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

BMC Infectious Diseases

Research Article

Fred Nsubuga¹  Alex Riolexus Ario¹  Richardson Mafigiri² 

[1] Uganda Public Health Fellowship Program – Field Epidemiology Track, Kampala, Uganda;Uganda Public Health Fellowship Program – Field Epidemiology Track, Kampala, Uganda;Uganda Public Health Fellowship Program, Ministry of Health, P.O. Box 7272, Kampala, Uganda;

关键词: Measles;    Outbreak;    Risk factors;    Uganda;   

DOI  :  10.1186/s12879-017-2558-7

 received in 2017-02-01, accepted in 2017-06-19,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundOn 18 August 2015, Kyegegwa District reported eight deaths during a measles outbreak to the Uganda Ministry of Health (MoH). We investigated this death cluster to verify the cause, identify risk factors, and inform public health interventions.MethodsWe defined a probable measles case as onset of fever and generalised rash in a Kyegegwa District resident from 1 February – 15 September 2015, plus ≥1 of the following: coryza, conjunctivitis, and cough. A confirmed measles case was a probable case with measles-specific IgM positivity. A measles death was a death of a probable or confirmed case-person. We conducted an active case-finding to identify measles patients who survived or died. In a case-control study, we compared risk factors between 16 measles patients who died (cases) and 48 who survived (controls), matched by age (±4 years) and village of residence.ResultsWe identified 94 probable measles cases, 10 (11%) were confirmed by positive measles-specific IgM. Of the 64 probable measles patients aged <5 years, 16 died (case-fatality rate = 25%). In the case-control study, no history of vaccination against measles was found in 94% (15/16) among the case-persons (i.e., measles patients who died) and 54% (26/48) among the controls (i.e., measles patients who survived) (ORM-H = 12; 95% CI = 1.6–104), while 56% (9/16) of case-persons and 67% (17/48) of controls (ORM-H = 2.3; 95% CI =0.74–7.4) did not receive vitamin A supplementation during illness. 63% (10/16) among the case-persons and 6.3% (3/48) of the controls (ORM-H = 33; 95% CI = 6.8–159) were not treated for measles illness at a health facility (a proxy for more appropriate treatment), while 38% (6/16) of the case-persons and 25% (12/48) of the controls (ORM-H = 2.5; 95% CI = 0.67–9.1) were malnourished.ConclusionLack of vaccination and no treatment in a health facility increased the risk for measles deaths. The one-dose measles vaccination currently in the national vaccination schedule had a protective effect against measles death. We recommended enhancing measles vaccination and adherence to measles treatment guidelines.

【 授权许可】

CC BY   
© The Author(s). 2017