Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Vaccine. 2012 Jul 13;30(33):5000-8. doi: 10.1016/j.vaccine.2012.05.024. Epub 2012 May 28.
We investigated a large measles outbreak that occurred in 2009 in Burkina Faso in order to describe the epidemic, assess risk factors associated with measles, and estimate measles vaccine effectiveness.
We reviewed national surveillance and measles vaccine coverage data, and conducted a case-control study in three geographic areas. Case-patients were randomly selected from the national case-based measles surveillance database or, when a case-patient could not be traced, were persons in the same community who experienced an illness meeting the WHO measles clinical case definition. Controls were matched to the same age stratum (age 1-14 years or age 15-30 years) and community as case-patients. Risk factors were assessed using conditional logistic regression.
Lack of measles vaccination was the main risk factor for measles in all three geographic areas for children aged 1-14 years (adjusted matched odds ratio [aMOR] [95% confidence interval (CI)], 19.4 [2.4-155.9], 5.9 [1.6-21.5], and 6.4 [1.8-23.0] in Bogodogo, Zorgho, and Sahel, respectively) and persons aged 15-30 years (aMOR [95% CI], 3.2 [1.1-9.7], 19.7 [3.3-infinity], 8.0 [1.8-34.8] in Bogodogo, Zorgho, and Sahel, respectively). Among children aged 1-14 years, VE of any measles vaccination prior to 2009 was 94% (95% CI, 45-99%) in Bogodogo, 87% (95% CI, 37-97%) in Zorgho, and 84% (95% CI, 41-96%) in Sahel. Main reasons for not receiving measles vaccination were lack of knowledge about vaccination campaigns or need for measles vaccination and absence during vaccination outreach or campaign activities.
These results emphasize the need for improved strategies to reduce missed opportunities for vaccination and achieve high vaccination coverage nationwide in order to prevent large measles outbreaks and to continue progress toward measles mortality reduction.
我们调查了 2009 年布基纳法索的一次大规模麻疹暴发，以描述疫情，评估与麻疹相关的危险因素，并估计麻疹疫苗的效力。
我们回顾了国家监测和麻疹疫苗覆盖率数据，并在三个地理区域开展了病例对照研究。病例患者是从国家基于病例的麻疹监测数据库中随机选择的，或者当无法追踪到病例患者时，是在同一社区经历符合世界卫生组织麻疹临床病例定义的疾病的人。对照与病例患者的年龄层（1-14 岁或 15-30 岁）和社区相匹配。使用条件逻辑回归评估危险因素。
在三个地理区域，所有 1-14 岁儿童中，麻疹疫苗接种不足是麻疹的主要危险因素（调整后的匹配比值比[aMOR] [95%置信区间（CI）]，Bogodogo 为 19.4 [2.4-155.9]，Zorgho 为 5.9 [1.6-21.5]，Sahel 为 6.4 [1.8-23.0]）和 15-30 岁的人（aMOR [95%CI]，Bogodogo 为 3.2 [1.1-9.7]，Zorgho 为 19.7 [3.3-无穷大]，Sahel 为 8.0 [1.8-34.8]）。在 1-14 岁的儿童中，2009 年之前任何麻疹疫苗接种的疫苗效力为 94%（95%CI，45-99%），Bogodogo 为 87%（95%CI，37-97%），Sahel 为 84%（95%CI，41-96%）。未接种麻疹疫苗的主要原因是缺乏对疫苗接种运动的了解或对麻疹疫苗接种的需求，以及在疫苗推广或接种活动期间不在场。
这些结果强调需要改进策略，以减少错过接种机会的情况，并在全国范围内实现高疫苗接种覆盖率，以防止大规模麻疹暴发，并继续朝着降低麻疹死亡率的方向取得进展。
