Antenatal

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3\ri0\sl-253\slmult0 \fs16\cf0\f0\charscalex100\b {10}\b0 \par\column\pard\li0\r
i0\sl-253\slmult0 \fs16\cf0\f0\charscalex100\b \i {The Open Public Health Journa
l,}\b0 \i0 \fs16\cf0\f0\charscalex100\b { 2011, }\b0 \fs16\cf0\f0\charscalex100\
b \i {4, }\b0 \i0 \fs16\cf0\f0\charscalex100\b {10-16 }\b0 \par\column\pard\li0\
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sect\sectd\sbknone\pard\li613\ri0\sl-466\slmult0 \fs32\cf0\f0\charscalex100\b {S
ero-Prevalence of Antenatal Rubella in UITH }\b0 \par\pard\li613\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li613\ri0\sl-333\slmult0 \fs24\cf0\f0\charscalex100 {O.O.
Agbede}{\super \fs16\up4\cf0\f0\charscalex100 {1}}\fs24\cf0\f0\charscalex100 {,
O.O. Adeyemi}{\super \fs16\up4\cf0\f0\charscalex100 {*,1}}\fs24\cf0\f0\charscal
ex100 {, A.W.O. Olatinwo}{\super \fs16\up4\cf0\f0\charscalex100 {2}}\fs24\cf0\f0
\charscalex100 {, T.J. Salisu}{\super \fs16\up4\cf0\f0\charscalex100 {3}}\fs24\c
f0\f0\charscalex100 { and O.M. Kolawole}{\super \fs16\up4\cf0\f0\charscalex100 {
4}}\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li613\ri0\sl-400\slmult
0 \fs12\cf0\f0\charscalex100\i {1}\i0 \fs18\cf0\f0\charscalex100\i {Department o
f Medical Microbiology and Parasitology, University of Ilorin, P.M.B. 1515, Ilor
in, Nigeria }\i0 \par\pard\li613\ri0\sl-360\slmult0 \fs12\cf0\f0\charscalex100\i
{2}\i0 \fs18\cf0\f0\charscalex100\i {Department of Obstetrics and Gynecology, U
niversity of Ilorin, P.M.B. 1515, Ilorin, Nigeria }\i0 \par\pard\li613\ri0\sl-34
6\slmult0 \fs12\cf0\f0\charscalex100\i {3}\i0 \fs18\cf0\f0\charscalex100\i {Depa
rtment of Chemical Pathology, University of Ilorin Teaching Hospital, Nigeria }\
i0 \par\pard\li613\ri0\sl-346\slmult0 \fs12\cf0\f0\charscalex100\i {4}\i0 \fs18\
cf0\f0\charscalex100\i {Department of Microbiology, University of Ilorin, P.M.B.
1515, Ilorin, Nigeria }\i0 \par\pard\li1453\ri0\sl-213\slmult0 \fs18\cf0\par\pa
rd\li1453\ri0\sl-253\slmult0 \fs18\cf0\f0\charscalex100\b {Abstract: }\b0 { }\fs
16\cf0\f0\charscalex100 {Rubella virus is a teratogen that may induce fo
etal death or Congenital Rubella Syndrome in the newborn. }\par\pard\li1
453\ri0\sl-213\slmult0 \fs16\cf0\f0\charscalex100 {Studies carried out in Niger
ia, have recorded 68.5% prevalence in pregnant women in the south-west and 54.
1% in the }\par\pard\li1453\ri0\sl-226\slmult0 \fs14\cf0\f0\charscalex100 {North
-west. There has been a dearth of information in the North central.
Sentinel studies have placed the incidence of }\par\pard\li1453\ri0\sl-213
\slmult0 \fs18\cf0\f0\charscalex100 {rubella on a seasonal distribution, with an
average of 5-9-year variable epidemic pattern. }\par\pard\li1453\ri0\sl-346\slm
ult0 \fs16\cf0\f0\charscalex100 {A descriptive study was carried out on pregnant
women between July and September 2009, to establish baseline data on }\par\pard
\li1453\ri0\sl-213\slmult0 \fs16\cf0\f0\charscalex100 {the sero-prevalence of an
tenatal rubella in pregnant women in Ilorin. A total of 92 pregnant women in the
first and second }\par\pard\li1453\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex10
0 {trimesters of pregnancy were recruited from the antenatal clinics of the Univ
ersity of Ilorin Teaching Hospital. }\par\pard\li1453\ri0\sl-333\slmult0 \fs16\
cf0\f0\charscalex100 {A 3ml blood sample was collected from each consenting subj
ect and serum assayed for Rubella IgG/ IgM antibodies by }\par\pard\li1453\ri0\s
l-226\slmult0 \fs16\cf0\f0\charscalex100 {indirect ELISA test. Anti-rubella viru
s antibodies were reported in the sera of 14 pregnant women that participated in
the }\par\pard\li1453\ri0\sl-213\slmult0 \fs16\cf0\f0\charscalex100 {study. A p
revalence of 16.3% was recorded. The primigravidae had a higher prevalence (27.0
%) than the multigravidae }\par\pard\li1453\ri0\sl-226\slmult0 \fs16\cf0\f0\char
scalex100 {(12.0%). There was a gradual rise in seroprevalence from fir
st trimester pregnancies (13.0%) to second trimester }\par\pard\li1453\ri0
\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {pregnancies (19.1%). }\par\pard\li14

53\ri0\sl-346\slmult0 \fs16\cf0\f0\charscalex100 {High seroprevalence of rubella
infections during organogenesis poses high risk to foetus. Since 85% of the sub
jects were }\par\pard\li1453\ri0\sl-213\slmult0 \fs16\cf0\f0\charscalex100 {susc
eptible to rubella virus infection, it is advisable for health planners to preve
nt further occurrence of antenatal rubella }\par\pard\li1453\ri0\sl-226\slmult0
\fs18\cf0\f0\charscalex100 {that may result to congenital rubella anomalies by t
he immunisation of women of child bearing age. }\par\pard\li613\ri0\sl-333\slmul
t0 \fs20\cf0\f0\charscalex100\b {Keywords: }\b0 \fs20\cf0\f0\charscalex100 {Sero
-prevalence, antenatal rubella.}\par\pard\sect\sectd\sbknone\cols2\colno1\colw59
46\colsr-0\colno2\colw5493\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li61
3\ri0\sl-373\slmult0 \fs20\cf0\f0\charscalex100\b {INTRODUCTION }\b0 \par\pard\l
i893\ri0\sl-333\slmult0 \fs18\cf0\f0\charscalex100 {Rubella is caused by a
positive sense RNA virus of the }\par\pard\li613\ri0\sl-226\slmult0 \fs18\c
f0\f0\charscalex100 {family }{ }\fs18\cf0\f0\charscalex100\i {Rubiviridae}\i0 \f
s16\cf0\f0\charscalex100 {. It affects all ages and sex [1]. Rubella }\p
ar\pard\li613\ri0\sl-213\slmult0 \fs16\cf0\f0\charscalex100 {virus is a biolo
gical teratogen of the TORCH complex [2]. }\par\pard\li613\ri0\sl-226\slmu
lt0 \fs16\cf0\f0\charscalex100 {Acute infections that occur in early pregn
ancy may induce }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\f0\charscalex100
{foetal death or Congenital Rubella Syndrome [3]. Clinical }\par\pard\li
613\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {manifestations of rubella inc
lude acute febrile illness, macu-}\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\f
0\charscalex100 {lopapula rash and lymphadenopathy in adults and children
}\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {[4]. These sy
mptoms are often confused with similar rash-}\par\pard\li613\ri0\sl-213\sl
mult0 \fs18\cf0\f0\charscalex100 {associated illnesses caused by other vira
l and non-viral }\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100
{pathogens or even some drugs, making differential diagnosis }\par\pard\li613\r
i0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {unreliable [1, 5]. Rubella invokes
a serological response that }\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\ch
arscalex100 {is detectable at the onset of its characteristic rash and
con-}\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {tinues to e
volve over the next few weeks [1]. Viral-specific }\par\pard\li613\ri0\sl-226\sl
mult0 \fs18\cf0\f0\charscalex100 {IgM antibodies are first detected 10 days post
infection, and }\par\pard\li613\ri0\sl-213\slmult0 \fs16\cf0\f0\charscalex100 {
peaks at about 4 weeks post infection. This may persist for }\par\pard
\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {over 7 months after an acu
te infection. By three weeks post }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf
0\f0\charscalex100 {infection, anti-rubella virus antibodies are present i
n all }\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {immunoglo
bulin classes, including IgG, IgA, IgD, and IgE }\par\pard\li613\ri0\sl-2
13\slmult0 \fs20\cf0\f0\charscalex100 {[1]. The infectious period of rubell
a virus is from 7 days }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li613\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li613\ri0\sl-186\slmult0 \fs16\c
f0\f0\charscalex100 {*Address correspondence to this author at the Departm
ent of Medical }\par\pard\li613\ri0\sl-200\slmult0 \fs14\cf0\f0\charscalex100 {
Microbiology and Parasitology, University of Ilorin. P.M.B. 1515, Ilorin,
}\par\pard\li613\ri0\sl-173\slmult0 \fs16\cf0\f0\charscalex100 {Nigeria; Tel: +
234 (0)802 3333 740; E-mail: peluwa@yahoo.com }\par\column\pard\li0\ri0\sl-213\s
lmult0 \fs18\cf0\par\pard\li0\ri0\sl-373\slmult0 \fs20\cf0\f0\charscalex100 {bef
ore to 5\uc1\u8211X7 days after onset of rash [6]. At this period, the }\par\par
d\li0\ri0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {virus remains detectable
only in the Nasopharynx, where it }\par\pard\li0\ri0\sl-226\slmult0 \fs20\
cf0\f0\charscalex100 {can be isolated from up to 1 week before, to up to 2 wee
ks }\par\pard\li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {after the onset
of rash [4].}\par\pard\li280\ri0\sl-333\slmult0 \fs18\cf0\f0\charscalex100 {In
early laboratory diagnosis of rubella infections, }\par\pard\li0\ri0\sl-21
3\slmult0 \fs20\cf0\f0\charscalex100 {detection of plasma cells in circulating b
lood was considered }\par\pard\li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100
{as one of the diagnostic standards. However, further HAI }\par\pard\li

