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Tefera SF, Admasu N, Abebe H, Feyisa GC, Midaksa G. Measles outbreak investigation in Tocha district, southwestern Ethiopia: an unmatched case-control study. Front Public Health 2024; 12:1331798. [PMID: 38689775 PMCID: PMC11060179 DOI: 10.3389/fpubh.2024.1331798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/27/2024] [Indexed: 05/02/2024] Open
Abstract
Background 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. Methods 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 p value ≤0.05 with 95% confidence interval. Results 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. Conclusion 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.
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Affiliation(s)
- Simon Fikadu Tefera
- Ethiopian Field Epidemiology Laboratory Training Program (FETP), Jimma University, Jimma, Ethiopia
| | - Nigatu Admasu
- Ethiopian Field Epidemiology Laboratory Training Program (FETP), Jimma University, Jimma, Ethiopia
| | - Habtamu Abebe
- Lecturer of Biostatistics, Department of Epidemiology, Jimma University, Jimma, Ethiopia
| | - Gemechu Chemeda Feyisa
- Ethiopian Field Epidemiology Laboratory Training Program (EFETP), Jimma University, Jimma, Ethiopia
| | - Gachana Midaksa
- School of Public Health, College of Medicine and Health Science, Mizan–Tepi University, Mizan, Ethiopia
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Saidu Y, Agbor VN, Di Mattei P, Nchinjoh SC, Edwidge NN, Njoh AA, Muteh NJ, Prescott M, Wiwa O, Diack D, Flegere J, Montomoli E, Costa Clemens SA, Clemens R. Development of a composite scoring system to rank communities at high risk of zero-dose children in Cameroon: A geospatial analysis. J Glob Health 2023; 13:04136. [PMID: 37971948 PMCID: PMC10653342 DOI: 10.7189/jogh.13.04136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Background Despite growing efforts to improve access to vaccination, millions of children, especially in developing countries, have not received a single dose of diphtheria, tetanus, and pertussis (DTP) vaccine. Consequently, they are often called zero-dose children (ZDC). With limited health resources, prioritising communities for rapid and mass zero-dose catch-up vaccination in missed communities to avert epidemic outbreaks is complicated by unreliable denominators used to compute vaccination coverages. Incorporating other indicators of access and utilisation of vaccination services can help with identifying and ranking missed communities based on the likelihood of finding ZDC. We described the process of generating a scoring method to rank health areas in Cameroon based on their likelihood of containing ZDC. Methods We used geospatial analysis to compute and aggregate health area characteristics, including hard-to-reach (HTR) areas (defined as areas of settlement above a one- (for urban areas) or 15-kilometre radius (for rural areas) beyond a vaccinating health facility), amount of area covered by slums and new area settlement, and percentage of children unvaccinated for DTP-1. We attributed a weight based on the ability to limit accessibility or utilisation of vaccination services to each characteristic and computed the score as a weighted average of health area characteristics. The health area score ranged from 0 to 1, with higher scores representing a higher likelihood of containing ZDC. We stratified the analysis by rural and urban health areas. Results We observed substantial district and regional variations in health area scores, with hotspots health areas (administrative level 4) observed in the Far North (0.83), North (0.81), Adamawa (0.80), East (0.75), and South West (0.67) regions. The Adamawa region had the highest percentage of health areas with the highest score (78%), followed by the East (50%), West (48%), and North (46%) regions. For most regions (Far North, South, South West, Littoral, West, and North West), DTP-1 contributed the most to the score. However, HTR settlement areas within a health area contributed substantially to the overall score in the East, North, and Adamawa regions. Conclusions We found substantial variations in health area scores with hotspots in the Far North, North, Adamawa, East, and South West regions. Although DTP-1 could be used as an indicator to identify health areas with ZDC for most communities, HTR settlement area was a valuable indicator in ranking priority health areas in the East, North, and Adamawa regions, further emphasising the need to consider other indicators before prioritisation.
