Factors contributing to measles transmission during an outbreak in Kamwenge District, Western Uganda, April to August 2015

Nsubuga, Fred; Bulage, Lilian; Ampeire, Immaculate; Matovu, Joseph K. B.; Kasasa, Simon; Tanifum, Patricia; Riolexus, Alex Ario; Zhu, Bao–Ping

doi:10.1186/s12879-017-2941-4

Cited by 19 publications

(25 citation statements)

References 23 publications

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“…The estimated VE for the one-dose vaccination during this investigation (95%) was higher than previous estimates of 64% (14) 75% (24) and 77% based on a review of published literature on the eld effectiveness of live attenuated measles containing vaccines (25) ; however, the con dence interval for the current estimate (80-100%) overlaps with those of the previous estimates [17-85% (14) and 25-92% (24), respectively]. Observed VE in the eld varies and is in uenced by many factors, such as number of doses administered, vaccine quality, cold-chain failure, and host factors (26).…”

Section: Discussioncontrasting

confidence: 89%

“…Transmission occurs when susceptible individuals share the same con ned spaces with, or within 2 hours of the departure of infectious patients (13). However since patients can become infectious as early as four days before the classic measles rash appears, infection can spread for days before the need for isolation becomes apparent, making healthcare facilities a fertile ground for measles transmission (14)(15)(16)(17)(18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

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Measles Outbreak Amplified in a Pediatric Ward: Lyantonde District, Uganda, August 2017

Biribawa

Atuhairwe²,

Bulage³

et al. 2020

Preprint

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Background: Measles is a highly infectious viral disease. In August 2017, Lyantonde District, Uganda reported a measles outbreak to Uganda Ministry of Health. We investigated the outbreak to assess the scope, factors facilitating transmission, and recommend control measures.Methods: We defined a probable case as sudden onset of fever and generalized rash in a resident of Lyantonde, Lwengo, or Rakai Districts from 1 June-30 September 2017, plus ≥1 of the following: coryza, conjunctivitis, or cough. A confirmed case was a probable case with serum positivity of measles-specific IgM. We conducted a neighborhood- and age-matched case-control study to identified exposure factors, and used conditional logistic regression to analyze the data. We estimated vaccine effectiveness and vaccination coverage.Results: We identified 81 cases (75 probable, 6 confirmed); 4 patients (4.9%) died. In the case-control study, 47% of case-patients and 2.3% of controls were hospitalized at Lyantonde Hospital pediatric department for non-measles conditions 7-21 days before case-patient’s onset (ORadj=34, 95%CI: 5.1-225). Estimated vaccine effectiveness was 95% (95%CI: 75-99%) and vaccination coverage was 76% (95%CI: 68-82%). During the outbreak, an “isolation” ward was established inside the general pediatric ward where there was mixing of both measles and non-measles patients. Conclusions: This outbreak was amplified by nosocomial transmission and facilitated by low vaccination coverage. We recommended moving the isolation ward outside of the building, supplemental vaccination, and vaccinating pediatric patients during measles outbreaks.

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Section: Discussioncontrasting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Measles Outbreak Amplified in a Pediatric Ward: Lyantonde District, Uganda, August 2017

Biribawa

Atuhairwe²,

Bulage³

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…The estimated VE for the one-dose vaccination during this investigation (95%) was higher than previous estimates of 64% (14) 75% (23) and 77% (24) ; however, the confidence interval for the current estimate (80-100%) overlaps with those of the previous estimates [17-85% (14) and 25-92% (23), respectively]. Observed VE in the field varies and is influenced by many factors, such as number of doses administered, vaccine quality, cold-chain failure, and host factors (25).…”

Section: Discussioncontrasting

confidence: 89%

“…Measles is endemic in Uganda. Outbreaks have been recently reported in various parts of the country, and this outbreak is likely linked to one of more of those recent outbreaks, several of which have also been linked to exposure in healthcare settings (14). In another outbreak, measles was associated with congregation of children at water-collection points (23).…”