0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {studies have shown that pla
sma cell detection in rubella }\par\pard\li0\ri0\sl-213\slmult0 \fs20\cf0\f0
\charscalex100 {patients have a very low sensitivity and low specificity alike }
\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {[7]. Viral isolat
ion may occasionally be warranted parti-}\par\pard\li0\ri0\sl-213\slmult0 \
fs20\cf0\f0\charscalex100 {cularly during infections in pregnancy, but this is
expensive }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {[1] and
as a result of the non-cytopathic effect of rubella }\par\pard\li0\ri0
\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {virus in cell cultures, it is
not usually recommended [4]. }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\c
harscalex100 {Nucleic acid amplification techniques have been developed }\
par\pard\li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {since the 1990s f
or the detection of rubella virus RNA in }\par\pard\li0\ri0\sl-226\slmult
0 \fs20\cf0\f0\charscalex100 {clinical samples of orophangeal sources [4].
However, a }\par\pard\li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {defin
itive diagnosis of rubella is a suspected case with a }\par\pard\li0\ri
0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {positive test for rubella-specif
ic IgM in all ages, by ELISA }\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\f
0\charscalex100 {[1, 4, 8]. Test results for the detection of rubella
virus-spe-}\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {cific I
gG and IgM antibodies by ELISA are presented as }\par\pard\li0\ri0\sl-21
3\slmult0 \fs20\cf0\f0\charscalex100 {positive, borderline and negative, which i
s a reflection of the }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex1
00 {spectra of the photocell detected light of the Spectropho-}\par\pard
\li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {tometry, which determines
both qualitative and quantitative }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf
0\f0\charscalex100 {results in a given run. }\par\pard\sect\sectd\sbknone\pard\
li4626\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li4626\ri0\sl-213\slmult0 \fs18\cf0
\par\pard\li4626\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li4626\ri0\sl-173\slmult0
\*\tx5933\fs16\cf0\f0\charscalex100\b {1874-9445/11 }\b0 \tab \fs16\cf0\f0\char
scalex100\b {2011 Bentham Open }\b0 \par\pard\sect\sectd\sbknone\pard\sect\sectd
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22F11EA57362CDCF98906FFF009E7B0633401DDD1451400514514005145140051451400514514005
14514005145140051451400514514005145140051451400514514005145140051451400514514005
14514005145140051451400514514005145140051451400514514005145140051451400514514005
14514005145140051451400514514005145140051451400514514005145140051451400514514005
14514005145140051451400514514005145140051451400514514005145140051451400514514005
14514005145140051451400514514005145140051451400514514005145140051451400514514005
14514005145140051451400514514005145140051451400514514005145140051451400514514005
14514005145140051451400514514005145140051451400514514005145140051451400514514005
14514005145140051451400514514005145140051451400514514005145140051451400514514005
14514005145140051451400514514005145140051451400514514005145140051451400514514005
14514005145140051451400514514005145140051451400514514005145140051451400514514005
14514005145140051451400514514005145140051451400514514005145140051451400514514005
145140051451400514514005145140051451401FFFD9}
}}}}\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\margtsxn653\margbsxn240\col
s2\colno1\colw5946\colsr-0\colno2\colw5493\pard\li613\ri0\sl-253\slmult0 \fs16\c
f0\f0\charscalex100\b \i {Sero-Prevalence of Antenatal Rubella in UITH }\b0 \i0
\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li613\ri0\sl-226\slmult0 \
fs20\cf0\f0\charscalex100\b {Vaccination }\b0 \par\pard\li893\ri0\sl-333\slmult0
\fs20\cf0\f0\charscalex100 {In 1969, a monovalent (inactivated) vaccine a
nd a tri-}\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {valen
t vaccine (i.e. Measles, Mumps and Rubella \uc1\u8211X MMR) }\par\pard\l
i613\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {were developed [6, 8], and h
ave since been accepted world-}\par\pard\li613\ri0\sl-226\slmult0 \fs16\cf0\f0\c
harscalex100 {wide and introduced into the WHO EPI [9] with a primary
}\par\pard\li613\ri0\sl-213\slmult0 \fs16\cf0\f0\charscalex100 {purpose of vac
cination in women to prevent the occurrence }\par\pard\li613\ri0\sl-226\sl
mult0 \*\tx1320\fs18\cf0\f0\charscalex100 {of CRS}\tab \fs18\cf0\f0\charscalex1
00 {[5, 10]. Although the burden of CRS is not well }\par\pard\li613\ri
0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {characterized in most countries}
{ }\fs18\cf0\f0\charscalex100 {[4, 11], it is estimated that }\par\pard\li6

13\ri0\sl-226\slmult0 \fs16\cf0\f0\charscalex100 {over 100,000 infants are b
orn with CRS each year, mostly }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf
0\f0\charscalex100 {occurring in developing countries that are yet to in
troduce }\par\pard\li613\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {rubella
vaccines [3, 11]. }\par\pard\li893\ri0\sl-320\slmult0 \fs18\cf0\f0\charscalex100
{In 1979, the Federal Government of Nigeria initiated the }\par\pard\li613\ri0\
sl-213\slmult0 \fs18\cf0\f0\charscalex100 {EPI which was sustainably re-vita
lized in 1999 to reduce }\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\cha
rscalex100 {disease burden from vaccine preventable diseases but left out }\par\
pard\li613\ri0\sl-213\slmult0 \fs16\cf0\f0\charscalex100 {rubella [4]. Studies
carried out in Nigeria, have revealed an }\par\pard\li613\ri0\sl-226\slm
ult0 \fs16\cf0\f0\charscalex100 {annual occurrence of 150\uc1\u8211X250 new
cases of congenital eye }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\f0\cha
rscalex100 {defect in the Federal Capital Territory [12]. In south western }\par
\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {Nigeria, a 68.5% prev
alence of rubella infection in pregnant }\par\pard\li613\ri0\sl-213\slmult0 \fs1
8\cf0\f0\charscalex100 {women have been observed in Ibadan [13], and 76%
in }\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {Lagos [14]
. In Maiduguri (North-western Nigeria) 54.1% }\par\pard\li613\ri0\sl-213\sl
mult0 \fs16\cf0\f0\charscalex100 {prevalence was however observed in pregna
nt women [15]. }\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100
{With epidemics occurring in varied intervals by geographical }\par\pard\li613\r
i0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {locations}{ }\fs18\cf0\f0\charscal
ex100 {[3, 6], sentinel studies have placed the incidence of }\par\pard\li613\ri
0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {rubella on a seasonal distribut
ion, with an average of 5-9-}\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\f
0\charscalex100 {year epidemic pattern that is highly variable in both }
\par\pard\li613\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {developed and dev
eloping countries [11]. }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\par\pard\l
i613\ri0\sl-253\slmult0 \fs20\cf0\f0\charscalex100\b {Study Objectives }\b0 \par
\pard\li893\ri0\sl-333\slmult0 \fs16\cf0\f0\charscalex100 {This study was car
ried out to establish baseline data on }\par\pard\li613\ri0\sl-213\slmult0
\fs16\cf0\f0\charscalex100 {the sero-prevalence of antenatal rubella in p
regnant women }\par\pard\li613\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {i
n Ilorin. }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li613\ri0\sl-30
6\slmult0 \fs18\cf0\f0\charscalex100\b {MATERIAL AND METHODS }\b0 \par\pard\li89
3\ri0\sl-333\slmult0 \fs18\cf0\f0\charscalex100 {A descriptive study was car
ried out at the Antenatal }\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\c
harscalex100 {clinics of the University of Ilorin Teaching Hospital (UITH), }\pa
r\column\pard\li1306\ri0\sl-253\slmult0 \fs16\cf0\f0\charscalex100\b \i {The Ope
n Public Health Journal,}\b0 \i0 \fs16\cf0\f0\charscalex100\b { 2011, }\b0 \fs16
\cf0\f0\charscalex100\b \i {Volume 4
}\b0 \i0 \fs16\cf0\f0\charscalex100\b {
11}\b0 \par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-226\slmult
0 \fs20\cf0\f0\charscalex100 {Ilorin. A total of 92 subjects were recruit
ed by simple }\par\pard\li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {ran
dom selection from a population size of 124 pregnant }\par\pard\li0\ri0\
sl-226\slmult0 \fs18\cf0\f0\charscalex100 {women not exceeding 24 weeks of
gestation, between July }\par\pard\li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charsc
alex100 {and September 2009. The sample size was determined by the }\par\pard\li
0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {Fisher\uc1\u8217Xs formula (f
or populations less than 10,000). Ethical }\par\pard\li0\ri0\sl-213\slmult0
\fs20\cf0\f0\charscalex100 {approval was obtained from the Ethical Committee of
UITH, }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {before the
study was carried out. A written informed consent }\par\pard\li0\ri0\sl-213\slmu
lt0 \fs20\cf0\f0\charscalex100 {was duly signed by each participating preg
nant woman }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {within
the first and second trimesters of pregnancy. Pregnant }\par\pard\li0\ri0\sl-21
3\slmult0 \fs20\cf0\f0\charscalex100 {women in the third trimester of preg
nancy including other }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscale
x100 {pregnant women who were not registered at, nor attended the }\par\pard\li0
\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {antenatal clinics of the UITH, w
ere excluded from this study. }\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pa
rd\li0\ri0\sl-253\slmult0 \fs18\cf0\f0\charscalex100\b {Sample Collection and Pr
ocessing }\b0 \par\pard\li280\ri0\sl-333\slmult0 \fs20\cf0\f0\charscalex100 {A
structured questionnaire was designed and standard-}\par\pard\li0\ri0\sl-22
6\slmult0 \fs20\cf0\f0\charscalex100 {ised. Data was collected by three train
ed research assistants }\par\pard\li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charscale
x100 {through structured interviews. A 3ml blood sample was }\par\pard\li
0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {collected from each respondent
into sterile non-anticoagulant }\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\f0\ch
arscalex100 {bottles. Sera were separated by centrifugation at 3,000 rpm
}\par\pard\li0\ri0\sl-253\slmult0 \fs20\cf0\f0\charscalex100 {for 5 minutes and
stored in serum vial aliquots at -20}{\super \fs12\up3\cf0\f0\charscalex100 {o}
}\fs20\cf0\f0\charscalex100 {C. }\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\
pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100\b {Laboratory Analysis }\
b0 \par\pard\li280\ri0\sl-333\slmult0 \fs18\cf0\f0\charscalex100 {Sera were test
ed for Rubella virus-specific IgG and IgM }\par\pard\li0\ri0\sl-213\slmult0 \fs2
0\cf0\f0\charscalex100 {antibodies by the enzyme-linked immunosorbent assay
}\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {(ELISA) test; u
sing the SERION ELISA classic Rubella }\par\pard\li0\ri0\sl-213\slmult0 \fs
20\cf0\f0\charscalex100 {Virus IgG/IgM kit (Germany) according to the man
ufac-}\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {turer\uc1\u82
17Xs instructions. All specimens were analysed by indirect }\par\pard\li0\ri0\sl
-213\slmult0 \fs20\cf0\f0\charscalex100 {ELISA techniques. IgG test results were
interpreted as a ratio }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscale
x100 {of the sample optical density (OD) of 450 nm and the sample }\par\pard\li0
\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {rate/cut-off value as follows
: <0.30 U/ml = negative; 0.30-}\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f
0\charscalex100 {0.55 = Borderline; and >0.55 = positive. IgM test resu
lts }\par\pard\li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {were interpre
ted as similarly as follows: <0.135 U/ml = }\par\pard\li0\ri0\sl-226\slmu
lt0 \fs20\cf0\f0\charscalex100 {negative; 0.135-0.230 = Borderline; and >0.
230 = positive. }\par\pard\li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {
The controls and the calibrators passed the validation check }\par\pard\li0\r
i0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {recommended by the manufacturers o
f both the IgG and the }\par\pard\li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex
100 {IgM kits. }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666
\margrsxn133\pard\li640\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li640\ri0\sl-213\s
lmult0 \fs18\cf0\par\pard\li640\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li640\ri0\
sl-213\slmult0 \fs18\cf0\par\pard\li640\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li
640\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li640\ri0\sl-213\slmult0 \fs18\cf0\par
\pard\li640\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li640\ri0\sl-213\slmult0 \fs18
\cf0\par\pard\li640\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li640\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li640\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li640\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li640\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li640\
ri0\sl-213\slmult0 \fs18\cf0\par\pard\li640\ri0\sl-213\slmult0 \fs18\cf0\par\par
d\li640\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li640\ri0\sl-213\slmult0 \fs18\cf0
\par\pard\li640\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li640\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li640\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li640\ri0\sl-253\s
lmult0 \fs18\cf0\f0\charscalex100\b {Fig. (1). Distribution of Rubella virus-spe
cific IgG and IgM in the sera of pregnant women (N = 92). }\b0 \par\pard\li640\r
i0\sl-320\slmult0 \fs18\cf0\f0\charscalex100 {This figure shows the Distribution
of Rubella Virus-specific IgG and IgM in the sera of the pregnant women that pa
rticipated in this study. }\par\pard\li640\ri0\sl-226\slmult0 \fs18\cf0\f0\chars
calex100 {The IgG test results shows that 8 (9.0%) pregnant women tested borderl
ine, 6 (7%) tested positive, while 78 (85.0%) tested negative. Also, 2 }\par\par
d\li640\ri0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {(2.2%) pregnant women\uc1
\u8217Xs sera tested borderline for IgM, 1 (1.1%) tested positive while 89 (96.7
%) of tested negative. }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\mar
glsxn666\margrsxn133\pard\sect\sectd\sbkpage
{\shp{\*\shpinst\shpleft1306\shptop1560\shpright2826\shpbottom1986\shpfhdr0\shpw
r3\shpwrk0\shpfblwtxt1\shplid2032\shpz0\shpbxpage\shpbypage
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613\ri0\sl-253\slmult0 \fs16\cf0\f0\charscalex100\b {12
}\b0 \fs16\cf0\f0\c
harscalex100\b \i {The Open Public Health Journal,}\b0 \i0 \fs16\cf0\f0\charscal
ex100\b { 2011, }\b0 \fs16\cf0\f0\charscalex100\b \i {Volume 4 }\b0 \i0 \par\par
\f0\charscalex100\b {Table 1. Prevalence of Rubella Virus Infection among Types
of Pregnancy (N=92) }\b0 \par\column\pard\li0\ri0\sl-253\slmult0 \fs16\cf0\f0\c
harscalex100\b \i {Agbede et al. }\b0 \i0 \par\pard\sect\sectd\sbknone\pgwsxn122
40\pghsxn15840\marglsxn666\margrsxn133\cols4\colno1\colw3506\colsr-0\colno2\colw
2386\colsr-0\colno3\colw2186\colsr-0\colno4\colw3360\pard\li760\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li760\ri0\sl-293\slmult0 \*\tx2306\fs16\cf0\f0\charscalex1
00\b {Type of Pregnancy }\b0 \tab \fs16\cf0\f0\charscalex100\b {No. Tested }\b0
\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-293\slmult
0 \fs16\cf0\f0\charscalex100\b {New Cases: IgM +ve (%) }\b0 \par\column\pard\li0
\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-293\slmult0 \fs16\cf0\f0\chars
calex100\b {Old Cases: IgG +ve (%) }\b0 \par\column\pard\li0\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li0\ri0\sl-293\slmult0 \fs16\cf0\f0\charscalex100\b {Prevalen
ce of Rubella Virus Infection }\b0 \par\pard\sect\sectd\sbknone\pgwsxn12240\pgh
sxn15840\marglsxn666\margrsxn133\cols5\colno1\colw2586\colsr-0\colno2\colw1493\c
olsr-0\colno3\colw2306\colsr-0\colno4\colw2773\colsr-0\colno5\colw2280\pard\li97
3\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li973\ri0\sl-186\slmult0 \fs16\cf0\f0\ch
arscalex100 { No response }\par\pard\li1000\ri0\sl-320\slmult0 \fs16\cf0\f0\char
scalex100 { Primigravid }\par\pard\li1000\ri0\sl-306\slmult0 \fs16\cf0\f0\charsc
alex100 { Multigravid }\par\pard\li1226\ri0\sl-306\slmult0 \fs16\cf0\f0\charscal
ex100 {Total }\par\column\pard\li40\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li40\r
i0\sl-186\slmult0 \fs16\cf0\f0\charscalex100 {5 }\par\pard\li0\ri0\sl-320\slmult
0 \fs16\cf0\f0\charscalex100 {37 }\par\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\
charscalex100 {50 }\par\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {
92 }\par\column\pard\li26\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li26\ri0\sl-186\
slmult0 \fs16\cf0\f0\charscalex100 {1 (20.0) }\par\pard\li66\ri0\sl-320\slmult0
\fs16\cf0\f0\charscalex100 {1 (2.7) }\par\pard\li66\ri0\sl-306\slmult0 \fs16\cf0
\f0\charscalex100 {1 (2.0) }\par\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\charsc
alex100 {3 (3.3%) }\par\column\pard\li106\ri0\sl-213\slmult0 \fs18\cf0\par\pard\
li106\ri0\sl-186\slmult0 \fs16\cf0\f0\charscalex100 {0 (0.0) }\par\pard\li66\ri0
\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {9 (24.3) }\par\pard\li0\ri0\sl-306\s
lmult0 \fs16\cf0\f0\charscalex100 {5 (10.0%) }\par\pard\li26\ri0\sl-306\slmult0
\fs16\cf0\f0\charscalex100 {14 (15.2) }\par\column\pard\li0\ri0\sl-213\slmult0 \
fs18\cf0\par\pard\li0\ri0\sl-186\slmult0 \fs16\cf0\f0\charscalex100 {20.0% }\par
\pard\li0\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {27.0% }\par\pard\li0\ri
0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {12.0% }\par\pard\li0\ri0\sl-306\slm
ult0 \fs16\cf0\f0\charscalex100 {18.5% }\par\pard\sect\sectd\sbknone\pgwsxn12240
\pghsxn15840\marglsxn666\margrsxn133\cols2\colno1\colw3333\colsr-0\colno2\colw81
06\pard\li1093\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {Statistical Test
(95% CI) }\par\pard\li1093\ri0\sl-306\slmult0 \fs14\cf0\f0\charscalex100 {Statis
tical Test (99% CI) }\par\column\pard\li0\ri0\sl-320\slmult0 \*\tx1213\*\tx2373
\*\tx3560\fs16\cf0\f0\charscalex100 {Lower: -0.056 }\tab \fs16\cf0\f0\charscalex
100 {Upper: 0.009 }\tab \fs16\cf0\f0\charscalex100 {Lower: 0.019 }\tab \fs16\cf0
\f0\charscalex100 {Upper: 0.187 }\par\pard\li0\ri0\sl-306\slmult0 \*\tx1213\*\tx
2346\*\tx3560\fs16\cf0\f0\charscalex100 {Lower: -0.067 }\tab \fs16\cf0\f0\charsc
alex100 {Upper: 0.020 }\tab \fs16\cf0\f0\charscalex100 {Lower: -0.008 }\tab \fs1
6\cf0\f0\charscalex100 {Upper: 0.214 }\par\pard\sect\sectd\sbknone\pgwsxn12240\p
ghsxn15840\marglsxn666\margrsxn133\pard\li640\ri0\sl-240\slmult0 \fs12\cf0\f0\ch
arscalex100 {This table shows the point prevalence of rubella infection a
mong the types of pregnancy. It was observed that the prevalence of r
ubella virus infection among the primigravid }\par\pard\li640\ri0\sl-173\sl
mult0 \fs10\cf0\f0\charscalex100 {pregnant women was 27% while it was 12% among
the multigravid pregnant women. Statistical testing at 95% CI shows no signific
ant difference however; at 99% CI there is }\par\pard\li640\ri0\sl-160\slmult0
\fs14\cf0\f0\charscalex100 {significance. }\par\pard\li640\ri0\sl-213\slmult0 \f
s18\cf0\par\pard\li640\ri0\sl-306\slmult0 \fs18\cf0\f0\charscalex100\b {Table 2.
Prevalence of Rubella Virus Infection among Pregnancy Trimester (N = 92) }\b0
\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\col
s2\colno1\colw2800\colsr-0\colno2\colw8640\pard\li1293\ri0\sl-213\slmult0 \fs18\
cf0\par\pard\li1293\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100\b {Trimester }
\b0 \par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-306\sl
mult0 \*\tx1413\*\tx3453\*\tx5373\fs16\cf0\f0\charscalex100\b {Total No. Tested
}\b0 \tab \fs16\cf0\f0\charscalex100\b {New Cases: IgM +ve (%) }\b0 \tab \fs16\c
f0\f0\charscalex100\b {Old Cases: IgG +ve (%) }\b0 \tab \fs16\cf0\f0\charscalex1
00\b {Prevalence of Rubella Virus Infection }\b0 \par\pard\sect\sectd\sbknone\pg
wsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols5\colno1\colw3280\colsr-0\coln
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186\pard\li1200\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1200\ri0\sl-186\slmult0
\fs16\cf0\f0\charscalex100 {Not specified }\par\pard\li1480\ri0\sl-306\slmult0 \
fs16\cf0\f0\charscalex100 {First }\par\pard\li1386\ri0\sl-306\slmult0 \fs16\cf0\
f0\charscalex100 {Second }\par\pard\li1453\ri0\sl-306\slmult0 \fs16\cf0\f0\chars
calex100 {Total }\par\pard\li1533\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1533\r
i0\sl-186\slmult0 \fs16\cf0\f0\charscalex100 {Statistical Test (95% CI)}\par\col
umn\pard\li40\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li40\ri0\sl-186\slmult0 \fs1
6\cf0\f0\charscalex100 {1 }\par\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\charsca
lex100 {23 }\par\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {68 }\pa