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Affiliation(s)
- Yauba Saidu
- Clinton Health Access Initiative Inc., Yaoundé, Cameroon
- Institute for Global Health, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Valirie N Agbor
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | | | | | - Andreas A Njoh
- Expanded Program on Immunization, Cameroon Ministry of Public Health, Yaoundé, Cameroon
- School of Global Health and Bioethics, Euclid University, Bangui, Central African Republic
| | | | - Marta Prescott
- Global Analytics and Implementation Research Team, Clinton Health Access Initiative Inc., Boston, USA
| | - Owens Wiwa
- Clinton Health Access Initiative Inc., Yaoundé, Cameroon
| | - Demba Diack
- Gavi, the Vaccine Alliance, Geneva, Switzerland
| | | | - Emanuele Montomoli
- Institute for Global Health, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- VisMederi srl, Siena, Italy
| | - Sue A Costa Clemens
- Institute for Global Health, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- Department of Pediatrics, University of Oxford, Oxford, UK
| | - Ralf Clemens
- Institute for Global Health, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- International Vaccine Institute, IVI, Seoul, Republic of Korea
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Tariku MK, Worede DT, Belete AH, Bante SA, Misikir SW. Attack rate, case fatality rate and determinants of measles infection during a measles outbreak in Ethiopia: systematic review and meta-analysis. BMC Infect Dis 2023; 23:756. [PMID: 37919689 PMCID: PMC10623867 DOI: 10.1186/s12879-023-08757-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 10/26/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Although Ethiopia is working towards measles elimination, a recurrent measles outbreak has occurred. To take appropriate measures, previously, many fragmented and inconsistent outbreak investigations were done, but there is no consolidated evidence on attack rate, case fatality rate, and determinants of measles infection during the measles outbreak. This systematic review and meta-analysis aimed to identify cumulative evidence on attack rate, case fatality rate, and determinants of measles infection during the outbreak. METHODS A systematic literature review and Meta-analysis was used. We searched Google Scholar, Medline/PubMed, Cochrane/Wiley Library, EMBASE, Science Direct, and African Journals Online databases using different terms. Investigations that applied any study design, data collection- and analysis methods related to the measles outbreak investigation were included. Data were extracted in an Excel spreadsheet and imported into STATA version 17 software for meta-analysis. The I2 statistics were used to test heterogeneity, and 'Begg's and 'Egger's tests were used to assess publication bias. The odds ratio (OR) with a 95% confidence interval (CI) was presented using forest plots. RESULTS Eight measles outbreak investigations with 3004 measles cases and 33 deaths were included in this study. The pooled attack rate (A.R.) and case fatality rate were 34.51/10,000 [95% CI; 21.33-47.70/10,000] population and 2.21% [95% CI; 0.07-2.08%], respectively. Subgroup analysis revealed the highest attack rate of outbreaks in the Oromia region (63.05 per 10,000 population) and the lowest in the Amhara region (17.77 per 10,000 population). Associated factors with the measles outbreak were being unvaccinated (OR = 5.96; 95% CI: 3.28-10.82) and contact history (OR = 3.90; 95% CI: 2.47-6.15). CONCLUSION Our analysis revealed compelling evidence within the outbreak descriptions, highlighting elevated attack and case fatality rates. Measles infection was notably linked to being unvaccinated and having a contact history. Strengthening routine vaccination practices and enhancing contact tracing measures are vital strategies moving forward.
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Affiliation(s)
- Mengistie Kassahun Tariku
- Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, 269, Ethiopia.
| | - Daniel Tarekegn Worede
- Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, 269, Ethiopia
| | - Abebe Habtamu Belete
- Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, 269, Ethiopia
| | - Simachew Animen Bante
- Department of Midwifery College of Health Sciences, Bahir Dar University, Bahir Dar, 79, Ethiopia
| | - Sewnet Wongiel Misikir
- Department of Laboratory Technology, Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, 680, Ethiopia
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Us MC, Coci K, Akkuş E, Okay B, Akkoç G. A Single-Center Evaluation of Pediatric Measles Cases in Istanbul, Türkiye, in 2019. Jpn J Infect Dis 2023; 76:267-274. [PMID: 37121672 DOI: 10.7883/yoken.jjid.2022.701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Although measles can be prevented and eliminated by vaccination, it is a highly contagious viral disease that can lead to serious complications, disability, and death. The aim of this retrospective study was to evaluate the characteristics of measles cases in a single center. All children with clinically suspected measles who attended the Pediatric Clinic at Esenler Maternity and Child Health Hospital in Istanbul, Türkiye, between January 1 and June 30, 2019 were included in the analysis. None of the children with measles were fully vaccinated. The incidence and duration of conjunctivitis were significantly higher in the unvaccinated group than in the partially vaccinated group (P = 0.027 and P = 0.019, respectively). Unvaccinated patients had a significantly lower median leukocyte count (P = 0.019) and significantly higher median C-reactive protein level (P = 0.021). The vitamin A level and leukocyte count were moderately positively correlated (r = 0.698; P = 0.008). Children should be fully vaccinated in order to prevent measles.
