Design and Implement Retrospective Review of Congenital Rubella Syndrome (CRS) Cases and Assess Capacity of CRS Surveillance in Selected Health Facilities

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Vacancy announcement - consultant
WHO Rwanda in Collaboration with Rwanda Biomedical Center (RBC) is inviting applicants from suitable qualified Rwandan Nationals to fill the following Consultancy:
Title: Design and implement retrospective review of Congenital Rubella Syndrome (CRS) cases and assess capacity of CRS surveillance in selected health facilities
Grade: NOC
Duty Station: Kigali
Date issue: 15/04/2022
Deadline: 24/04/2022
1. Background
Since the establishment of Measles Rubella active surveillance in 2003 and the introduction of Measles Rubella containing vaccine in 2013, the surveillance system has been strengthened to collect information on the burden of the diseases. Although Rubella surveillance is strengthened, it cannot capture every case of rubella since it is frequently mild or asymptomatic. The Congenital Rubella Syndrome (CRS) is the most severe outcome of rubella, and the prevention of CRS is the primary reason for rubella vaccination. Thus, the goals for CRS surveillance are linked to national goals for rubella vaccination, including monitoring the progress to achieve and maintain elimination.
In the context of Rubella vaccine introduction, the systematic collection of Rubella and CRS data inform the performance of Rubella vaccination and elimination. The surveillance data surveillance data complement each other to provide a more complete picture of program progress. Rubella surveillance relies on the measles surveillance system to detect cases; however, rubella is typically milder than measles, resulting in a lower percentage of persons with rubella seeking health care and a lower percentage of cases being identified. CRS cases are detected through separate surveillance systems, often using a few sentinel sites, which might not be nationally representative, but should be able to identify and confirm CRS cases.

2. Justification
Rwanda is moving towards eliminating Measles Rubella, and this implies on the strengthening of both measles, Rubella and CRS. The efforts to reinforce the CRS surveillance system was concretized by the establishment of one sentinel surveillance site at Muhima District Hospital, however the site was not maintained. The revitalization of CRS surveillance is therefore critical to generate information for the monitoring of the impact of rubella vaccine introduction in reducing the incidence of CRS and inform the progress of Rubella and CRS elimination.
To establish a baseline on CRS surveillance system and collect data that will inform the establishment of sentinel surveillance, the hospital record review to identify any missed cases would be essential to identify all cases that meet the suspected CRS case definition, for a period of five years. In this regards Rwanda Biomedical Center is planning to conduct a retrospective review of CRS cases and assessment of the capability of selected health facilities to detect, investigate and report CRS. The findings from the review and assessment will inform planning for the reestablishment of CRS sentinel surveillance.
3. Purpose of the assignment
The purpose of this assignment is to support the Ministry of Health to identify suspected CRS cases through review of records for diagnoses compatible with clinical manifestations of CRS. In addition, the consultant will support the design and implementation of an assessment of capabilities of selected health facilities to conduct sentinel surveillance of CRS.
4. Organizational context
The consult will work under the supervision of the WHO EPI focal point in collaboration with the Director of Diseases Surveillance Unit within the Public Health Surveillance and Emergency Preparedness and Response (PHS&EPR) Division in Rwanda Biomedical Center (RBC).
5. Work assignment

The consultant will be responsible for designing and implementation the CRS retrospective medical record review and health facility capacity assessment. In collaboration with WHO and RBC, the consultant will be tasked to:
1. Design data collection tools for both medical records review and health facility assessment
2. Review of existing relevant literature on rubella and CRS cases in the country
3. Review measles case-based surveillance / lab data to identify and describe Rubella outbreaks which occurred in the country if applicable
4. Review clinical records covering a defined period following the documented onset of the rubella outbreak if any
5. Identify cases that fit the standard WHO clinical case definitions for CRS
6. Review records to find out if any history of maternal rash illness was provided during pregnancy, and if any lab confirmation was available for the suspected CRS case
7. Establish the line list, compile the assessment data, analyze, and produce the report
6. Deliverables
The consultant is requested to deliver the following:
• Submission of inception report which include the methodology and implementation timelines
• Data collection tools developed and validated
• Compilation, analysis of data, and submission of preliminary reports for review
• Submission of final reports
The above-mentioned deliverables shall be produced over two months
7. Qualifications of the consultant
Education:
• University degree in Medicine, Public Health or Epidemiology with
Experience:
• Having experience in diseases surveillance with good understanding of Rubella and Congenital Rubella Syndrome epidemiology
• Have experience in conducting retrospective data collection, analysis, and interpretation
Skills
• Good communication and writing skills
• Teamwork

8. Submit tender
Interested candidates shall submit their CVs by email to afwcorw@who.int
9. Selection and contract signing
After analysis of CVs, WHO Rwanda will notify the selected candidate in writing and call for discussion followed by contract signing if fully agree. The work is expected to start immediately after contract signing.
Done at Kigali, 14th April 2022
Dr Brian CHIROMBO
WHO Representative