Objective: Rubella is a viral infection that can lead to serious fetal anomalies such as Congenital Rubella Syndrome (CRS) if contracted during pregnancy, posing a significant public health threat. The main aim of this study is to compare rubella seroprevalence rates between Syrian refugee pregnant women and Turkish pregnant women living in Türkiye, and to reveal immunity differences between these populations.
Material and Method: This retrospective seroprevalence study included 1360 pregnant women who visited our hospital between January 1, 2019 and January 1, 2025. Rubella IgG and IgM antibody levels were analyzed using the ELISA method on blood samples collected from the selected populations. Demographic and serological data were analyzed using the R statistical software (version 4.4.1) for statistical analysis.
Results: Of the pregnant women included, 617 were Syrian and 743 were Turkish. Rubella IgM was positive in %0.7 of Syrian pregnant women, while no Turkish pregnant women tested positive for rubella IgM. Rubella IgG positivity was %74.6 in Syrians and %90.2 in Turks. Our study showed that rubella IgG seropositivity was significantly lower in Syrian pregnant women compared to Turkish pregnant women.
Conclusion: These findings clearly indicate that the level of immunity against rubella is lower in the Syrian refugee population in Türkiye than in the Turkish population. As the host country, Türkiye should strengthen its comprehensive and accessible immunization programs, particularly for Syrian migrant and refugee populations.
Ethical approval was received by the Adıyaman University Non-Interventional Clinical Research Ethics Committee (Date: 14.01.2025, Decision No: 2025/1-10). The Declaration of Helsinki was adhered to.
Destekleyen Kurum
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Teşekkür
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Kaynakça
Orenstein WA, Hinman A, Nkowane B, Olive JM, Reingold A. Measles and rubella global strategic plan 2012–2020 midterm review. Vaccine. 2018;36 Suppl 1:A1–A34. doi:10.1016/j.vaccine.2017.09.026
Cetinkaya RA, Yenilmez E. The seroprevalence of rubella in pregnant women in Turkey: a meta-analysis research of 90988 Rubella IgM, 84398 Rubella IgG, and 522 avidity results. Turk J Obstet Gynecol. 2019;16(1):63–71. doi:10.4274/tjod.galenos.2018.89663
Mongua-Rodriguez N, Díaz-Ortega JL, García-García L, Ferreira-Guerrero E, García-Sancho C, Gutiérrez G, et al. A systematic review of rubella vaccination strategies implemented in the Americas: impact on incidence and seroprevalence rates of rubella and congenital rubella syndrome. Vaccine. 2013;31(17):2145–51. doi:10.1016/j.vaccine.2013.02.047
Nasika A, Bogogiannidou Z, Mouchtouri VA, Kourlaba G, Sfikakis PP, Panagiotakopoulos G, et al. Measles immunity status of Greek population after the outbreak in 2017–2018: results from a seroprevalence national survey. Vaccines (Basel). 2023;11(7):1220. doi:10.3390/vaccines11071220
Barah F, Chehada AG. Prevalence of rubella IgG antibodies among Syrian females of childbearing age. Saudi Med J. 2010;31(1):78–81. PMID: 20029196.
Meng Q, Luo J, Li L, Li Y, Bao C, Wang X, et al. Rubella seroprevalence among pregnant women in Beijing, China. BMC Infect Dis. 2018;18(1):130. doi:10.1186/s12879-018-3032-x
Thayyil J, Kuniyil V, Moorkoth AP, Rao B, Selvam P. Prevalence of rubella-specific IgG antibodies in unimmunized young female population. J Family Med Prim Care. 2016;5(3):658–62. doi:10.4103/2249-4863.197311
Mahjour J. WHO warns of increased risk of disease epidemics in Syria and in neighbouring countries as summer approaches. Cairo: World Health Organization Regional Office for the Eastern Mediterranean; 2013. Available from: https://www.emro.who.int/ (Accessed: 1 June 2025).
Yucel Celik O, Aksu G, Obut M, Keleş A, Gültekin Çalık M, Dağdeviren G, et al. Rubella immunity in native Turkish and Syrian immigrant pregnant women between 2010–2018. Eur Res J. 2022;8(1):37–43. doi:10.18621/eurj.827322
Kul G, Turan G. Comparison of Toxoplasma and rubella seropositivity rates of Syrian and Turkish pregnant women. Cukurova Med J. 2021;46(3):975–81. DOI: 10.17826/cumj.903637
Nalça-Erdin B, Ekenoğlu-Merdan Y, Can B, Öztürk R, Gültekin H, Karadağ A, et al. Evaluation of Toxoplasma gondii, rubella, and CMV antibody positivity and avidity test results in female patients admitted to a state hospital in İstanbul. Klimik Derg. 2024;37(2):110–4. doi:10.5152/kd.2024.23136
Özmert EN. Dünya’da ve Türkiye’de aşılama takvimindeki gelişmeler. Cocuk Sagligi Hast Derg. 2008;51(3):168–75. Available from: https://cshd.org.tr/article/view/383 (Accessed: 1 June 2025).