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Affiliation(s)
- Mahmut Caner Us
- Department of Pediatrics, Maternity Ward, Esenler Maternity and Child Health Hospital, Türkiye
- Department of Pediatrics, Haseki Training and Research Hospital, Türkiye
| | - Kübra Coci
- Department of Pediatrics, Maternity Ward, Esenler Maternity and Child Health Hospital, Türkiye
| | - Erkan Akkuş
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Cerrahpasa Medical Faculty, Istanbul University, Türkiye
| | - Berker Okay
- Department of Pediatrics, Maternity Ward, Esenler Maternity and Child Health Hospital, Türkiye
| | - Gülşen Akkoç
- Department of Infectious Diseases, Haseki Training and Research Hospital, Türkiye
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Mengistu ST, Achila OO, Tewelde AT, Hamida ME, Tekle F, Michae I, Said M, Fsahatsion D, Abai H, Mulugeta R, Tsegai T, Woldu LG, Werke WY. Epidemiology of confirmed measles virus cases, surveillance, incidence, and associated factors in Eritrea: 18-year retrospective analysis. Front Public Health 2023; 11:1218317. [PMID: 37780421 PMCID: PMC10533993 DOI: 10.3389/fpubh.2023.1218317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Background Despite the outstanding measles vaccine coverage (MVC) in Eritrea, sporadic outbreaks are not uncommon. Therefore, understanding the incidence of laboratory-confirmed measles virus cases, related factors, and spatial inequalities in testing and surveillance remains crucial. In this analysis, we evaluated the incidence and spatiotemporal distribution of measles in Eritrea. An evaluation of the factors associated with measles vaccination and IgM positive (+) febrile rash was also undertaken. Methods A retrospective (period: 2002-2020) study was carried out by abstracting data from the integrated disease surveillance and response database (IDSR). Data was analyzed using descriptive statistics and binary logistic regression. Spatial variability and distribution of confirmed cases was evaluated using ArcGIS Pro version 3.0.1. Results In total, 9,111 suspected cases, 2,767 [1,431 (51.7%) females] were serologically tested. The median (IQR) age, minimum-maximum age were 7 years (IQR: 4-14 years) and 1 month-97 years, respectively. Among the 608(21.9%) laboratory-confirmed cases, 534 (87.8%) were unvaccinated and 53 (9.92%) were < 1 year old. The crude incidence rate for MV was 14/100,000 persons. The age-specific positivity rate per 100,000 suspected cases tested was 21.5 with individuals >30 years presenting with the highest rates (69.9/100,000). Higher odds (OR) of MV test positivity was associated with age at onset - higher in the following age-bands [10-14 years: OR = 1.6 (95%CI, 1.1-2.2, value of p = 0.005); 15-29 years: OR = 7.0 (95%CI, 5.3-9.2, value of p = 0.005); and > =30 years: OR = 16.7 (95%CI, 11.7-24) p < 0.001]. Other associations included: Address - higher in Anseba (OR = 2.3, 95%CI: 1.7-3.1, value of p<0.001); Debub (OR = 2.7, 95%CI: 1.9-3.9, value of p < 0.001); Gash-Barka (OR = 15.4, 95%CI: 10.9-21.7, value of p < 0.001); Northern Red Sea (OR = 11.8, 95%CI: 8.5-16.2, value of p < 0.001); and Southern Red Sea (OR = 14.4, 95%CI: 8.2-25.2, value of p < 0.001). Further, test positivity was higher in health centers (OR = 2.5, 95%CI: 1.9-3.4, value of p < 0.001) and hospitals (OR = 6.8, 95%CI: 5.1-9.1, value of p < 0.001). Additional factors included vaccination status - higher in the unvaccinated (OR = 14.7, 95%CI: 11.4-19.1, value of p < 0.001); and year of onset of rash - (higher >2015: OR = 1.4, 95%CI: 1.1-1.7, value of p<0.001). Uptake of measles vaccine associated with a similar complement of factors. Conclusion In large part, efforts to eliminate measles in Eritrea are hindered by disparities in vaccine coverage, under-surveillance, and low vaccination rates in neighboring countries. Enhanced surveillance and regional micro planning targeting hard-to-reach areas can be an effective strategy to improve measles elimination efforts in Eritrea.
