Kalil Falaho Sani, Gemeda Desta Hiko, Bedaso Mohammed Hasen, Wario Shukri Kabeta
Field Epidemiology Training Program, Department of Epidemiology, Jimma University, Jimma, Ethiopia.
Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, Ethiopia.
Pan Afr Med J. 2020 May 14;36:20. doi: 10.11604/pamj.2020.36.20.21169. eCollection 2020.
Measles is a vaccine-preventable viral infection of humans, primarily affecting children <5 years. During early 2019, outbreak of measles occurred in Ginnir district of Bale zone, Southeast Ethiopia. We investigated to describe the outbreak and identify risk factors.
We conducted a descriptive and 1:2 unmatched case-control study in Ginnir district from March 18 to April 29, 2019. Fifty-six cases and 112 controls were recruited. For descriptive study, we identified 1043 cases recorded on the line-list and for case-control study, cases were identified using national standard case-definition. Mothers of case-patients and controls were interviewed using structured questionnaire. We estimated vaccine efficacy (VE) from case-control study. We conducted bivariate and multivariable logistic regression.
In four-months period, a total of 1,043 suspected measles cases epidemiologically linked to five laboratory confirmed cases reported. Of which, 555 (53.2%) were males and 714 (68.5%) were <5 years. The median age of cases was 36 months (IQR=12-60 months). The overall attack rate (AR) was 63/10,000 population with case fatality ratio of 0.5% (5 deaths/1043). Infant <9 months were the most affected age groups (AR=31/1000). Majority (79%) of measles cases were not vaccinated against measles. Last-year (2017/18) administrative measle vaccine coverage of the district was 76.7%. Being unvaccinated against measles (AOR=5.4, 95%CI=2.2-13.4), travel history (AOR=4.02, 95%CI=1.2-13.6), contact with measles case-patient (AOR=5.6, 95%CI=2.12-14.4) and mothers knowledge of measles transmission (AOR=0.36, 95%CI=0.15-0.87) were associated with measles infection. VE in children aged 9-59 months was 90% (95%CI=69-97%).
This confirmed measles outbreak was caused by failure to vaccinate, as indicated by the high VE, low administrative coverage, and 79% unvaccinated cases. Strengthening routine and supplementary immunization are required.
麻疹是一种可通过疫苗预防的人类病毒感染，主要影响5岁以下儿童。2019年初，埃塞俄比亚东南部巴勒州金尼尔区爆发了麻疹疫情。我们进行调查以描述此次疫情并确定风险因素。
2019年3月18日至4月29日，我们在金尼尔区开展了一项描述性研究以及1:2配对的病例对照研究。招募了56例病例和112名对照。对于描述性研究，我们在一览表上确定了1043例记录病例；对于病例对照研究，根据国家标准病例定义确定病例。使用结构化问卷对病例患者和对照的母亲进行访谈。我们从病例对照研究中估算疫苗效力（VE）。我们进行了双变量和多变量逻辑回归分析。
在四个月的时间里，总共报告了1043例疑似麻疹病例，经流行病学调查与5例实验室确诊病例相关。其中，555例（53.2%）为男性，714例（68.5%）年龄小于5岁。病例的中位年龄为36个月（四分位间距=12 - 60个月）。总体发病率（AR）为63/10000人口，病死率为0.5%（5例死亡/1043例）。9个月以下婴儿是受影响最严重的年龄组（AR = 31/1000）。大多数（79%）麻疹病例未接种麻疹疫苗。该地区去年（2017/18年）的行政麻疹疫苗接种覆盖率为76.7%。未接种麻疹疫苗（比值比[AOR]=5.4，95%置信区间[CI]=2.2 - 13.4）、旅行史（AOR = 4.02，95%CI =