r\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {92 }\par\column\pard\l
i306\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li306\ri0\sl-186\slmult0 \fs16\cf0\f0
\charscalex100 {0 (0) }\par\pard\li240\ri0\sl-306\slmult0 \fs16\cf0\f0\charscale
x100 {1 (4.3) }\par\pard\li240\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {2
(2.9) }\par\pard\li240\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {3 (3.3) }\
par\pard\li0\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {Lower: -0.043 }\par\
pard\li40\ri0\sl-173\slmult0 \fs16\cf0\f0\charscalex100 {Upper: 0.030}\par\colum
n\pard\li306\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li306\ri0\sl-186\slmult0 \fs1
6\cf0\f0\charscalex100 {0 (0) }\par\pard\li240\ri0\sl-306\slmult0 \fs16\cf0\f0\c
harscalex100 {2 (8.3) }\par\pard\li160\ri0\sl-306\slmult0 \fs16\cf0\f0\charscale
x100 {11 (16.2) }\par\pard\li160\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {
13 (14.1) }\par\pard\li0\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {Lower: 0.159 }\par\pard\li26\ri0\sl-173\slmult0 \fs16\cf0\f0\charscalex100 {Upper: 0.03
2}\par\column\pard\li106\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li106\ri0\sl-186\
slmult0 \fs16\cf0\f0\charscalex100 {0% }\par\pard\li0\ri0\sl-306\slmult0 \fs16\c
f0\f0\charscalex100 {13.0% }\par\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\charsc
alex100 {19.1% }\par\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {17.
4% }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133
\pard\li640\ri0\sl-253\slmult0 \fs12\cf0\f0\charscalex100 {This table shows the
point prevalence rates of rubella infection within the pregnancy trimester varia
ble. Statistical testing with 95% CI shows significance. }\par\pard\sect\sectd\s
bknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols2\colno1\colw5946\col
sr-0\colno2\colw5493\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li613\ri0\
sl-333\slmult0 \fs20\cf0\f0\charscalex100\b {Data Entry and Analysis }\b0 \par\p
ard\li893\ri0\sl-346\slmult0 \fs18\cf0\f0\charscalex100 {Prevalence was define
d as old and new cases (i.e. IgG }\par\pard\li613\ri0\sl-213\slmult0 \fs1
8\cf0\f0\charscalex100 {and IgM positives), existing in the population du
ring the }\par\pard\li613\ri0\sl-213\slmult0 \fs16\cf0\f0\charscalex100 {study
period [16]. Data entry and analysis were carried out }\par\pard\li613\
ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {with the SPSS 11 and Microsoft Ex
cel 2003 softwares. Data }\par\pard\li613\ri0\sl-213\slmult0 \fs16\cf0\f0\charsc
alex100 {was statistically tested using the Chi-square and the T-test. }
\par\pard\li613\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {Results were con
sidered to be statistically significant where}\par\pard\li613\ri0\sl-226\slmult
0 \fs20\cf0\f0\charscalex100\i {p<0.05. }\i0 \par\pard\li613\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li613\ri0\sl-240\
slmult0 \fs20\cf0\f0\charscalex100\b {RESULTS }\b0 \par\pard\li893\ri0\sl-346\sl
mult0 \fs18\cf0\f0\charscalex100 {Multigravid pregnant women made up the m
ajority (50; }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {54
.35%) of the subjects, as well as second trimester pregnant }\par\pard\li613\ri0
\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {women (68; 73.9%). Although most
(48; 52%) of the sub-}\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\char
scalex100 {jects had live children, some reported past pregnancy losses }\par\pa
rd\li613\ri0\sl-253\slmult0 \fs18\cf0\f0\charscalex100 {(13; 14.1%), 50% of whic
h occurred around the 10}{\super \fs10\up3\cf0\f0\charscalex100 {th}}\fs18\cf0\f
0\charscalex100 { week of }\par\pard\li613\ri0\sl-213\slmult0 \fs20\cf0\f0\chars
calex100 {gestation. }\par\column\pard\li280\ri0\sl-213\slmult0 \fs18\cf0\par\pa
rd\li280\ri0\sl-333\slmult0 \fs20\cf0\f0\charscalex100 {Rubella virus-specific
IgG and IgM antibodies were }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\
charscalex100 {detected in the sera of 3 subjects; IgG antibodies were
}\par\pard\li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {detected in the se
ra of 11 subjects, while 1 subject had only }\par\pard\li0\ri0\sl-213\slmult0 \f
s20\cf0\f0\charscalex100 {IgM antibodies detected in her sera. Fig. (}\fs
20\cf0\f0\charscalex100\b {1}\b0 \fs20\cf0\f0\charscalex100 {) shows the }\par
\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {Distribution of Rubel
la Virus-specific IgG and IgM in the }\par\pard\li0\ri0\sl-213\slmult0 \fs
20\cf0\f0\charscalex100 {sera of the subjects. The obtained prevalence ra
te of this }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {study
was 16.3%. The age-stratified prevalence rates of }\par\pard\li0\ri0\sl-
226\slmult0 \fs20\cf0\f0\charscalex100 {1.1%, 3.3%, 9.8% 3.3%, 1.1% and 0% were