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Affiliation(s)
| | - Oliver Okoth Achila
- Unit of Clinical Laboratory Sciences, Orotta College of Medicine and Health Sciences, Asmara, Eritrea
| | | | | | - Freweini Tekle
- Serology Department, National Health Laboratory, Asmara, Eritrea
| | - Issaias Michae
- Serology Department, National Health Laboratory, Asmara, Eritrea
| | - Mensura Said
- Serology Department, National Health Laboratory, Asmara, Eritrea
| | - Dawit Fsahatsion
- Serology Department, National Health Laboratory, Asmara, Eritrea
| | - Haimanot Abai
- Serology Department, National Health Laboratory, Asmara, Eritrea
| | - Rahel Mulugeta
- Serology Department, National Health Laboratory, Asmara, Eritrea
| | - Tsigehana Tsegai
- Serology Department, National Health Laboratory, Asmara, Eritrea
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Mat Daud MRH, Yaacob NA, Ibrahim MI, Wan Muhammad WAR. Five-Year Trend of Measles and Its Associated Factors in Pahang, Malaysia: A Population-Based Study. IJERPH 2022; 19:8017. [PMID: 35805675 PMCID: PMC9265953 DOI: 10.3390/ijerph19138017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/15/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022]
Abstract
Measles is a disease that has resurfaced as a public health concern in Malaysia. Malaysia has had a Measles Elimination Program in place since 2004, but the incidence of measles in Pahang has not improved significantly. The purpose of this study was to describe the incidence and trend of measles in Pahang, as well as to identify the risk factors. The five-year population-based surveillance data of the entire Pahang state was extracted and analyzed for the trend and incidence of measles from January 2016 to December 2020. Multiple logistic regression was used to examine the relationship between measles and available sociodemographic data. A total of 2844 reported measles cases were investigated. Out of the measles cases reported, 7.41 percent were confirmed. According to the five-year fluctuating trend, the incidence rate ranges from 13.51 to 50.97 per 1,000,000 population. Confirmed measles was significantly associated with an indigenous background (AdjOR = 4.90, 95% CI: 1.74, 13.78), history of contact with measles cases (AdjOR = 14.03, 95% CI: 8.23, 23.90), and incomplete vaccination (AdjOR = 3.38, 95% CI: 2.28, 5.01). In conclusion, the incidence of measles in Pahang remains sporadic, owing to sporadic outbreaks. Vaccination is an important preventive measure that must reach out to the isolated populations such as indigenous people.