Section: Discussionmentioning

confidence: 91%

“…Transmission occurs when susceptible individuals share the same confined spaces with, or within 2 hours of the departure of infectious patients (13). However since patients can become infectious as early as four days before the classic measles rash appears, infection can spread for days before the need for isolation becomes apparent, making healthcare facilities a fertile ground for measles transmission (14)(15)(16)(17)(18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Measles Outbreak Amplified in a Pediatric Ward: Lyantonde District, Uganda, August 2017

Biribawa

Atuhairwe²,

Bulage³

et al. 2019

Preprint

Self Cite

View full text Add to dashboard Cite

Background: Measles is a highly infectious viral disease. In August 2017, Lyantonde District, Uganda reported a measles outbreak to Uganda Ministry of Health. We investigated to assess the outbreak scope, factors facilitating transmission, and recommend control measures. Methods: We defined a probable case as sudden onset of fever and generalized rash in a resident of Lyantonde, Lwengo, or Rakai Districts from 1 June-30 September 2017, plus ≥1 of the following: coryza, conjunctivitis, or cough. A confirmed case was a probable case with serum positivity of measles-specific IgM. We conducted a neighborhood- and age-matched case-control study to identified exposure factors, and used conditional logistic regression to analyze the data. We estimated vaccine effectiveness and vaccination coverage. Findings: We identified 81 cases (75 probable, 6 confirmed); 4 patients (4.9%) died. In the case-control study, 47% of case-patients and 2.3% of controls were hospitalized at Lyantonde Hospital pediatric department for non-measles conditions 7-21 days before case-patient’s onset (ORadj=34, 95%CI: 5.1-225). Estimated vaccine effectiveness was 95% (95%CI: 75-99%) and vaccination coverage was 76% (95%CI: 68-82%). During the outbreak, an “isolation” ward was established inside the pediatric ward. Measles and non-measles patients were mixed in regular pediatric wards. Conclusion:This outbreak was amplified by nosocomial transmission and facilitated by low vaccination coverage. We recommended moving the isolation ward outside of the building, supplemental vaccination, and vaccinating pediatric patients during measles outbreaks.

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Measles Outbreak Investigation in Aneded District, Northwest Ethiopia: A Case-Control Study

Tariku,

Belete,

Worede

et al. 2024

J Epidemiol Glob Health

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Background Between 2000 and 2018, global measles deaths decreased by 73%, but the disease remains prevalent in many developing countries, especially in Africa and Asia. Although Ethiopia was attempting to eliminate the measles, it still ranks fourth in the world in terms of the number of cases. The aim of the investigation was to describe the outbreak and identify its determinants in the Aneded district. Methods Between March 3, 2020, and April 2, 2020, the 89 patients and 178 controls participated in a case-control study. Data were gathered by means of in-person interviews with household leaders. The attack and case fatality rates were determined. In multivariable logistic regression analysis, variables having a p-value of less than 0.05 were considered statistically significant cut-off points. Results An investigation was conducted on a total of 89 measles cases, with 3 deaths and 178 controls. In total, there were 1.65 attacks per 1000 people, or 3.4% of the case fatality rate. There were 155 days of outbreak duration. The disease was significantly associated with being female [adjusted odds ratios (AOR) = 2.66; 95% confidence interval (CI) = 1.38–5.11], under 5 years old [AOR = 7.24; 95% CI = 2.58–20.31], positive in attitude [AOR = 0.22; 95% CI = 0.11–0.42], and having a contact history [AOR = 3.19; 95% CI = 1.67–6.10]. Conclusion The measles outbreak, with its higher attack and case fatality rate, has been influenced by factors like household attitudes, age, sex, contact and travel history and needs to be reduced through early detection, active surveillance, and fostering favorable attitudes towards disease prevention and control.

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Factors contributing to measles transmission during an outbreak in Kamwenge District, Western Uganda, April to August 2015

Cited by 19 publications

References 23 publications

Measles Outbreak Amplified in a Pediatric Ward: Lyantonde District, Uganda, August 2017

Measles Outbreak Amplified in a Pediatric Ward: Lyantonde District, Uganda, August 2017

Measles Outbreak Amplified in a Pediatric Ward: Lyantonde District, Uganda, August 2017

Measles Outbreak Investigation in Aneded District, Northwest Ethiopia: A Case-Control Study

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