observed in the }\par\pard\li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {pr
egnant women within age groups 16-20, 21-25, 26-30, 31-}\par\pard\li0\ri0\sl-213
\slmult0 \fs20\cf0\f0\charscalex100 {35, 36-40 and 41-50 respectively (p>0.
05). However, preg-}\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex10
0 {nant women with primary education, secondary, tertiary and }\par\pard\li0\ri0
\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {no education had prevalence rates of
2.2%, 6.5%, 7.6% and }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex1
00 {2.2% respectively (p<0.05). }\par\pard\li280\ri0\sl-373\slmult0 \fs18\cf0\f0
\charscalex100 {Tables }{ }\fs18\cf0\f0\charscalex100\b {1}\b0 \fs18\cf0\f0\char
scalex100 { and }{ }\fs18\cf0\f0\charscalex100\b {2}\b0 \fs18\cf0\f0\charscalex
100 { show the prevalence of Rubella Virus }\par\pard\li0\ri0\sl-226\slmul
t0 \fs20\cf0\f0\charscalex100 {infection amongst Primigravid and Multigravid Pre
gnancies, }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {and Preg
nancy Trimesters respectively. }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn1
5840\marglsxn666\margrsxn133\pard\li640\ri0\sl-413\slmult0 \fs18\cf0\f0\charscal
ex100\b {Table 3. Relationship between Rubella Virus-Specific IGG and IGM Antib
odies and Pregnancy Loss (N = 92) }\b0 \par\pard\sect\sectd\sbknone\pgwsxn12240\
pghsxn15840\marglsxn666\margrsxn133\cols3\colno1\colw3933\colsr-0\colno2\colw453
3\colsr-0\colno3\colw2973\pard\li826\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li826
\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100\b {Pregnancy }\b0 \par\column\par
d\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-240\slmult0 \fs16\cf0\f0\
charscalex100\b {IgG }\b0 \par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\
pard\li0\ri0\sl-240\slmult0 \fs16\cf0\f0\charscalex100\b {IgM }\b0 \par\pard\sec
t\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols2\colno1\col
w1893\colsr-0\colno2\colw9546\pard\li1040\ri0\sl-173\slmult0 \fs16\cf0\f0\charsc
alex100\b {Loss }\b0 \par\column\pard\li0\ri0\sl-240\slmult0 \*\tx1386\*\tx2560\
*\tx3653\*\tx4546\*\tx5933\*\tx7106\*\tx8200\fs16\cf0\f0\charscalex100\b {Border
Line (%) }\b0 \tab \fs16\cf0\f0\charscalex100\b {Negative (%) }\b0 \tab \fs16\c
f0\f0\charscalex100\b {Positive (%) }\b0 \tab \fs16\cf0\f0\charscalex100\b {Tota
l (%) }\b0 \tab \fs16\cf0\f0\charscalex100\b {Border Line (%) }\b0 \tab \fs16\cf
0\f0\charscalex100\b {Negative (%) }\b0 \tab \fs16\cf0\f0\charscalex100\b {Posit
ive (%) }\b0 \tab \fs16\cf0\f0\charscalex100\b {Total (%) }\b0 \par\pard\sect\se
ctd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols9\colno1\colw232
0\colsr-0\colno2\colw1200\colsr-0\colno3\colw1200\colsr-0\colno4\colw946\colsr-0
\colno5\colw1093\colsr-0\colno6\colw1360\colsr-0\colno7\colw1146\colsr-0\colno8\
colw906\colsr-0\colno9\colw1266\pard\li1053\ri0\sl-346\slmult0 \fs16\cf0\f0\char
scalex100 {N/A }\par\column\pard\li0\ri0\sl-346\slmult0 \fs16\cf0\f0\charscalex1
00 {0 (0) }\par\column\pard\li0\ri0\sl-346\slmult0 \fs16\cf0\f0\charscalex100 {1
(6.7) }\par\column\pard\li0\ri0\sl-346\slmult0 \fs16\cf0\f0\charscalex100 {0 (0
) }\par\column\pard\li0\ri0\sl-346\slmult0 \fs16\cf0\f0\charscalex100 {1 (6.7) }
\par\column\pard\li0\ri0\sl-346\slmult0 \fs16\cf0\f0\charscalex100 {1 (33.3) }\p
ar\column\pard\li0\ri0\sl-346\slmult0 \fs16\cf0\f0\charscalex100 {0 (0) }\par\co
lumn\pard\li0\ri0\sl-346\slmult0 \fs16\cf0\f0\charscalex100 {0 (0) }\par\column\
pard\li0\ri0\sl-346\slmult0 \fs16\cf0\f0\charscalex100 {1 (33.3) }\par\pard\sect
\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols8\colno1\colw
2213\colsr-0\colno2\colw1360\colsr-0\colno3\colw1053\colsr-0\colno4\colw2133\col
sr-0\colno5\colw1360\colsr-0\colno6\colw1053\colsr-0\colno7\colw1000\colsr-0\col
no8\colw1266\pard\li1093\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {No }\par
\column\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {7 (46.7) }\par\c
olumn\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {0 (0) }\par\column
\pard\li0\ri0\sl-306\slmult0 \*\tx960\fs16\cf0\f0\charscalex100 {4 (26.7) }\tab
\fs16\cf0\f0\charscalex100 {11 (73.3) }\par\column\pard\li0\ri0\sl-306\slmult0 \
fs16\cf0\f0\charscalex100 {1 (33.3) }\par\column\pard\li0\ri0\sl-306\slmult0 \fs
16\cf0\f0\charscalex100 {0 (0) }\par\column\pard\li0\ri0\sl-306\slmult0 \fs16\cf
0\f0\charscalex100 {1 (33.3) }\par\column\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\
f0\charscalex100 {2 (66.7) }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840
\marglsxn666\margrsxn133\cols9\colno1\colw2213\colsr-0\colno2\colw1306\colsr-0\c
olno3\colw1106\colsr-0\colno4\colw986\colsr-0\colno5\colw1146\colsr-0\colno6\col
w1360\colsr-0\colno7\colw1053\colsr-0\colno8\colw1026\colsr-0\colno9\colw1240\pa
rd\li1066\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {Yes }\par\pard\li1026\r

i0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {Total }\par\column\pard\li40\ri0\s
l-306\slmult0 \fs16\cf0\f0\charscalex100 {1 (6.7) }\par\pard\li0\ri0\sl-320\slmu
lt0 \fs16\cf0\f0\charscalex100 {8 (53.3) }\par\column\pard\li53\ri0\sl-306\slmul
t0 \fs16\cf0\f0\charscalex100 {0 (0) }\par\pard\li0\ri0\sl-320\slmult0 \fs16\cf0
\f0\charscalex100 {1 (6.7) }\par\column\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0
\charscalex100 {2 (13.3) }\par\pard\li53\ri0\sl-320\slmult0 \fs16\cf0\f0\charsca
lex100 {6 (40) }\par\column\pard\li80\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex
100 {3 (20) }\par\pard\li0\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {15 (10
0) }\par\column\pard\li93\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {0 (0) }
\par\pard\li0\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {2 (66.7) }\par\colu
mn\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {0 (0) }\par\pard\li0\
ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {0 (0) }\par\column\pard\li93\ri0\
sl-306\slmult0 \fs16\cf0\f0\charscalex100 {0 (0) }\par\pard\li0\ri0\sl-320\slmul
t0 \fs16\cf0\f0\charscalex100 {1 (33.3) }\par\column\pard\li80\ri0\sl-306\slmult
0 \fs16\cf0\f0\charscalex100 {0 (0) }\par\pard\li0\ri0\sl-320\slmult0 \fs16\cf0\
f0\charscalex100 {3 (100) }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\
marglsxn666\margrsxn133\pard\li640\ri0\sl-240\slmult0 \fs14\cf0\f0\charscalex100
{IgG: X}{\super \fs8\up2\cf0\f0\charscalex100\ul {2}\ul0 }\fs12\cf0\f0\charscal
ex100 { = 15.95, df = 4, p = 0.003 / IgM: X}{\super \fs8\up2\cf0\f0\charscalex10
0\ul {2}\ul0 }\fs12\cf0\f0\charscalex100 { = 7.50, df = 4, p = 0.112. }\par\pard
\li640\ri0\sl-160\slmult0 \fs12\cf0\f0\charscalex100 {This table shows the relat
ionship between rubella virus-specific IgG and IgM antibodies and pregnancy loss
. It was observed that of the 15 women whose sera tested positive for }\par\pard
\li640\ri0\sl-173\slmult0 \fs10\cf0\f0\charscalex100 {rubella virus-specific IgG
antibodies, 3 (20%) had history of pregnancy loss (p<0.05). However, of the 3 p
regnant women whose sera tested positive for rubella virus-specific IgM }\par\pa
rd\li640\ri0\sl-160\slmult0 \fs12\cf0\f0\charscalex100 {antibodies, none had his
tory of pregnancy loss. }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\ma
rglsxn666\margrsxn133\pard\sect\sectd\sbkpage
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3\margtsxn653\margbsxn213\cols2\colno1\colw5946\colsr-0\colno2\colw5493\pard\li6
13\ri0\sl-253\slmult0 \fs16\cf0\f0\charscalex100\b \i {Sero-Prevalence of Antena
tal Rubella in UITH }\b0 \i0 \par\pard\li893\ri0\sl-213\slmult0 \fs18\cf0\par\pa
rd\li893\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {Table }{ }\fs20\cf0\f0\c
harscalex100\b {3}\b0 \fs20\cf0\f0\charscalex100 { shows the relationship be
tween rubella virus-}\par\pard\li613\ri0\sl-213\slmult0 \fs20\cf0\f0\charscale
x100 {specific IgG and IgM antibodies and pregnancy loss. It }\par\pard\
li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {revealed that, of the 15 wo
men whose sera tested positive for }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0
\f0\charscalex100 {rubella virus-specific IgG antibodies, 3 (20%) had pre
vious }\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {history o