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Tsegaye G, Gezahegn Y, Tesfaye A, Mulatu G, Bulcha GG, Berhanu N. Measles Outbreak Investigation in Guradamole District of Bale Zone, South Eastern Ethiopia, 2021. Infect Drug Resist 2022; 15:669-683. [PMID: 35250282 PMCID: PMC8893148 DOI: 10.2147/idr.s343270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/20/2022] [Indexed: 11/23/2022] Open
Abstract
Background Method Results Conclusion
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Affiliation(s)
- Geremew Tsegaye
- Ethiopian Field Epidemiology and Laboratory Training Program, Faculty of Public Health, Jimma University, Jimma, Ethiopia
- Correspondence: Geremew Tsegaye, Ethiopian Field Epidemiology and Laboratory Training Program, Faculty of Public Health, Jimma University, Jimma, Ethiopia, Email
| | - Yenealem Gezahegn
- Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Assegid Tesfaye
- Ethiopian Field Epidemiology and Laboratory Training Program, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Gadissa Mulatu
- Disease Control and Prevention Department, Bale Zone Health Office, Robe, Ethiopia
| | - Gemechu Gudina Bulcha
- Public Health Emergency Management Department, Oromia Regional Health Bureau, Addis Ababa, Ethiopia
| | - Naod Berhanu
- Field Epidemiology, Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
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Mokaya EN, Isaac Z, Anyuon NA. Measles outbreak investigation in Aweil East county, South Sudan. Pan Afr Med J 2021; 40:87. [PMID: 34909076 PMCID: PMC8607948 DOI: 10.11604/pamj.2021.40.87.28370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 08/14/2021] [Indexed: 11/11/2022] Open
Abstract
During January 2018-June 2020, Aweil East confirmed five measles outbreaks. In March 2020, Aweil East reported twenty measles IgM+ cases. Before this outbreak, Aweil East had confirmed an outbreak in late November 2019. Even after conducting outbreak reactive vaccinations (ORV) in December 2019 and February 2020, measles spread was not interrupted. The nationally supported measles follow-up campaign (MFUC) conducted in late February 2020 was deferred in Aweil East because of the February ORV. We reviewed the measles data collected through passive and active surveillance. A matched case-control study was conducted to evaluate potential exposures. Face-to-face interviews with cases and controls using a semi-structured questionnaire were used to collect demographics, disease, and exposures related data. A total of 687 cases with eight deaths; attack and case fatality rate of 123/100,000 population and 1.16%, respectively. Among the cases, 51.8% were male, the median age was four years, and 59% of cases ≥9 months were unvaccinated. Eighty point six percent (80.6%) of cases reported after the February ORV were unvaccinated. The outbreak peaked in late March 2020. Unvaccinated persons had higher odds of getting measles (adjusted odds ratio (AOR)=8.569; 95% CI [1.41- 53.4], p=0.02). Non exposed persons had a lower odd of getting measles (AOR=0.114; 95% CI [0.02-0.61], p=0.011). During 2018-2019, the accumulated number of unvaccinated children (18,587) is more than a birth cohort of the county. Persistent low routine vaccination is the most critical driver of the measles outbreaks. Low-quality ORV and the intermediate population density are secondary drivers of the outbreaks.
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Nassar AAH, Al Amad MA, Qasim M, Dureab F. Risk factors for measles outbreak in Ataq and Habban districts, Shabwah governorate, Yemen, February to May 2018. BMC Infect Dis 2021; 21:551. [PMID: 34112091 PMCID: PMC8193880 DOI: 10.1186/s12879-021-06207-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 05/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recent conflict and war in Yemen lead to collapse of the health system, decrease of immunization coverage and spread of many outbreaks. On May 22, 2018, the surveillance officer in Shabwah governorate reported an increased number of suspected measles. On May 24, 2018, a team from Yemen-Field Epidemiology Training Program was sent to investigate. The aims were to describe the outbreak, determine the risk factors for measles infection and recommend control measures. METHODOLOGY A descriptive followed by case-control study design (1:2 ratio) were performed. National Measles Surveillance Program case definition and predesigned questionnaire were used to collect data from 73 cases and 146 controls. Attack rate (AR), adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) were calculated. P value < 0.05 was considered as the cut point for significant. Epi info version 7.2 was used. RESULTS A total of 73 suspected cases were found. Almost 53% were from Habban district, 63% were males and 56% were among age group < 5 years. The overall AR was 82/100,000 population. Measles was significantly associated with contact with case (aOR = 27.3, 95% CI:1.3-551.7), malnourished children aged 6-60 months (aOR = 24.9, 95% CI;1.9-329.6) and unvaccinated children (aOR = 17.2, 95% CI:2.9-100.7). The six collected blood samples found to be positive for measles IgM. CONCLUSIONS Measles outbreak in Ataq and Habban districts was confirmed. Contact with measles cases, malnutrition and un-vaccination were the potential contributing factors of measles outbreak in Shabwah governorate. An urgent vaccination campaign with health education interventions are highly recommended. Reactivation of the outreach immunization services and strengthening surveillance and response systems are top priority to take place at district and governorate levels.
