhubaneswar, IndiaKing George's Medical University, Lucknow, IndiaNiloufer Hospital, Hyderabad, IndiaIndira Gandhi Institute of Child Health, Bengaluru, IndiaJawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IndiaGovernment Medical College, Trivandrum, IndiaGovernment Medical College, Trivandrum, IndiaAll India Institute of Medical Sciences, Bhopal, IndiaMahatma Gandhi Institute of Medical Sciences, Sewagram, IndiaICMR-National Institute of Virology, Pune, IndiaICMR-National Institute of Virology, Pune, IndiaKing George's Medical University, Lucknow, IndiaAll India Institute of Medical Sciences, Bhopal, IndiaAll India Institute of Medical Sciences, Bhopal, IndiaPostgraduate Institute of Medical Education and Research, Chandigarh, IndiaPostgraduate Institute of Medical Education and Research, Chandigarh, IndiaPostgraduate Institute of Medical Education and Research, Chandigarh, IndiaAll India Institute of Medical Sciences, Jodhpur, IndiaKing George's Medical University, Lucknow, IndiaJawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IndiaGovernment Medical College, Trivandrum, IndiaAll India Institute of Medical Sciences, Bhopal, IndiaICMR – National Institute of Epidemiology, Chennai, IndiaICMR – National Institute of Epidemiology, Chennai, IndiaPostgraduate Institute of Medical Education and Research, Chandigarh, IndiaPostgraduate Institute of Medical Education and Research, Chandigarh, IndiaAll India Institute of Medical Sciences, Jodhpur, IndiaAll India Institute of Medical Sciences, Jodhpur, IndiaAll India Institute of Medical Sciences, Bhubaneswar, IndiaAll India Institute of Medical Sciences, Bhubaneswar, IndiaKing George's Medical University, Lucknow, IndiaNiloufer Hospital, Hyderabad, IndiaNiloufer Hospital, Hyderabad, IndiaICMR-National Institute of Virology, Pune, IndiaChristian Medical College, Vellore, IndiaJawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IndiaGovernment Medical College, Trivandrum, IndiaAll India Institute of Medical Sciences, Bhopal, IndiaMahatma Gandhi Institute of Medical Sciences, Sewagram, IndiaKEM Hospital, Pune, IndiaIndira Gandhi Institute of Medical Sciences, Patna, IndiaInstitute of Child Health, Kolkata, IndiaICMR – National Institute of Epidemiology, Chennai, India; Corresponding author. R127, TNHB, Ayapakkam, Chennai, 600077, India.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.http://www.sciencedirect.com/science/article/pii/S2772368223001282Congenital rubella syndromeCardiac lesionsSentinel surveillance |
| spellingShingle | 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 Profile of cardiac lesions among laboratory confirmed congenital rubella syndrome (CRS) infants: a nationwide sentinel surveillance, India, 2016–22Research in context The Lancet Regional Health - Southeast Asia Congenital rubella syndrome Cardiac lesions Sentinel surveillance |
| title | Profile of cardiac lesions among laboratory confirmed congenital rubella syndrome (CRS) infants: a nationwide sentinel surveillance, India, 2016–22Research in context |
| title_full | Profile of cardiac lesions among laboratory confirmed congenital rubella syndrome (CRS) infants: a nationwide sentinel surveillance, India, 2016–22Research in context |
| title_fullStr | Profile of cardiac lesions among laboratory confirmed congenital rubella syndrome (CRS) infants: a nationwide sentinel surveillance, India, 2016–22Research in context |
| title_full_unstemmed | Profile of cardiac lesions among laboratory confirmed congenital rubella syndrome (CRS) infants: a nationwide sentinel surveillance, India, 2016–22Research in context |
| title_short | Profile of cardiac lesions among laboratory confirmed congenital rubella syndrome (CRS) infants: a nationwide sentinel surveillance, India, 2016–22Research in context |
| title_sort | profile of cardiac lesions among laboratory confirmed congenital rubella syndrome crs infants a nationwide sentinel surveillance india 2016 22research in context |
| topic | Congenital rubella syndrome Cardiac lesions Sentinel surveillance |
| url | http://www.sciencedirect.com/science/article/pii/S2772368223001282 |
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