f pregnancy loss (p<0.05). However, of the 3 }\par\pard\li613\ri0\sl-213\
slmult0 \fs20\cf0\f0\charscalex100 {pregnant women whose sera tested positive fo
r rubella virus-}\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {
specific IgM antibodies, there was no case of pregnancy loss }\par\pard\li613\ri
0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {(p>0.05). Table }\fs18\cf0\f0\chars
calex100\b {4}\b0 \fs18\cf0\f0\charscalex100 { presents the clinical symptoms re
ported by }\par\pard\li613\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {the pr
egnant women, while Tables }\fs20\cf0\f0\charscalex100\b {4}\b0 \fs20\cf0\f0\cha
rscalex100 { and }\fs20\cf0\f0\charscalex100\b {5}\b0 \fs20\cf0\f0\charscalex100
{ show the relation-}\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\f0\charscalex
100 {ship between rubella virus-specific IgG and IgM antibody }\par\pard\
li613\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {and clinical symptoms repor
ted by the pregnant women. }\par\pard\li893\ri0\sl-333\slmult0 \fs18\cf0\f0\char
scalex100 {Multiple clinical symptoms of rubella virus infection }\par\par
d\li613\ri0\sl-213\slmult0 \fs16\cf0\f0\charscalex100 {were recorded in the
pregnant women}\fs18\cf0\f0\charscalex100\b {.}\b0 \fs16\cf0\f0\charscalex100 {
However, of the 92 }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\f0\charsca
lex100 {pregnant women, 1 (1.1%) reported to have had all four }\par\pa
rd\li613\ri0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {clinical symptoms to
rubella virus infection (i.e. swollen }\par\pard\li613\ri0\sl-226\slmult0 \f
s18\cf0\f0\charscalex100 {lymph nodes, joint pains, rashes and fever), 2
(2.3%) }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {reported
a combination of fever, rashes and joint pains, while }\par\pard\li613\ri0\sl-2
26\slmult0 \fs18\cf0\f0\charscalex100 {5 (5.7%) reported fever and joint pains o
nly (p<0.05). It was }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\f0\charscalex
100 {also observed that 1 (6.7%) of the pregnant women that had }\par\pard\li613
\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {rubella virus-specific IgG an
tibodies presented with rash; }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\f
0\charscalex100 {although none of the women reported swollen lymph nodes, }\par\
pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {3 (20%) women howev
er, reported joint pains, while 3 }\par\pard\li613\ri0\sl-213\slmult0 \fs16
\cf0\f0\charscalex100 {(20%) others reported fever (p<0.05). It was also
observed }\par\pard\li613\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {that 1
(6.7%) of the pregnant women that had rubella virus-}\par\pard\li613\ri0\sl-213
\slmult0 \fs20\cf0\f0\charscalex100 {specific IgM antibodies had no clinical sym
ptoms (p>0.05). }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li613\ri0
\sl-346\slmult0 \fs20\cf0\f0\charscalex100\b {DISCUSSION }\b0 \par\pard\li893\ri
0\sl-346\slmult0 \fs18\cf0\f0\charscalex100 {The predominance of first anten
atal reporting in the }\par\pard\li613\ri0\sl-213\slmult0 \fs16\cf0\f0\charsc
alex100 {second trimester of pregnancy confirms the claim that most }\pa
r\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {pregnant women in
Ilorin report late for antenatal care }\par\pard\li613\ri0\sl-213\slmult0
\fs18\cf0\f0\charscalex100 {[Agbede, 2009, Personal Communication]. Thus, assess
ment }\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {of risk bur
dens for congenital anomalies may prove difficult }\par\pard\li613\ri0\sl-213\sl
mult0 \fs18\cf0\f0\charscalex100 {in the study area. The reported cases o
f pregnancy loss }\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex10
0 {(during organogenesis) by some of the pregnant women may }\par\pard\li613\ri0
\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {be a reflection of the teratogenic e
ffect of rubella infection or }\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\c
harscalex100 {the effect of other teratogenic agents of the TORCH complex }\par\
pard\li613\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {on first and second tr
imester pregnancies [2]. }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\par\pard\
li613\ri0\sl-253\slmult0 \fs20\cf0\f0\charscalex100\b {Rubella Virus-Specific Ig
G Antibody }\b0 \par\pard\li893\ri0\sl-333\slmult0 \fs18\cf0\f0\charscalex100 {T
he detection of Rubella virus-specific IgG in the sera of }\par\pard\li613\ri0\s
l-226\slmult0 \fs18\cf0\f0\charscalex100 {14 (15.22%) of the pregnant women that
participated in this }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\f0\charscale
x100 {study (p<0.05) implies that such women were exposed to }\par\pard\
li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {rubella virus and therea

fter naturally developed lifelong }\par\pard\li613\ri0\sl-213\slmult0 \fs18\c
f0\f0\charscalex100 {immunity against the infection [11]. This is because none o
f }\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {the pregnant w
omen had ever received antirubella vaccines. }\par\pard\li613\ri0\sl-213\slmult
0 \fs20\cf0\f0\charscalex100 {Borderline IgG results however, reflect ongoi
ng develop-}\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {ment
of rubella virus-specific IgG and IgM antibodies in the }\par\pard\li613\ri0\sl
-213\slmult0 \fs20\cf0\f0\charscalex100 {sera of the pregnant women. }\par\colu
mn\pard\li1306\ri0\sl-253\slmult0 \fs16\cf0\f0\charscalex100\b \i {The Open Publ
ic Health Journal,}\b0 \i0 \fs16\cf0\f0\charscalex100\b { 2011, }\b0 \fs16\cf0\f
0\charscalex100\b \i {Volume 4
}\b0 \i0 \fs16\cf0\f0\charscalex100\b {13}\b0
\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-226\slmult0 \fs2
0\cf0\f0\charscalex100\b {Rubella Virus-Specific IgM Antibody }\b0 \par\pard\li2
80\ri0\sl-333\slmult0 \fs18\cf0\f0\charscalex100 {The detection of rubella v
irus-specific antibodies of the }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f
0\charscalex100 {IgM class in the sera of 3 (3.26%) of the 92 pregnant women }\p
ar\pard\li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {that participated i
n confirmed that rubella infection was }\par\pard\li0\ri0\sl-226\slmult0 \f
s20\cf0\f0\charscalex100 {ongoing in those pregnant women [8]. Thus impli
es a }\par\pard\li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {possibility
that the infection occurred at least 10 days earlier }\par\pard\li0\ri0\sl-226\s
lmult0 \fs20\cf0\f0\charscalex100 {[1]. However, detection of IgM class of
antibodies was }\par\pard\li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {
reported as }{ }\fs20\cf0\f0\charscalex100\b \i {positive}\b0 \i0 \fs20\cf0\f0\
charscalex100 { and }{ }\fs20\cf0\f0\charscalex100\b \i {borderline}\b0 \i0 \fs
20\cf0\f0\charscalex100 { \uc1\u8211X which highlight the }\par\pard\li0\ri0
\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {course of the ongoing infection. The
two borderline IgM test }\par\pard\li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charscal
ex100 {results which were recorded in two subjects indicate the }\par\pa
rd\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {possibility of an ongoi
ng infection that was captured after }\par\pard\li0\ri0\sl-213\slmult0 \fs1
8\cf0\f0\charscalex100 {about four months and at least 10 days since th
e infection }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {occur
red respectively [1]. }\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\
ri0\sl-253\slmult0 \fs20\cf0\f0\charscalex100\b {Primary Rubella Virus Infection
}\b0 \par\pard\li280\ri0\sl-333\slmult0 \fs18\cf0\f0\charscalex100 {It was ob
served that one patient\uc1\u8217Xs sample sera had a }\par\pard\li0\ri0\
sl-213\slmult0 \fs20\cf0\f0\charscalex100 {Borderline IgM test result and a nega
tive antirubella IgG test }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charsca
lex100 {result. This implies the possibility of a recent rubella }\par\p
ard\li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {infection occurring about
ten days prior to the serum test [1]. }\par\pard\li0\ri0\sl-226\slmult0 \fs18\c
f0\f0\charscalex100 {However, the participant was a 34-year old woman in
her }\par\pard\li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {second trim
ester of pregnancy but did not respond to the }\par\pard\li0\ri0\sl-226\
slmult0 \fs20\cf0\f0\charscalex100 {questionnaire. }\par\pard\li0\ri0\sl-213\slm
ult0 \fs18\cf0\par\pard\li0\ri0\sl-373\slmult0 \fs18\cf0\f0\charscalex100\b {THE
RUBELLA PREVALENCE IN THE PREGNANT }\b0 \par\pard\li0\ri0\sl-213\slmult0 \
fs20\cf0\f0\charscalex100\b {WOMEN }\b0 \par\pard\li280\ri0\sl-333\slmult0 \fs18
\cf0\f0\charscalex100 {The low prevalence rate of rubella virus infection
s }\par\pard\li0\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {observed from
the results obtained (16.3%) in this study as }\par\pard\li0\ri0\sl-213\s
lmult0 \fs20\cf0\f0\charscalex100 {compared to previous studies carried out
in south western }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex10
0 {Nigeria (58%) and North Western Nigeria (63%) may be }\par\pard\li0\r
i0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {attributed to the rainy season
during which the study was }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\
charscalex100 {carried out (June to September 2009). However, these }\par
\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {studies mentioned did
not specify the period in which they }\par\pard\li0\ri0\sl-226\slmult0 \

fs18\cf0\f0\charscalex100 {were carried out nor did they specify the dur
ation of study. }\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {
In addition, reported epidemics of rubella (in the temperate }\par\pard\
li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {climates) have been observed
to occur in seasonal patterns \uc1\u8211X }\par\pard\li0\ri0\sl-213\slmult0 \fs1
8\cf0\f0\charscalex100 {during the late winter with peaks in the springs
[1, 11]. A }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {tro
pical correlate will be the dry (Harmatan) season \uc1\u8211X during }\par\pard\
li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {which the very low humidity p
romotes the easy transmission }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\cha
rscalex100 {of postnatal rubella infections (through the respiratory route). }\p
ar\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-253\slmult0 \fs20\c
f0\f0\charscalex100\b {Prevalence of Rubella Virus Infection among Variables }\b
0 \par\pard\li280\ri0\sl-333\slmult0 \fs16\cf0\f0\charscalex100 {The age-strati
fied prevalence of rubella infection among }\par\pard\li0\ri0\sl-213\slmult
0 \fs20\cf0\f0\charscalex100 {the pregnant women below 20 years of age was 20%,
which }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {has no stati
stical difference from the results obtained in other }\par\pard\li0\ri0\sl-213\s
lmult0 \fs20\cf0\f0\charscalex100 {studies carried out among pregnant women
aged 14 to 19 }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100
{years (23.8%) in Maiduguri (North-eastern Nigeria) [15]. }\par\pard\li0\r
i0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {However, this study showed an init
ial increase followed by a }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840
\marglsxn666\margrsxn133\cols3\colno1\colw8266\colsr-0\colno2\colw1586\colsr-0\c
olno3\colw1586\pard\li640\ri0\sl-413\slmult0 \fs18\cf0\f0\charscalex100\b {Table
4. Clinical Symptoms Reported among Pregnant Women (N = 92) }\b0 \par\pard\li1
440\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1440\ri0\sl-306\slmult0 \*\tx4093\*\
tx5893\fs14\cf0\f0\charscalex100\b {Clinical Symptoms }\b0 \tab \fs16\cf0\f0\cha
rscalex100\b {Total No. }\b0 \tab \fs16\cf0\f0\charscalex100\b {No Response (%)
}\b0 \par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\s
lmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-2
93\slmult0 \fs16\cf0\f0\charscalex100\b {Yes (%) }\b0 \par\column\pard\li0\ri0\s
l-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\r
i0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-293\slmult0 \fs16\cf0\f0\charsca
lex100\b {No (%) }\b0 \par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\margl
sxn666\margrsxn133\cols5\colno1\colw4333\colsr-0\colno2\colw1946\colsr-0\colno3\
colw1960\colsr-0\colno4\colw1573\colsr-0\colno5\colw1626\pard\li1866\ri0\sl-213\
slmult0 \fs18\cf0\par\pard\li1866\ri0\sl-186\slmult0 \fs16\cf0\f0\charscalex100
{Rashes }\par\pard\li1746\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {Joints
pain }\par\pard\li1386\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {Swollen ly
mph nodes }\par\pard\li1906\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {Fever
}\par\pard\li640\ri0\sl-240\slmult0 \fs14\cf0\f0\charscalex100 {X}{\super \fs8\
up2\cf0\f0\charscalex100 {2}}\fs12\cf0\f0\charscalex100 {= 4.0, df = 1, p = 0.04
6. }\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-186\sl
mult0 \fs16\cf0\f0\charscalex100 {87 }\par\pard\li0\ri0\sl-306\slmult0 \fs16\cf0
\f0\charscalex100 {92 }\par\pard\li0\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex1
00 {92 }\par\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {92 }\par\co
lumn\pard\li53\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li53\ri0\sl-186\slmult0 \fs
16\cf0\f0\charscalex100 {0 (0) }\par\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\ch
arscalex100 {5 (5.4) }\par\pard\li0\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex10
0 {5 (5.4) }\par\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {5 (5.4)
}\par\column\pard\li80\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li80\ri0\sl-186\sl
mult0 \fs16\cf0\f0\charscalex100 {3 (3.4) }\par\pard\li0\ri0\sl-306\slmult0 \fs1
6\cf0\f0\charscalex100 {13 (14.1) }\par\pard\li80\ri0\sl-320\slmult0 \fs16\cf0\f
0\charscalex100 {1 (1.1) }\par\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\charscal
ex100 {16 (17.4) }\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0
\ri0\sl-186\slmult0 \fs16\cf0\f0\charscalex100 {84 (96.6) }\par\pard\li0\ri0\sl306\slmult0 \fs16\cf0\f0\charscalex100 {74 (80.4) }\par\pard\li0\ri0\sl-320\slmu
lt0 \fs16\cf0\f0\charscalex100 {86 (93.5) }\par\pard\li0\ri0\sl-306\slmult0 \fs1
6\cf0\f0\charscalex100 {71 (77.2) }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghs