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Affiliation(s)
| | | | - Mohammed Qasim
- Evaluation and Monitor Department, World Health Organization- Yemen, Sana'a, Yemen
| | - Fekri Dureab
- Heidelberg Institute of Global Health, Medical School , Heidelberg University, 69120, Heidelberg, Germany.,IRIA, Akkon-Hochschule fuer Humanwissenschaften, 12099, Berlin, Germany
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W/Kidan F, Getachew D, Mekonnen B, Woldeselassie Hammeso W. Risk Factors of Measles Outbreak Among Students of Mizan-Tepi University, Tepi Campus, Southwest Ethiopia. Infect Drug Resist 2021; 14:963-970. [PMID: 33737818 PMCID: PMC7961205 DOI: 10.2147/idr.s296928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/20/2021] [Indexed: 11/23/2022] Open
Abstract
Background Measles is a serious respiratory disease that is spread easily through coughing and sneezing of the measles virus for which humans are the only reservoir. Even though prevention and elimination strategies had been implemented, the outbreaks of measles infection quietly occur in different parts of the world. As of November 2019 a suspected measles outbreak was reported from Tepi campus student’s clinic. We investigated the outbreak to determine its possible sources, control measures and identify associated risk factors among students of Mizan-Tepi University. Methods A facility based unmatched case-control study was conducted. An interviewer administered questionnaire was used to collect the data. Data were cleaned and entered to Epi-info7 and analyzed using SPSS-20. A logistic regression analysis was conducted to identify risk factors associated with measles outbreak at a p-value ≤0.05. Results A total of 40 measles cases were reported during the investigation. The probable source of the outbreak was an index case who had a travel history to a district with the measles epidemic. Five samples were collected for confirmation of the diagnosis. No measles-related deaths were reported. The major risk factors for measles infection in Mizan-Tepi University were being unvaccinated [AOR = 5.21, 95% CI (1.938, 12.058)], being female [AOR = 4.21, 95% CI (1.426, 11.182)], age group of 18–20 [AOR = 0.123, 95% CI (0.041, 0.37)] and having a contact history [AOR = 0.149, 95% CI (0.041, 0.544)]. Conclusion The findings of the present investigation indicated that being unvaccinated and having a contact history with confirmed or suspected cases increased the risk of measles infection. Reduction in the level of protective antibodies over time may accelerate transmission of measles in the campus. Strengthening case-based surveillance and supplemental measles vaccination are imperative.
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Affiliation(s)
- Fekede W/Kidan
- School of Public Health Department of Epidemiology and Biostatistics, Collage of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Dawit Getachew
- School of Public Health Department of Epidemiology and Biostatistics, Collage of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Besufekad Mekonnen
- School of Public Health Department of Public Health, Collage of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Workineh Woldeselassie Hammeso
- School of Pharmacy, Department Pharmacology and Pharmaceutical Chemistry College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
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Sweileh WM. Bibliometric analysis of global scientific literature on vaccine hesitancy in peer-reviewed journals (1990-2019). BMC Public Health 2020; 20:1252. [PMID: 32807154 PMCID: PMC7433157 DOI: 10.1186/s12889-020-09368-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 08/10/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Vaccine hesitancy is a growing threat to national and global health security. The current study was undertaken to provide insights into the global scientific literature on vaccine hesitancy in peer-reviewed journals. METHOD The current study was a descriptive bibliometric study. A validated search strategy on vaccine hesitancy was implemented using SciVerse Scopus. Bibliometric indicators such as (1) annual growth of publications, (2) key players, (3) research themes, (4) pathogens/diseases encountered, (5) top-cited documents, and (6) annual growth of publications stratified by world region and by age category were presented. The study period was from 1990 to 2019. RESULTS Search strategy found 2791 documents. The h-index of the retrieved literature was 89. The leading journal was Vaccine (369; 13.2%%) followed by Human Vaccines and Immunotherapeutics (129; 4.6%). Authors from the USA led with 1125 (40.3%) followed by authors from Italy (234; 8.4%) and the UK (204; 7.3%). The US CDC led with 140 (5.0%) documents followed by Emory University (USA) (81, 2.9%). The list of active authors included six from the USA while the remaining were from France, Australia, and Canada. Research themes in the retrieved literature focused on influenza, human papillomavirus, and the role of parents in immunization of their children. The region of the Americas and the European region had the greatest share of publications and showed steep growth of publications lately. Vaccine hesitancy research on adolescents was most noticed after 2007 while that on children was present all the time but escalated lately. Titles/abstracts analysis indicated that 621(22.3%) documents focused on influenza, 392 (14.0%) focused on Human papillomavirus, and 292 (10.5%) focused on measles. The top-cited documents in literature published after 2015 focused on the definition and strategies to overcome vaccine hesitancy. CONCLUSION The last decade witnessed a noticeable increase in the number of publications. Influenza vaccine and parental concerns about the human papillomavirus vaccine were the main focus of the retrieved literature. Information on vaccine hesitancy needs to be collected from all countries to build a better coalition against the anti-vaccination groups. Re-building trust in vaccines requires targeting parents by providing adequate information on the vaccines.
