Exploring the social and biological dimensions of infectious disease: rubella population dynamics in Madagascar

Abstract

Introduction: Rubella is a contagious childhood disease that infects children. Though not fatal, if pregnant women are infected with rubella, their fetus can be infected, resulting in congenital rubella syndrome, a disease with serious, and fatal complications. As Madagascar is on the verge of introducing a rubella-containing vaccine, it is important to explore the population dynamics of rubella and the possible social obstacles that will prevent its success. This study seeks to do so by exploring different biological and social dynamics of rubella in Madagascar. A dataset provided by the Institut Pasteur of Madagascar, where rubella and measles testing is routinely done, consisting of serological and demographic information, will be used. Methods: Statistical tests were performed to measure the significance of predictor variables. We measured the relationship between age and incidence, and age and titers. This was followed by a measurement of the relationship between incidence and titers. We then measured the relationship between population size and incidence, and population size and titers. We measured the relationship between the number of health centers and incidence. Lastly, a descriptive analysis was done using maps to compare poverty levels to incidence.Results: We found that age was a significant predictor of incidence and titers. In addition, we found that incidence, or the number of new cases, had a significant relationship with titers. Population size and the number of health centers were not found to be significant predictors of incidence and/or titers. Discussion: With age and incidence proving to be significant predictor of titers, these two dynamics will be key factors to consider when determining the best mode of implementation. Further testing should be done in order to determine if population size is significant, without the sampling bias that was evident in this study. Lastly, the possibility that the poorer regions would be home to vulnerable populations, is worth exploring as careful implementation is needed for adequate vaccination coverage.