xn15840\marglsxn666\margrsxn133\pard\li640\ri0\sl-173\slmult0 \fs12\cf0\f0\chars
calex100 {This table presents the various clinical symptoms of rubella infection
, reported by the pregnant women that participated in this study. Of the 92 preg
nant women, 3 (3.4%) reported }\par\pard\li640\ri0\sl-160\slmult0 \fs12\cf0\f0\c
harscalex100 {rashes, 13 (14.1%) reported joint pains, 1 (1.1%) reported swollen
lymph nodes and 16 (17.4%) reported fever. This result however shows statistica
l significance. }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn66
6\margrsxn133\pard\sect\sectd\sbkpage
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fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\s
lmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\
sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\
ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\
li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\p
ar\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\c
f0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-266\slmult0 \fs
16\cf0\f0\charscalex100\b {IgG }\b0 \par\column\pard\li53\ri0\sl-306\slmult0 \fs
16\cf0\f0\charscalex100 {0 (0) }\par\pard\li0\ri0\sl-320\slmult0 \fs16\cf0\f0\ch
arscalex100 {1 (6.7) }\par\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex10
0 {1 (6.7) }\par\pard\li53\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {0 (0)
}\par\pard\li53\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {0 (0) }\par\pard\
li0\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {1 (6.7) }\par\pard\li0\ri0\sl
-306\slmult0 \fs16\cf0\f0\charscalex100 {1 (6.7) }\par\pard\li53\ri0\sl-306\slmu
lt0 \fs16\cf0\f0\charscalex100 {0 (0) }\par\pard\li53\ri0\sl-306\slmult0 \fs16\c
f0\f0\charscalex100 {0 (0) }\par\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\charsc
alex100 {1 (6.7) }\par\pard\li0\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {1
(6.7) }\par\pard\li53\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {0 (0) }\pa
r\pard\li53\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {0 (0) }\par\pard\li0\
ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {1 (6.7) }\par\column\pard\li93\ri

0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {0 (0) }\par\pard\li133\ri0\sl-320\s
lmult0 \fs16\cf0\f0\charscalex100 {6 () }\par\pard\li93\ri0\sl-306\slmult0 \fs16
\cf0\f0\charscalex100 {0 (0) }\par\pard\li53\ri0\sl-306\slmult0 \fs16\cf0\f0\cha
rscalex100 {6 (40) }\par\pard\li93\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100
{0 (0) }\par\pard\li53\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {6 (40) }\
par\pard\li93\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {0 (0) }\par\pard\li
53\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {6 (40) }\par\pard\li93\ri0\sl306\slmult0 \fs16\cf0\f0\charscalex100 {0 (0) }\par\pard\li53\ri0\sl-306\slmult0
\fs16\cf0\f0\charscalex100 {6 (40) }\par\pard\li93\ri0\sl-320\slmult0 \fs16\cf0
\f0\charscalex100 {0 (0) }\par\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\charscal
ex100 {5 (33.3) }\par\pard\li40\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {1
(6.7) }\par\pard\li53\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {6 (40) }\p
ar\column\pard\li320\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {0 (0) }\par\
pard\li226\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {2 (13.3) }\par\pard\li
266\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {1 (6.7) }\par\pard\li266\ri0\
sl-306\slmult0 \fs16\cf0\f0\charscalex100 {1 (6.7) }\par\pard\li320\ri0\sl-306\s
lmult0 \fs16\cf0\f0\charscalex100 {0 (0) }\par\pard\li226\ri0\sl-320\slmult0 \fs
16\cf0\f0\charscalex100 {2 (13.3) }\par\pard\li266\ri0\sl-306\slmult0 \fs16\cf0\
f0\charscalex100 {1 (6.7) }\par\pard\li266\ri0\sl-306\slmult0 \fs16\cf0\f0\chars
calex100 {1 (6.7) }\par\pard\li320\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100
{0 (0) }\par\pard\li226\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {2 (13.3)
}\par\pard\li266\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {1 (6.7) }\par\p
ard\li266\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {1 (6.7) }\par\pard\li32
0\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {0 (0) }\par\pard\li226\ri0\sl-3
20\slmult0 \fs16\cf0\f0\charscalex100 {2 (13.3) }\par\pard\li0\ri0\sl-213\slmult
0 \fs18\cf0\par\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-186\sl
mult0 \fs16\cf0\f0\charscalex100\b {Symptoms }\b0 \par\column\pard\li26\ri0\sl-3
06\slmult0 \fs16\cf0\f0\charscalex100 {1 (6.7) }\par\pard\li0\ri0\sl-320\slmult0
\fs16\cf0\f0\charscalex100 {12 (81) }\par\pard\li80\ri0\sl-306\slmult0 \fs16\cf
0\f0\charscalex100 {0 (0) }\par\pard\li40\ri0\sl-306\slmult0 \fs16\cf0\f0\charsc
alex100 {9 (60) }\par\pard\li40\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {3
(20) }\par\pard\li0\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {12 (80) }\pa
ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {12 (80) }\par\pard\li80\ri0\sl-30
6\slmult0 \fs16\cf0\f0\charscalex100 {0 (0) }\par\pard\li0\ri0\sl-306\slmult0 \f
s16\cf0\f0\charscalex100 {12 (80) }\par\pard\li80\ri0\sl-320\slmult0 \fs16\cf0\f
0\charscalex100 {0 (0) }\par\pard\li40\ri0\sl-306\slmult0 \fs16\cf0\f0\charscale
x100 {9 (60) }\par\pard\li40\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {3 (2
0) }\par\pard\li0\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {12 (80) }\par\c
olumn\pard\li66\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {0 (0) }\par\pard\
li0\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {1 (6.7) }\par\pard\li66\ri0\s
l-306\slmult0 \fs16\cf0\f0\charscalex100 {0 (0) }\par\pard\li0\ri0\sl-306\slmult
0 \fs16\cf0\f0\charscalex100 {1 (6.7) }\par\pard\li66\ri0\sl-306\slmult0 \fs16\c
f0\f0\charscalex100 {0 (0) }\par\pard\li0\ri0\sl-320\slmult0 \fs16\cf0\f0\charsc
alex100 {1 (6.7) }\par\pard\li66\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {
0 (0) }\par\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {1 (6.7) }\pa
ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {1 (6.7) }\par\pard\li66\ri0\sl-32
0\slmult0 \fs16\cf0\f0\charscalex100 {0 (0) }\par\pard\li0\ri0\sl-306\slmult0 \f
s16\cf0\f0\charscalex100 {1 (6.7) }\par\pard\li66\ri0\sl-306\slmult0 \fs16\cf0\f
0\charscalex100 {0 (0) }\par\pard\li0\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex
100 {1 (6.7) }\par\pard\li160\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li160\ri0\sl
-213\slmult0 \fs18\cf0\par\pard\li160\ri0\sl-186\slmult0 \fs16\cf0\f0\charscalex
100\b {IgM }\b0 \par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666
\margrsxn133\cols6\colno1\colw3586\colsr-0\colno2\colw1413\colsr-0\colno3\colw14
00\colsr-0\colno4\colw2453\colsr-0\colno5\colw1386\colsr-0\colno6\colw1200\pard\
li1186\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1186\ri0\sl-213\slmult0 \fs18\cf0
\par\pard\li1186\ri0\sl-266\slmult0 \fs16\cf0\f0\charscalex100 {Swollen lymph no
des }\par\pard\li1693\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1693\ri0\sl-213\sl
mult0 \fs18\cf0\par\pard\li1693\ri0\sl-213\slmult0 \fs16\cf0\f0\charscalex100 {F

