Trend in mortality from a recent measles outbreak in Cameroon: a retrospective analysis of 223 measles cases in the Benakuma Health District

Abstract

IntroductionMeasles is a highly contagious viral infection with high mortality in poorly vaccinated regions. We sought to establish the trend in mortality and the factors that favoured the recent measles outbreak that occurred in Benakuma, in the North west region of Cameroon from the 21/06/2015 to 26/09/2015.MethodsWe carried out a retrospective register analysis of 223 measles cases. Time trends were established using the Mann-Kendall test while survival was assessed using the Kaplan-Meier survival analysis and log rank test for comparisons.ResultsWe had a case fatality of 8.5% and the mortality decreased significantly (p = 0.01) after the following public health interventions were instituted: community sensitisation and education; outbreak response immunisation and the use of a clinician in controlling the outbreak. Furthermore, the number of cases (p < 0.01) and the duration from onset of illness to consultation at a health facility (p < 0.01) decreased significantly after the institution of the aforementioned interventions. Also, survival during the outbreak was better in females (p = 0.02) and in those treated in health facilities (p < 0.01).ConclusionThe poor vaccination status in Benakuma coupled with negative cultural beliefs; poor socioeconomic and environmental factors and inadequate public health policies predisposed the region to a measles outbreak and favoured the spread of the virus. Public health policies should be revisited, modified and intensified to scale up vaccination coverage in measles endemic zones in Cameroon to help eliminate the disease and facilitate the overall attainment of the Sustainable Development Goals.

Epidemiology and molecular characterization of the re-emerging measles virus among children and adults in the Haut-Ogooue, Gabon

“…The report of the French health authorities in April 2018 reported 1527 cases of measles since the beginning of the year. In Central Africa, Cameroon reported the endemic circulation of the B3 MeV genotype between 2010 and 2011 and during a recent measles outbreak in 2015 [22, 23]. In Gabon, this study is the first to describe the circulation of genotype B3.…”

Relationship of Measles Cases in Measles Vaccinated Children During Outbreak of Measles in Bahawalpur.

“…This study showed that case fatality was significantly higher in children vaccinated with two doses of vaccine (5.24%) as compared to either ones vaccinated with one dose (2.29%) or unvaccinated ones (0.68%) but other studies showed that mortality was significantly associated with unvaccinated status. 14,17,19,24 The case fatality was significantly higher in males vaccinated with two doses of vaccine as compared to either ones vaccinated with one There were 14.18% children in this study who had measles before ≤ 9 months of age while other national studies 11,20,25,31,32 showed 13.5% -54.4% had measles before ≤ 9 months of age.…”

“…3 he case fatality rate was 2.87% in this study. The national studies 20,25 showed lower case fatality rate while other ones 14,15,16,17,19,24 gave higher values (3.41% -16%). The international studies 22,23,[26][27][28][29] also gave variable results from 0-8.5%.…”

“…There were 52.97% males in this study. Other national 11-21 and international 10,22,23 studies except two national studies 24,25 and one international study 9 showed male dominance.…”

“…Both national [11][12][13][14][16][17][18][19][20]24,25 and international 9,22,23,26,27 studies, unlike this study, showed high rate of unvaccinated children. Rabia et al 2014 15 showed that 62% were vaccinated (only 8.6% with two doses).…”