Zahradeen SU, Muhammad ID, Adamou N, Rabiu A, Yusuf MA, Shuaibu SAD, Ibrahim G. Seroprevalence and risk factors for rubella infection in pregnant women attending a tertiary hospital in Kano-Nigeria. Pan Afr Med J. 2023 Dec 4;46:97. doi: 10.11604/pamj.2023.46.97.39433. PMID: 38405097; PMCID: PMC10891375.
Eiset AH, Wejse C. Review of infectious diseases in refugees and asylum seekers: current status and going forward. Public Health Rev. 2017;38:22. doi:10.1186/s40985-017-0065-4
Mipatrini D, Stefanelli P, Severoni S, Rezza G. Vaccinations in migrants and refugees: a challenge for European health systems. A systematic review of current scientific evidence. Pathog Glob Health. 2017;111(2):59–68. doi:10.1080/20477724.2017.1281374
Kütüphaneme Ekle
Göçün Anne Sağlığı Üzerindeki Etkisi: Suriyeli Mülteci ve Türk Gebe Kadınlarda Rubella Seroprevalans Farklılıkları
Amaç: Rubella enfeksiyonu, gebelik sırasında maruz kalındığında Konjenital Rubella Sendromu (KRS) gibi ciddi fetal anomalilere yol açabilen ve halk sağlığı açısından önemli bir tehdit oluşturan viral bir hastalıktır. Bu çalışmanın temel amacı, Türkiye’de ikamet eden Suriyeli mülteci gebe kadınlar ile Türk gebe kadınlar arasında rubella seroprevalans oranlarını karşılaştırmak ve bu popülasyonlar arasındaki immünite farklılıklarını ortaya koymaktır.
Gereç ve Yöntem: 1 Ocak 2019 ve 1 Ocak 2025 yılları arasında hastanemize başvuran 1360 gebe ile yapılmıştır. Çalışma retrospektif bir seroprevelans çalışmasıdır. Çalışmada, belirlenen popülasyonlardan alınan kan örnekleri kullanılarak rubella IgG ve IgM antikor düzeyleri ELISA yöntemiyle analiz edilmiştir. Toplanan demografik ve serolojik veriler, istatistiksel analizler için R istatistik yazılımı (sürüm 4.4.1) kullanılarak değerlendirilmiştir.
Bulgular: Çalışmamıza dahil edilen gebelerden 617’si Suriyeli, 743’ü Türk vatandaşıydı. Rubella IgM sıklığı Suriyeli gebelerde %0,7 oranında pozitifken, Türk gebelerde hiçbir hastada rubella IgM pozitifliği izlenmedi. Suriyelilerde rubella IgG dağılımları incelendiğinde pozitif olanların oranı %74,6 iken Türklerde rubella IgG pozitif olanların oranı %90,2 olarak elde edilmiştir. Çalışmamız Suriyeli gebe kadınlar arasında rubella IgG seropozitifliğinin Türk gebe kadınlara kıyasla anlamlı derecede daha düşük olduğunu ortaya koymuştur.
Sonuç: Elde ettiğimiz bu bulgular, Türkiye’deki Suriyeli mülteci popülasyonunda rubella’ya karşı immünite düzeylerinin Türk popülasyonuna kıyasla daha düşük olduğunu net bir şekilde ortaya koymaktadır. Ev sahibi ülke olarak Türkiye’nin, özellikle Suriyeli göçmen ve mülteci popülasyonları için kapsamlı ve erişilebilir aşılama programlarını güçlendirmesi gerektiği yönünde önemli bir öneri sunmaktadır.
Etik onay Adıyaman Üniversitesi girişimsel olmayan klinik araştırmalar Etik Kurulu tarafından alınmıştır ( Tarih: 14.01.2025 , Karar No: 2025/1-10). Helsinki bildirgesine sadık kalınmıştır.
