Risk factors for measles death: Kyegegwa District, western Uganda, February–September, 2015

Mafigiri, Richardson; Nsubuga, Fred; Ario, Alex Riolexus

doi:10.1186/s12879-017-2558-7

Cited by 15 publications

(14 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, we used the proportion of control-persons vaccinated in the case-control study to estimate the measles VC, in order to provide data quickly to MoH for rapid outbreak control. While similar methods have been used previously in outbreak investigation settings [ 9 , 10 ], this method assumed that the control-persons in the case-control study represented the general population, which might have been an invalid assumption and could have led to a biased estimate. A more appropriate method would have been a population sample survey.…”

Section: Discussionmentioning

confidence: 99%

“…To obtain a quick estimate of VC in the outbreak area for the purpose of outbreak control, we used the percentage of controls who had a history of measles vaccination to estimate measles VC for all persons aged ≥9 m and by age groups (9 m-5y, 6–12, and 13-52y), assuming that the controls were representative of the general population [ 9 , 10 ]. As with the calculation of VE, children aged <9 m were excluded in calculating VC.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 2018

Self Cite

View full text Add to dashboard Cite

BackgroundIn April 2015, Kamwenge District, western Uganda reported a measles outbreak. We investigated the outbreak to identify potential exposures that facilitated measles transmission, assess vaccine effectiveness (VE) and vaccination coverage (VC), and recommend prevention and control measures.MethodsFor this investigation, a probable case was defined as onset of fever and generalized maculopapular rash, plus ≥1 of the following symptoms: Coryza, conjunctivitis, or cough. A confirmed case was defined as a probable case plus identification of measles-specific IgM in serum. For case-finding, we reviewed patients’ medical records and conducted in-home patient examination. In a case-control study, we compared exposures of case-patients and controls matched by age and village of residence. For children aged 9 m-5y, we estimated VC using the percent of children among the controls who had been vaccinated against measles, and calculated VE using the formula, VE = 1 - ORM-H, where ORM-H was the Mantel-Haenszel odds ratio associated with having a measles vaccination history.ResultsWe identified 213 probable cases with onset between April and August, 2015. Of 23 blood specimens collected, 78% were positive for measles-specific IgM. Measles attack rate was highest in the youngest age-group, 0-5y (13/10,000), and decreased as age increased. The epidemic curve indicated sustained propagation in the community. Of the 50 case-patients and 200 controls, 42% of case-patients and 12% of controls visited health centers during their likely exposure period (ORM-H = 6.1; 95% CI = 2.7–14). Among children aged 9 m-5y, VE was estimated at 70% (95% CI: 24–88%), and VC at 75% (95% CI: 67–83%). Excessive crowding was observed at all health centers; no patient triage-system existed.ConclusionsThe spread of measles during this outbreak was facilitated by patient mixing at crowded health centers, suboptimal VE and inadequate VC. We recommended emergency immunization campaign targeting children <5y in the affected sub-counties, as well as triaging and isolation of febrile or rash patients visiting health centers.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…29 In this study, measles had affected male children more, while different studies have shown the same and alternate results for the sex ratio. 25…”

Section: Discussionmentioning

confidence: 99%

Measles Outbreak Investigation in Nomadic Population Nasirabad, Balochistan, Pakistan February 2018

Ahmed¹,

Saeed²,

Ahmed³

et al. 2020

Global Biosecurity

View full text Add to dashboard Cite

Introduction: On 14 February 2018, the District Health Officer of Nasirabad reported 16 suspected measles cases from the nomadic population of Dera Murad Jamali to the disease surveillance and response unit of Quetta and requested an investigation. A FELTP fellow was deputed by the Director of General Health Services, Balochistan to investigate the outbreak, evaluate risk factors and recommend control measures. Methodology: A purposive sampling technique was adopted and a case control study was planned and conducted. Case was defined as "acute onset of generalized maculopapular rash and fever with cough or coryza or conjunctivitis from 29 January to 20 February 2018 in a resident of Dera Murad Jamali". Active case searches along with interviews were conducted through a semi structured questionnaire. Demographic, socioeconomic, clinical and epidemiological information was collected along with assessment of routine immunization. Five blood samples were sent for serology. Results: A total of 49 cases (AR= 0.17%), including five deaths (CFR=10.2%), were identified. Males, 61% (n=30), were more affected. The median age was three years (age range=1-10 years). The age-group 0-4 years, 69% (n=34), was most affected. The median age group of controls were four years (age range 1-11 years). Of the cases, 71% were unimmunized for any routine antigen while 32% of controls were unimmunized. Pneumonia, 42.8% (n=21), and diarrhea, 38.7% (n=19), were the most common complications. All five samples were positive for measles IgM. Significant statistical association was found between nomadic populations having zero routine doses of measles containing vaccines (MCV1) (OR 2.85; CI 1.83-4.42; p value <0.0021) and developing measles. Conclusion: Nomadic populations with low immunization was a probable cause of outbreak, resulting in the rapid spread of measles amongst susceptible individuals in the community. Laboratory tests confirmed the outbreak. As a control measure, measles mop-up vaccinations and six health education sessions were suggested and carried out. It was also recommended that proper outreach microplanning and regular pulse immunization should be adopted in future.

show abstract

“…However, measles can cause serious complications, including blindness, encephalitis, severe diarrhea, ear infection, and pneumonia, particularly in malnourished children and immune-compromised patients (5)(6)(7). The case-fatality rate in developing countries is usually 3-5%; however, in some localities it may be as high as 10-30% (5,8).…”

Section: Introductionmentioning

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

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.

show abstract

Risk factors for measles death: Kyegegwa District, western Uganda, February–September, 2015

Cited by 15 publications

References 11 publications

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

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

Measles Outbreak Investigation in Nomadic Population Nasirabad, Balochistan, Pakistan February 2018

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

Contact Info

Product

Resources

About