Nsungu M
Provincial Medical Director's Office, Marondera, Zimbabwe.
Cent Afr J Med. 1995 Nov;41(11):336-9.
From July to October 1994, Mashonaland East Province in Zimbabwe experienced measles outbreaks in which 2118 cases were reported. According to routine statistics, 69 pc of these patients were previously vaccinated against measles, 22 pc were not vaccinated and 9 pc had an unknown vaccination status. The measles vaccine coverages in the nine districts of this province during the year prior to the outbreak ranged from 58 pc to 87 pc with a provincial average of 72 pc. Three hundred and fifty eight patients who came in contact with health services during one month were investigated further. The prevalence of measles related complications among vaccinated and unvaccinated patients was 18,5 pc and 51,7 pc respectively (X2 = 56,01, p < 0,001; df = 2. While no death occurred among vaccinated patients, the case fatality rate among unvaccinated patients was 27,3 pc (X2 = 45,15, p < 0,001; df = 2). The later an outbreak was recognized the longer it was likely to last and the higher the case fatality rate was (Correlation coefficient = 0,76; 95 pc CI 0,02 - 0,96). It is concluded that the Expanded Programme on Immunization in this area is not a failure and that for outbreak control measures to be effective, they have to be implemented as early as possible, preferably within one week of the onset of an outbreak. District managers should put more emphasis on the use of data by Rural Health Centre staff in order to recognize outbreaks early.
1994年7月至10月，津巴布韦东马绍纳兰省爆发麻疹疫情，报告病例达2118例。根据常规统计，这些患者中69%曾接种过麻疹疫苗，22%未接种，9%的接种状况不明。在此次疫情爆发前一年，该省九个地区的麻疹疫苗接种覆盖率在58%至87%之间，全省平均覆盖率为72%。对一个月内接触过医疗服务的358名患者进行了进一步调查。接种疫苗和未接种疫苗的患者中，麻疹相关并发症的患病率分别为18.5%和51.7%（X² = 56.01，p < 0.001；自由度 = 2）。接种疫苗的患者中无死亡病例，而未接种疫苗的患者病死率为27.3%（X² = 45.15，p < 0.001；自由度 = 2）。疫情发现得越晚，持续时间可能越长，病死率越高（相关系数 = 0.76；95%置信区间0.02 - 0.96）。得出的结论是，该地区的扩大免疫规划并非失败，为使疫情控制措施有效，必须尽早实施，最好在疫情爆发后一周内实施。地区管理人员应更加强调农村卫生中心工作人员对数据的利用，以便尽早发现疫情。
