Seroprevalence of Rubella Virus-Specific IgG and IgM Antibodies and Associated Factors among Secondary School Female Students in Aden, Yemen

Abstract Background: Rubella is a highly contagious viral infection that poses a significant public health threat, particularly to pregnant women and their fetuses, potentially leading to congenital rubella syndrome (CRS). Adolescent girls represent a critical target population for rubella prevention, as they constitute the future cohort of pregnant women. This study aimed to determine the seroprevalence of rubella virus-specific IgG and IgM antibodies and identify associated factors among secondary school female students in Aden, Yemen. Methods: A cross-sectional study was conducted among 218 secondary school female students in Aden, Yemen, from October 2025 to May 2026. Venous blood samples were collected and tested for rubella-specific IgG and IgM antibodies using AccuBind ELISA Microwells (Monobind Inc., USA). Data on sociodemographic characteristics, vaccination status, and potential risk factors were collected using a structured questionnaire. Bivariate analyses using chi-square and Fisher's exact tests, followed by multivariable logistic regression analysis, were performed using SPSS version 26. Results: The overall seroprevalence of rubella IgG antibodies was 60.6% (n = 132, 95% CI: 55.7%–65.5%), while IgM antibodies were detected in 10.6% (n = 23, 95% CI: 7.4%–14.8%). Both IgG and IgM antibodies were positive in 2.8% (n = 6). The seroprevalence of IgG antibodies was significantly higher among students aged ≤17 years (51.8%) than among those aged >17 years (26.9%, p < 0.001). IgM seropositivity was significantly associated with public school attendance (13.2% vs. 4.5%, p = 0.042), maternal primary education (16.1%, p = 0.048), and vaccination status (19.4% vs. 7.1%, p = 0.010). Multivariable logistic regression revealed that age >17 years was significantly associated with lower odds of IgG seropositivity (AOR = 0.29, 95% CI: 0.14–0.60, p = 0.001). For IgM seropositivity, public school attendance (AOR = 3.45, 95% CI: 1.12–10.63, p = 0.031) and vaccination status (AOR = 2.89, 95% CI: 1.21–6.89, p = 0.017) were identified as independent predictors. Conclusion: This study revealed a moderate seroprevalence of rubella IgG antibodies (60.6%) and a notable IgM seropositivity rate (10.6%) among secondary school female students in Aden, Yemen. The significant association between vaccination status and IgM seropositivity warrants further investigation. The low vaccination coverage (28.4%) and the substantial proportion of susceptible students underscore the urgent need for comprehensive rubella vaccination strategies targeting adolescent girls to prevent future CRS cases.