ever }\par\pard\li1653\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1653\ri0\sl-213\s
lmult0 \fs18\cf0\par\pard\li1653\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1653\ri
0\sl-293\slmult0 \fs16\cf0\f0\charscalex100 {Rashes }\par\pard\li1533\ri0\sl-213
\slmult0 \fs18\cf0\par\pard\li1533\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1533\
ri0\sl-213\slmult0 \fs18\cf0\par\pard\li1533\ri0\sl-280\slmult0 \fs16\cf0\f0\cha
rscalex100 {Joints pain }\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\p
ard\li0\ri0\sl-186\slmult0 \fs16\cf0\f0\charscalex100 {Chi-square }\par\pard\li2
80\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {df }\par\pard\li226\ri0\sl-306
\slmult0 \fs16\cf0\f0\charscalex100 {Sig. }\par\pard\li0\ri0\sl-320\slmult0 \fs1
6\cf0\f0\charscalex100 {Chi-square }\par\pard\li280\ri0\sl-306\slmult0 \fs16\cf0
\f0\charscalex100 {df }\par\pard\li226\ri0\sl-306\slmult0 \fs16\cf0\f0\charscale
x100 {Sig. }\par\pard\li0\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {Chi-squ
are }\par\pard\li280\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {df }\par\par
d\li226\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {Sig. }\par\pard\li0\ri0\s
l-306\slmult0 \fs16\cf0\f0\charscalex100 {Chi-square }\par\pard\li280\ri0\sl-320
\slmult0 \fs16\cf0\f0\charscalex100 {df }\par\pard\li226\ri0\sl-306\slmult0 \fs1
6\cf0\f0\charscalex100 {Sig. }\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li0\ri0\sl-186\slmult0 \fs16\cf0\f0\charscalex100 {15.000 }\par\pard\li
186\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {2 }\par\pard\li40\ri0\sl-306\
slmult0 \fs16\cf0\f0\charscalex100 {0.001 }\par\pard\li0\ri0\sl-320\slmult0 \fs1
6\cf0\f0\charscalex100 {15.152 }\par\pard\li186\ri0\sl-306\slmult0 \fs16\cf0\f0\
charscalex100 {4 }\par\pard\li40\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {
0.004 }\par\pard\li0\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {15.865 }\par
\pard\li186\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {4 }\par\pard\li40\ri0
\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {0.003 }\par\pard\li0\ri0\sl-306\slmu
lt0 \fs16\cf0\f0\charscalex100 {18.068 }\par\pard\li186\ri0\sl-320\slmult0 \fs16
\cf0\f0\charscalex100 {4 }\par\pard\li40\ri0\sl-306\slmult0 \fs16\cf0\f0\charsca
lex100 {0.001 }\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri
0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-266\slmult0 \fs16\cf0\f0\charscal
ex100 {Swollen lymph nodes }\par\pard\li520\ri0\sl-213\slmult0 \fs18\cf0\par\par
\f0\charscalex100 {Fever }\par\pard\li466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\
li466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li466\ri0\sl-213\slmult0 \fs18\cf0\p
ar\pard\li466\ri0\sl-293\slmult0 \fs16\cf0\f0\charscalex100 {Rashes }\par\pard\l
i360\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li360\ri0\sl-213\slmult0 \fs18\cf0\pa
r\pard\li360\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li360\ri0\sl-280\slmult0 \fs1
6\cf0\f0\charscalex100 {Joints pain }\par\column\pard\li0\ri0\sl-213\slmult0 \fs
18\cf0\par\pard\li0\ri0\sl-186\slmult0 \fs16\cf0\f0\charscalex100 {Chi-square }\
par\pard\li280\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {df }\par\pard\li21
3\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {Sig. }\par\pard\li0\ri0\sl-320\
slmult0 \fs16\cf0\f0\charscalex100 {Chi-square }\par\pard\li280\ri0\sl-306\slmul
t0 \fs16\cf0\f0\charscalex100 {df }\par\pard\li213\ri0\sl-306\slmult0 \fs16\cf0\
f0\charscalex100 {Sig. }\par\pard\li0\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex
100 {Chi-square }\par\pard\li280\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {
df }\par\pard\li213\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {Sig. }\par\pa
rd\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {Chi-square }\par\pard\li28
0\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {df }\par\pard\li213\ri0\sl-306\
slmult0 \fs16\cf0\f0\charscalex100 {Sig. }\par\column\pard\li0\ri0\sl-213\slmult
0 \fs18\cf0\par\pard\li0\ri0\sl-186\slmult0 \fs16\cf0\f0\charscalex100 {6.964 }\
par\pard\li146\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {2 }\par\pard\li0\r
i0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {0.031 }\par\pard\li0\ri0\sl-320\sl
mult0 \fs16\cf0\f0\charscalex100 {7.500 }\par\pard\li146\ri0\sl-306\slmult0 \fs1
6\cf0\f0\charscalex100 {4 }\par\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\charsca
lex100 {0.112 }\par\pard\li0\ri0\sl-320\slmult0 \fs16\cf0\f0\charscalex100 {7.11
5 }\par\pard\li146\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {4 }\par\pard\l
i0\ri0\sl-306\slmult0 \fs16\cf0\f0\charscalex100 {0.130 }\par\pard\li0\ri0\sl-30
6\slmult0 \fs16\cf0\f0\charscalex100 {7.500 }\par\pard\li146\ri0\sl-320\slmult0
\fs16\cf0\f0\charscalex100 {4 }\par\pard\li0\ri0\sl-306\slmult0 \fs16\cf0\f0\cha
rscalex100 {0.112 }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn
666\margrsxn133\pard\li640\ri0\sl-240\slmult0 \fs12\cf0\f0\charscalex100 {This t

able shows the Relationship between rubella virus-specific IgG and IgM antibody
and clinical symptoms in the pregnant women. It was observed that 1 (6.7%) of th
e pregnant }\par\pard\li640\ri0\sl-160\slmult0 \fs10\cf0\f0\charscalex100 {women
that had rubella virus-specific IgG antibodies reported rashes (p<0.05), 3 (20%
) reported joint pains (p<0.05), none reported swollen lymph nodes (p<0.05), whi
le 3 (20%) }\par\pard\li640\ri0\sl-160\slmult0 \fs12\cf0\f0\charscalex100 {repor
ted fever (p<0.05). Also, 1 (6.7%) of the pregnant women that had rubella virusspecific IgM antibodies reported no clinical symptoms (p>0.05). }\par\pard\sect\
sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols2\colno1\colw5
946\colsr-0\colno2\colw5493\pard\li613\ri0\sl-386\slmult0 \fs20\cf0\f0\charscale
x100 {decrease in the prevalence among the increasing age groups }\par\pard\li
613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {(p>0.05), with the highest pr
evalence occurring amongst the }\par\pard\li613\ri0\sl-213\slmult0 \fs20\cf0\f0\
charscalex100 {pregnant women aged 26 \uc1\u8211X 30 years (9.8%). }\par\pard\l
i893\ri0\sl-320\slmult0 \fs18\cf0\f0\charscalex100 {This study also shows th
at religion, education and }\par\pard\li613\ri0\sl-226\slmult0 \fs16\cf0\f0\c
harscalex100 {Marital Status are not to be neglected by health planners
in }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {preparing
immunization strategies. Since married pregnant }\par\pard\li613\ri0\sl-226\
slmult0 \fs16\cf0\f0\charscalex100 {women were observed to be better educa
ted than the single }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\f0\charscal
ex100 {pregnant women, and women with tertiary education were }\par\pard\
li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {also observed to be more
exposed to rubella infections than }\par\pard\li613\ri0\sl-213\slmult0 \fs18\c
f0\f0\charscalex100 {any other level of education, this therefore implies that s
uch }\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {infections c
ould have been acquired outside the homes of the }\par\column\pard\li0\ri0\sl-38
6\slmult0 \fs18\cf0\f0\charscalex100 {affected pregnant women and possibly
in a closely packed }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex
100 {environment which describes the average classroom or }\par\pard\li0\r
i0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {lecture room in Ilorin. Howeve
r, further research in higher }\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0
\charscalex100 {institutions would be required to confirm this claim. }\par\pard
\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-253\slmult0 \fs20\cf0\f0\c
harscalex100\b {Prevalence of Rubella Virus Infection amongst }\b0 \par\par
d\li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100\b {Pregnancy Gravidity and T
rimesters }\b0 \par\pard\li280\ri0\sl-333\slmult0 \fs18\cf0\f0\charscalex100 {Al
though most of the pregnant women were multigravid, }\par\pard\li0\ri0\sl-226\sl
mult0 \fs18\cf0\f0\charscalex100 {the result of this study showed a highe
r prevalence in the }\par\pard\li0\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex
100 {primigravid women (27%) than the multigravid women }\par\pard\li0\ri0
\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {(12%). This result however shows
that multigravidity may }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn1584
0\marglsxn666\margrsxn133\pard\sect\sectd\sbkpage\pgwsxn12240\pghsxn15840\margls
xn666\margrsxn133\margtsxn653\margbsxn226\cols2\colno1\colw7253\colsr-0\colno2\c
olw4186\pard\li613\ri0\sl-253\slmult0 \fs16\cf0\f0\charscalex100\b \i {Sero-Prev
alence of Antenatal Rubella in UITH }\b0 \i0 \par\column\pard\li0\ri0\sl-253\slm
ult0 \fs16\cf0\f0\charscalex100\b \i {The Open Public Health Journal,}\b0 \i0 \f
s16\cf0\f0\charscalex100\b { 2011, }\b0 \fs16\cf0\f0\charscalex100\b \i {Volume
4
}\b0 \i0 \fs16\cf0\f0\charscalex100\b {15}\b0 \par\pard\sect\sectd\sbknone
\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols3\colno1\colw5946\colsr-0\c
olno2\colw853\colsr-0\colno3\colw4640\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\pa
r\pard\li613\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {not be a predispo
sing factor to rubella virus infection or }\par\pard\li613\ri0\sl-213\slmu
lt0 \fs20\cf0\f0\charscalex100 {immunity. However, results showed a gradual
rise in sero-}\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100
{prevalence from 13.04% amongst first trimester pregnancies }\par\column\pard\li
0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-226\slmult0 \fs20\cf0\f0\char
scalex100 {IgA }\par\pard\li0\ri0\sl-320\slmult0 \fs20\cf0\f0\charscalex100 {IgM
}\par\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-226\slmu
lt0 \fs20\cf0\f0\charscalex100 {= Alpha (}\fs20\cf0\f0\charscalex100 {\uc1\u945
X}\fs20\cf0\f0\charscalex100 {) Immunoglobulin }\par\pard\li0\ri0\sl-320\slmult
0 \fs20\cf0\f0\charscalex100 {= Mu () Immunoglobulin }\par\pard\sect\sectd\sbkn
one\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\cols2\colno1\colw5946\colsr0\colno2\colw5493\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {to
19.12% in second trimester pregnancies. This increase }\par\pard\li613\ri0
\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {was also reported in the study carri
ed out in Maidugury [15]. }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\f0\chars
calex100 {The statistical significant tests however reveal the gravity of }\par\
pard\li613\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {foetal risk to congeni
tal rubella infection in Ilorin and possi-}\par\pard\li613\ri0\sl-213\slmult0 \f
s18\cf0\f0\charscalex100 {bly provide an explanation for a recent case o
f congenital }\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {an
omalies observed in a new born delivered at the University }\par\pard\li613\ri0\
sl-213\slmult0 \fs18\cf0\f0\charscalex100 {of Ilorin Teaching Hospital, Ilorin,
Nigeria [Ekundayo, 2011, }\par\pard\li613\ri0\sl-226\slmult0 \fs20\cf0\f0\charsc
alex100 {Personal Communication]. }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li613\ri0\sl-253\slmult0 \fs16\cf0\f0\charscalex100\b {Prevalence of
Rubella Virus Infection among Pregnant }\b0 \par\pard\li613\ri0\sl-213\slmul
t0 \fs20\cf0\f0\charscalex100\b {Women who had Lost Pregnancies }\b0 \par\pard\l
i893\ri0\sl-346\slmult0 \fs18\cf0\f0\charscalex100 {The 3 women whose medical hi
story revealed pregnancy }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\f0\charsc
alex100 {losses during organogenesis and also tested positive for }\par\p
ard\li613\ri0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {rubella virus-specific
IgG antibodies (p<0.05), suggests that }\par\pard\li613\ri0\sl-226\slmult0 \fs
20\cf0\f0\charscalex100 {previous exposures to teratogenic agents during o
rganoge-}\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {nesis wa
s debilitating to the foetal development. The tell-tale }\par\pard\li613\ri0\sl226\slmult0 \fs16\cf0\f0\charscalex100 {sign of rubella virus in the sera
of these women implicates }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\f0\c
harscalex100 {the virus as possible cause of the abortions; however, further }\p
ar\pard\li613\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {tests would be requ
ired to confirm these assertions. }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\
par\pard\li613\ri0\sl-373\slmult0 \fs16\cf0\f0\charscalex100\b {CORRELATION OF
CLINICAL SYMPTOMS WITH }\b0 \par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\f0\c
harscalex100\b {RUBELLA VIRUS INFECTION OF PREGNANT }\b0 \par\pard\li613\ri0
\sl-213\slmult0 \fs20\cf0\f0\charscalex100\b {WOMEN }\b0 \par\pard\li893\ri0\sl346\slmult0 \fs16\cf0\f0\charscalex100 {The clinical symptoms reported by p
regnant women are }\par\pard\li613\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex1
00 {descriptive of rubella virus infection, although not all obser-}\par\pard\li
613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {ved cases had all symptom
s and some cases had no symp-}\par\pard\li613\ri0\sl-213\slmult0 \fs16\cf0
\f0\charscalex100 {toms at all [6, 15]. The observed rubella virus-speci
fic IgG }\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {antibod
ies amongst clinical symptoms of fever (20%), joint }\par\pard\li613\ri0\
sl-213\slmult0 \fs18\cf0\f0\charscalex100 {pains (20%) and rashes (6.7%) (p
<0.05), is in accordance }\par\pard\li613\ri0\sl-226\slmult0 \fs20\cf0\f0\cha
rscalex100 {with the claim that rubella virus infections may be sub-}\p
ar\pard\li613\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {clinical in certain
subjects for reasons yet unknown [4, 6]. }\par\pard\li893\ri0\sl-320\slmult0 \f
s18\cf0\f0\charscalex100 {It has been established that acute rubella virus infec
tions }\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {that occu
r in early pregnancy may induce foetal death or }\par\pard\li613\ri0\sl213\slmult0 \fs18\cf0\f0\charscalex100 {congenital rubella syndrome [3]. How
ever, this study has }\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charsca
lex100 {reported a seroprevalence of 13.04% in the first trimester of }\par\pard
\li613\ri0\sl-213\slmult0 \fs16\cf0\f0\charscalex100 {pregnancy and 19.12% in
the second trimester of pregnant }\par\pard\li613\ri0\sl-226\slmult0 \fs18
\cf0\f0\charscalex100 {women in Ilorin. This indicates a high risk to f
oetus. In }\par\pard\li613\ri0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {addit

