Ethiopian Field Epidemiology Laboratory Training Program (FETP), Jimma University, Jimma, Ethiopia.
Lecturer of Biostatistics, Department of Epidemiology, Jimma University, Jimma, Ethiopia.
Front Public Health. 2024 Apr 10;12:1331798. doi: 10.3389/fpubh.2024.1331798. eCollection 2024.
Measles continues to be a public health challenge in Ethiopia. Rumors of suspected measles were notified on April 8, 2023 from Tocha district. We conducted an assessment to describe measles outbreak and determine risk factors for measles infection in the Tocha district of the Dawuro zone, Southwest Ethiopia.
We conducted a 1:2 unmatched case-control studies from April to May 2023. We took all 147 cases registered on line list for descriptive analyses. We used a total of 74 randomly selected cases and 147 controls for case-control part. Any person in Tocha district with laboratory-confirmed measles IgM antibody; or any suspected person epidemiologically linked to confirmed measles cases from March 23 to April 26 2023, were included in the case. Neighborhood who did not fulfill this standard case definition were included in controls. Data were collected using standardized questionnaires deployed on Kobo Collect. Descriptive analyses were conducted using Epi info version 7.2.5.0. The analyses were performed using Statistical Package for Social Science (SPSS) version 26. Binary logistic regression analyses were utilized to select candidate variables. We conducted multiple logistic regression analysis to identify determinants of measles infection at a value ≤0.05 with 95% confidence interval.
The overall attack rate of 22.64/10,000 for general population and 104.59/10,000 among under-five children were attributed to the outbreak with a case fatality rate of 2.72%. Vaccine coverage in the last year and this year were 73.52 and 53.88%, respectively, while vaccine effectiveness in the district was 79%. Poor house ventilation (AOR = 3.540, 95% CI: 1.663-7.535) and having contact history with the case (AOR = 2.528, 95% CI: 1.180-4.557) were positively related to measles infection while being previously vaccinated for measles (AOR = 0.209, 95% CI: 0.180-4.577) reduce risk of measles infections.
The highest attack rate was observed among children under 5 years of age, with a case fatality rate of 2.72%. Vaccination coverage was less than what expected to develop herd immunity. Strategies to increase vaccination coverage and strengthening surveillance systems for rumor identification and early responses to prevent person to person transmission are recommended.
麻疹在埃塞俄比亚仍是一个公共卫生挑战。2023 年 4 月 8 日，托恰区报告了疑似麻疹的谣言。我们进行了评估，以描述在埃塞俄比亚西南部达乌罗地区托恰区的麻疹暴发，并确定麻疹感染的危险因素。
我们于 2023 年 4 月至 5 月进行了 1:2 例无匹配的病例对照研究。我们对登记在在线列表中的所有 147 例病例进行了描述性分析。我们总共使用了 74 名随机选择的病例和 147 名对照进行病例对照部分。任何在托恰区具有实验室确认的麻疹 IgM 抗体的人；或任何在 2023 年 3 月 23 日至 4 月 26 日期间与确诊麻疹病例有流行病学联系的疑似人员，均被纳入病例。不符合这一标准病例定义的邻里地区的人被纳入对照组。数据使用 Kobo 收集器上的标准化问卷收集。使用 Epi info 版本 7.2.5.0 进行描述性分析。使用统计软件包（SPSS）版本 26 进行分析。使用二元逻辑回归分析选择候选变量。我们进行了多变量逻辑回归分析，以确定 值≤0.05 时麻疹感染的决定因素，置信区间为 95%。
总人群的发病率为 22.64/10000，5 岁以下儿童的发病率为 104.59/10000，爆发的病死率为 2.72%。去年和今年的疫苗接种率分别为 73.52%和 53.88%，而该地区的疫苗效力为 79%。不良的房屋通风（AOR=3.540，95%CI：1.663-7.535）和与病例有接触史（AOR=2.528，95%CI：1.180-4.557）与麻疹感染呈正相关，而之前接种过麻疹疫苗（AOR=0.209，95%CI：0.180-4.577）则降低了麻疹感染的风险。
发病率最高的是 5 岁以下儿童，病死率为 2.72%。疫苗接种率低于预期，未能建立群体免疫。建议采取增加疫苗接种覆盖率的策略，并加强监测系统，以识别谣言并对其做出早期反应，防止人际传播。