Destekleyen Kurum
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Teşekkür
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Kaynakça
Orenstein WA, Hinman A, Nkowane B, Olive JM, Reingold A. Measles and rubella global strategic plan 2012–2020 midterm review. Vaccine. 2018;36 Suppl 1:A1–A34. doi:10.1016/j.vaccine.2017.09.026
Cetinkaya RA, Yenilmez E. The seroprevalence of rubella in pregnant women in Turkey: a meta-analysis research of 90988 Rubella IgM, 84398 Rubella IgG, and 522 avidity results. Turk J Obstet Gynecol. 2019;16(1):63–71. doi:10.4274/tjod.galenos.2018.89663
Mongua-Rodriguez N, Díaz-Ortega JL, García-García L, Ferreira-Guerrero E, García-Sancho C, Gutiérrez G, et al. A systematic review of rubella vaccination strategies implemented in the Americas: impact on incidence and seroprevalence rates of rubella and congenital rubella syndrome. Vaccine. 2013;31(17):2145–51. doi:10.1016/j.vaccine.2013.02.047
Nasika A, Bogogiannidou Z, Mouchtouri VA, Kourlaba G, Sfikakis PP, Panagiotakopoulos G, et al. Measles immunity status of Greek population after the outbreak in 2017–2018: results from a seroprevalence national survey. Vaccines (Basel). 2023;11(7):1220. doi:10.3390/vaccines11071220
Barah F, Chehada AG. Prevalence of rubella IgG antibodies among Syrian females of childbearing age. Saudi Med J. 2010;31(1):78–81. PMID: 20029196.
Meng Q, Luo J, Li L, Li Y, Bao C, Wang X, et al. Rubella seroprevalence among pregnant women in Beijing, China. BMC Infect Dis. 2018;18(1):130. doi:10.1186/s12879-018-3032-x
Thayyil J, Kuniyil V, Moorkoth AP, Rao B, Selvam P. Prevalence of rubella-specific IgG antibodies in unimmunized young female population. J Family Med Prim Care. 2016;5(3):658–62. doi:10.4103/2249-4863.197311
Mahjour J. WHO warns of increased risk of disease epidemics in Syria and in neighbouring countries as summer approaches. Cairo: World Health Organization Regional Office for the Eastern Mediterranean; 2013. Available from: https://www.emro.who.int/ (Accessed: 1 June 2025).
Yucel Celik O, Aksu G, Obut M, Keleş A, Gültekin Çalık M, Dağdeviren G, et al. Rubella immunity in native Turkish and Syrian immigrant pregnant women between 2010–2018. Eur Res J. 2022;8(1):37–43. doi:10.18621/eurj.827322
Kul G, Turan G. Comparison of Toxoplasma and rubella seropositivity rates of Syrian and Turkish pregnant women. Cukurova Med J. 2021;46(3):975–81. DOI: 10.17826/cumj.903637
Nalça-Erdin B, Ekenoğlu-Merdan Y, Can B, Öztürk R, Gültekin H, Karadağ A, et al. Evaluation of Toxoplasma gondii, rubella, and CMV antibody positivity and avidity test results in female patients admitted to a state hospital in İstanbul. Klimik Derg. 2024;37(2):110–4. doi:10.5152/kd.2024.23136
Özmert EN. Dünya’da ve Türkiye’de aşılama takvimindeki gelişmeler. Cocuk Sagligi Hast Derg. 2008;51(3):168–75. Available from: https://cshd.org.tr/article/view/383 (Accessed: 1 June 2025).
Zahradeen SU, Muhammad ID, Adamou N, Rabiu A, Yusuf MA, Shuaibu SAD, Ibrahim G. Seroprevalence and risk factors for rubella infection in pregnant women attending a tertiary hospital in Kano-Nigeria. Pan Afr Med J. 2023 Dec 4;46:97. doi: 10.11604/pamj.2023.46.97.39433. PMID: 38405097; PMCID: PMC10891375.
Eiset AH, Wejse C. Review of infectious diseases in refugees and asylum seekers: current status and going forward. Public Health Rev. 2017;38:22. doi:10.1186/s40985-017-0065-4
Mipatrini D, Stefanelli P, Severoni S, Rezza G. Vaccinations in migrants and refugees: a challenge for European health systems. A systematic review of current scientific evidence. Pathog Glob Health. 2017;111(2):59–68. doi:10.1080/20477724.2017.1281374
Akdan E, Kaplan S. Göçün Anne Sağlığı Üzerindeki Etkisi: Suriyeli Mülteci ve Türk Gebe Kadınlarda Rubella Seroprevalans Farklılıkları. Phnx Med J. 2026;7(3):98-101.