ion, a higher prevalence was recorded in primigravidae }\par\pard\li613\ri0\sl-2
26\slmult0 \fs20\cf0\f0\charscalex100 {than in multigravidae, with the high
est age-stratified preva-}\par\pard\li613\ri0\sl-213\slmult0 \fs16\cf0\f0\char
scalex100 {lence occurring in women aged 31 \uc1\u8211X 35 years. In a
ddition, }\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {since
85% of pregnant women in Ilorin are susceptible to }\par\pard\li613\ri0\
sl-213\slmult0 \fs16\cf0\f0\charscalex100 {rubella virus infection, it is a
dvisable for health planners to }\par\pard\li613\ri0\sl-226\slmult0 \fs18\cf
0\f0\charscalex100 {prevent further cases of antenatal rubella which may result
to }\par\pard\li613\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {congenital ru
bella anomalies which may result to a debilita-}\par\pard\li613\ri0\sl-226\slmul
t0 \fs16\cf0\f0\charscalex100 {ting impact on the National Gross Domestic
Product due to }\par\pard\li613\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100
{health impairments. }\par\pard\li893\ri0\sl-320\slmult0 \fs18\cf0\f0\charscale
x100 {Therefore, these results could serve as guide to health }\par\pard
\li613\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {planners for possible i
nterventions in preventing congenital }\par\pard\li613\ri0\sl-213\slmult0 \fs
18\cf0\f0\charscalex100 {rubella syndromes by mass vaccination of women o
f child }\par\pard\li613\ri0\sl-226\slmult0 \fs16\cf0\f0\charscalex100 {bearing
age [11] with special focus on teenagers and early }\par\pard\li613\ri
0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {adults. }\par\pard\li613\ri0\sl-213
\slmult0 \fs18\cf0\par\pard\li613\ri0\sl-373\slmult0 \fs20\cf0\f0\charscalex100\
b {ABBREVIATIONS }\b0 \par\pard\li613\ri0\sl-333\slmult0 \*\tx1466\fs20\cf0\f0\c
harscalex100 {CRS }\tab \fs20\cf0\f0\charscalex100 {= Congenital Rubella Syndro
me }\par\column\pard\li0\ri0\sl-213\slmult0 \*\tx853\fs20\cf0\f0\charscalex100 {
KAP }\tab \fs20\cf0\f0\charscalex100 {= Knowledge, Attitude and Practice }\par\
pard\li0\ri0\sl-306\slmult0 \*\tx853\fs20\cf0\f0\charscalex100 {MMR }\tab \fs20\
cf0\f0\charscalex100 {= Measles, Mumps and Rubella }\par\pard\li0\ri0\sl-320\sl
mult0 \*\tx853\fs20\cf0\f0\charscalex100 {RNA }\tab \fs20\cf0\f0\charscalex100 {
= Ribonucleic Acid }\par\pard\li0\ri0\sl-320\slmult0 \*\tx853\fs20\cf0\f0\chars
calex100 {SPSS }\tab \fs20\cf0\f0\charscalex100 {= Statistical Publishing Socie
ty Software }\par\pard\li0\ri0\sl-320\slmult0 \fs20\cf0\f0\charscalex100 {TORCH
= Toxoplasmosis, Rubella, Cytomegalovirus, }\par\pard\li1133\ri0\sl-213\slmul
t0 \fs20\cf0\f0\charscalex100 {Herpes and Others (which include type B }\par\pa
rd\li1133\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {hepatitis virus, coxasc
kie virus, mumps virus, }\par\pard\li1133\ri0\sl-213\slmult0 \fs20\cf0\f0\chars
calex100 {polio virus, rubeola, Varicella zoster virus, }\par\pard\li1133\ri0\s
l-226\slmult0 \fs20\cf0\f0\charscalex100 {Listeria, Gonorrhoea, Streptococcus an
d }\par\pard\li1133\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {Treponema) }
\par\pard\li0\ri0\sl-320\slmult0 \*\tx853\fs20\cf0\f0\charscalex100 {UITH }\tab
\fs20\cf0\f0\charscalex100 {= University of Ilorin Teaching Hospital, Ilorin,
}\par\pard\li1133\ri0\sl-226\slmult0 \fs20\cf0\f0\charscalex100 {Nigeria }\par\p
ard\li0\ri0\sl-320\slmult0 \*\tx853\fs20\cf0\f0\charscalex100 {WHO }\tab \fs20\c
f0\f0\charscalex100 {= World Health Organisation }\par\pard\li0\ri0\sl-213\slmu
lt0 \fs18\cf0\par\pard\li0\ri0\sl-373\slmult0 \fs20\cf0\f0\charscalex100\b {ACKN
OWLEDGEMENTS }\b0 \par\pard\li0\ri0\sl-333\slmult0 \fs20\cf0\f0\charscalex100 {R
esearch Assistance: }\par\pard\li0\ri0\sl-320\slmult0 \*\tx360\fs20\cf0\f1\char
scalex100 {\uc1\u61607X}\tab \fs18\cf0\f0\charscalex100 {ELKANAH Folashade Abo
sede Department of Micro-}\par\pard\li360\ri0\sl-213\slmult0 \fs20\cf0\f0\cha
rscalex100 {biology, University of Ilorin. }\par\pard\li0\ri0\sl-320\slmult0 \*\
tx360\fs20\cf0\f1\charscalex100 {\uc1\u61607X}\tab \fs20\cf0\f0\charscalex100 {E
TUKAKPAN Ntukidem Mayen Department of }\par\pard\li360\ri0\sl-226\slmult0 \f
s18\cf0\f0\charscalex100 {Medical Microbiology and Parasitology, University
of }\par\pard\li360\ri0\sl-213\slmult0 \fs20\cf0\f0\charscalex100 {Ilorin. }\pa
r\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-373\slmult0 \fs20\cf
0\f0\charscalex100\b {REFERENCES }\b0 \par\pard\li0\ri0\sl-306\slmult0 \*\tx573\
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ex100 {Bamgboye AE, Afolabi KA, Esumeh FI, Enweani IB. Prevalence }\par\
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ult0 \fs16\cf0\f0\charscalex100 {Afr J Med 2004; 23: 245-8. }\par\pard\li0\ri0\s
l-200\slmult0 \*\tx573\fs16\cf0\f0\charscalex100 {[14]}\tab \fs16\cf0\f0\charsca
lex100 {Onyenekwe CC, Kehinde-Agbeyangi TA, Ofor US, Arinola OG. }\par\par
d\li573\ri0\sl-186\slmult0 \fs14\cf0\f0\charscalex100 {Prevalence of rubella-Ig
G antibody in women of childbearing age }\par\pard\li573\ri0\sl-173\slmult0
\fs16\cf0\f0\charscalex100 {in Lagos, Nigeria. West Afr J Med 2000; 19(1): 23-6
. }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\
cols3\colno1\colw1466\colsr-0\colno2\colw4480\colsr-0\colno3\colw5493\pard\li613
\ri0\sl-306\slmult0 \fs20\cf0\f0\charscalex100 {EPI }\par\column\pard\li0\ri0\sl

-306\slmult0 \fs20\cf0\f0\charscalex100 {= Expanded Program of Immunization }\p
ar\column\pard\li0\ri0\sl-200\slmult0 \*\tx573\fs16\cf0\f0\charscalex100 {[15]}\
tab \fs16\cf0\f0\charscalex100 {Bukbuk DN, EL-Nafaty AU, Obed JY. Prevalenc
e of rubella-}\par\pard\li573\ri0\sl-173\slmult0 \fs16\cf0\f0\charscalex100 {sp
ecific IgG antibody in non-immunized pregnant women in }\par\pard\sect\se
ctd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margrsxn133\pard\sect\sectd\sbkp
age
7;32768}}
3\margtsxn666\margbsxn666\cols2\colno1\colw5946\colsr-0\colno2\colw5493\pard\li6
}\b0 \fs16\cf0\f0\ch
arscalex100\b \i {The Open Public Health Journal,}\b0 \i0 \fs16\cf0\f0\charscale
x100\b { 2011, }\b0 \fs16\cf0\f0\charscalex100\b \i {Volume 4 }\b0 \i0 \par\pard
\li1173\ri0\sl-386\slmult0 \fs16\cf0\f0\charscalex100 {Maiduguri, North Eastern
Nigeria. Cent Eur J Public Health 2002; }\par\pard\li1173\ri0\sl-186\slmult0 \fs
16\cf0\f0\charscalex100 {10(1-2): 21-3. }\par\column\pard\li4120\ri0\sl-253\slmu
lt0 \fs16\cf0\f0\charscalex100\b \i {Agbede et al. }\b0 \i0 \par\pard\li0\ri0\sl
-386\slmult0 \*\tx573\fs16\cf0\f0\charscalex100 {[16]}\tab \fs16\cf0\f0\charscal
ex100 {Park K. Principles of Epidemiology and Epidemiologic Methods. }\par
\pard\li573\ri0\sl-186\slmult0 \fs16\cf0\f0\charscalex100 {In: Park\uc1\u8217Xs
Textbook of Preventive and Social Medicine, 19}{\super \fs10\up2\cf0\f0\c
harscalex100 {th}}\fs16\cf0\f0\charscalex100 { ed. }\par\pard\li573\ri0\sl-173\
slmult0 \fs16\cf0\f0\charscalex100 {Jabalpur, India: M/s Banarsidas Bhanot 2007;
49-114. }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\margr
sxn133\cols3\colno1\colw4946\colsr-0\colno2\colw4346\colsr-0\colno3\colw2146\par
\f0\charscalex100 {Received: July 23, 2010 }\par\pard\li613\ri0\sl-320\slmult0 \
fs16\cf0\f0\charscalex100 {}{ }\fs16\cf0\f0\charscalex100 {Agbede}\fs16\cf0\f0\ch
arscalex100\i { et al.}\i0 \fs16\cf0\f0\charscalex100 {; Licensee }\fs16\cf0\f0\
charscalex100\i {Bentham Open}\i0 \fs16\cf0\f0\charscalex100 {. }\par\column\par
d\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-360\slmult0 \fs16\cf0\f0\
charscalex100 {Revised: March 09, 2011 }\par\column\pard\li0\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li0\ri0\sl-360\slmult0 \fs16\cf0\f0\charscalex100 {Accepted:
June 01, 2011 }\par\pard\sect\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn666\
margrsxn133\pard\li613\ri0\sl-266\slmult0 \fs16\cf0\f0\charscalex100 {This is an
open access article licensed under the terms of the Creative Commons Attributio
n Non-Commercial License (http://creativecommons.org/licenses/by-}\par\pard\li61
3\ri0\sl-186\slmult0 \fs16\cf0\f0\charscalex100 {nc/3.0/), which permits unrestr
icted, non-commercial use, distribution and reproduction in any medium, provided
the work is properly cited. }\par}

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\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {pregnancies (19.1%). }\par\pard\li14

{as one of the diagnostic standards. However, further HAI }\par\pard\li

{ }\fs18\cf0\f0\charscalex100 {[4, 11], it is estimated that }\par\pard\li6

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