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Affiliation(s)
- Waleed M Sweileh
- Department of Physiology, Pharmacology/Toxicology, Division of Biomedical Sciences, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
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Sitepu FY, Depari E, Mudatsir M, Harapan H. Being unvaccinated and contact with measles cases as the risk factors of measles outbreak, North Sumatera, Indonesia. Clinical Epidemiology and Global Health 2020. [DOI: 10.1016/j.cegh.2019.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Yassin ZJ, Yimer Nega H, Derseh BT, Sisay Yehuala Y, Dad AF. Knowledge of Health Professionals on Cold Chain Management and Associated Factors in Ezha District, Gurage Zone, Ethiopia. Scientifica (Cairo) 2019; 2019:6937291. [PMID: 31281711 PMCID: PMC6590539 DOI: 10.1155/2019/6937291] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 04/03/2019] [Accepted: 04/22/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Maintaining quality of vaccines has been one of the main challenges of immunization programs in Africa including Ethiopia, and this could mainly be explained by health professional's knowledge about cold chain management. There are limited studies done in Ethiopia linking the knowledge of health professionals on cold chain management, and that is why we needed to conduct this study. METHODOLOGY Institution-based cross-sectional study was conducted among all available health professionals in selected health facilities (232 health professionals). Face-to-face interview using a semistructured questionnaire was conducted to collect required information from September to October 2016. Observational checklist was used to spot availability and functionality of refrigerators. Data entry and cleaning was done using Epi Info and exported to SPSS for analysis. A multivariable logistic regression model was fitted to identify factors associated with health professional's knowledge about cold chain management. RESULT The response rate was 92.43%, and 119 (51.3%; 95% CI; 44.9%, 57.6%) health professionals had a satisfactory knowledge about cold chain management. Being trained on immunization program (AOR = 5.1; 95% CI: 2.68, 10.13), having a work experience above six years (AOR = 2.1; 95% CI: 1.8, 4.15), using EPI guidelines (AOR = 2.58; 95% CI: 1.47, 5.57), and being a BSc nurse/health officer (AOR = 2.4; 95% CI: 1.47, 14.4) had got better knowledge on cold chain management. CONCLUSION Health professionals working in the health centers and health posts had low knowledge on cold chain management. Longer work experience, in-service training, and using EPI guideline at work were factors that improved health professionals' knowledge about a cold chain management, which needs to be maintained.
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Affiliation(s)
- Zeyneba Jemal Yassin
- Ethiopian Field Epidemiology and Laboratory Training Program Resident, University of Gondar, Gondar, Ethiopia
| | - Habtamu Yimer Nega
- South Wollo Zone, Institute of Public Health Emergency Management Department, Dessie, Ethiopia
| | - Behailu Tariku Derseh
- Debre Berhan University, College of Health Sciences, Department of Public Health, Debre Berhan, Ethiopia
| | - Yetnayet Sisay Yehuala
- University of Gondar, Institute of Public Health, Department of Health Promotion and Behavioral Sciences, Gondar, Ethiopia
| | - Abel Fekadu Dad
- College of Medicine and Public Health, School of Public Health, Flinders University, Adelaide, Australia
- University of Gondar, Institute of Public Health, Department of Epidemiology Biostatistics, Gondar, Ethiopia
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