Measles outbreak in Western Uganda: a case-control study

BMC Infectious Diseases

Peter Chris Kawungezi¹  Abel Wilson Walekhwa¹  Rabbison Muhindo¹  Michael Matte¹  Emmanuel Baguma¹  Moses Ntaro¹  Edgar M. Mulogo¹  Ross M. Boyce²  Raquel Reyes³  Peyton Thompson⁴  Richard Migisha⁵  Chiara Achangwa⁶ 

[1] Department of Community Health, Faculty of Medicine, Mbarara University of Science & Technology, P.O. BOX 1410, Mbarara, Uganda;Department of Community Health, Faculty of Medicine, Mbarara University of Science & Technology, P.O. BOX 1410, Mbarara, Uganda;Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA;Department of Medicine, Division of Hospital Medicine, University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA;Department of Pediatrics, Division of Infectious Diseases, University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA;Department of Physiology, Faculty of Medicine, Mbarara University of Science & Technology, Mbarara, Uganda;Department of Public Health and Hygiene, University of Buea, P.O. Box 63, Buea, Cameroon;

关键词: Measles;    Outbreak;    Immunization;    Epidemiology;    Uganda;   

DOI  :  10.1186/s12879-021-06213-5

来源: Springer

【 摘 要 】

BackgroundMeasles outbreaks are prevalent throughout sub-Saharan Africa despite the preventive measures like vaccination that target under five-year-old children and health systems strengthening efforts like prioritizing the supply chain for supplies. Measles immunization coverage for Kasese district and Bugoye HC III in 2018 was 72 and 69%, respectively. This coverage has been very low and always marked red in the Red categorization (below the national target/poor performing) on the national league table indicators. The aim of this study was to assess the scope of the 2018–2019 measles outbreak and the associated risk factors among children aged 0–60 months in Bugoye sub-county, Kasese district, western Uganda.MethodsWe conducted a retrospective unmatched case-control study among children aged 0–60 months with measles (cases) who had either a clinical presentation or a laboratory confirmation (IgM positivity) presenting at Bugoye Health Centre III (BHC) or in the surrounding communities between December 2018 and October 2019.. Caregivers of the controls (whose children did not have measles) were selected at the time of data collection in July 2020. A modified CDC case investigation form was used in data collection. Quantitative data was collected and analyzed using Microsoft excel and STATA version 13. The children’s immunization cards and health registers at BHC were reviewed to ascertain the immunization status of the children before the outbreak.ResultsAn extended measles outbreak occurred in Bugoye, Uganda occured between December 2018 and October 2019. All 34 facility-based measles cases were documented to have had maculopapular rash, conjunctivitis, and cough. Also, the majority had fever (97%), coryza (94.1%), lymphadenopathy (76.5%), arthralgias (73.5%) and Koplik Spots (91.2%) as documented in the clinical registers. Similar symptoms were reported among 36 community-based cases. Getting infected even after immunized, low measles vaccination coverage were identified as the principal risk factors for this outbreak.ConclusionMeasles is still a significant problem. This study showed that this outbreak was associated with under-vaccination. Implementing a second routine dose of measles-rubella vaccine would not only increase the number of children with at least one dose but also boost the immunity of those who had the first dose.

【 授权许可】

CC BY