Epidemiology and clinical characteristics of the measle cases admitted in the tertiary care hospital, in Ghor, Afghanistan, in 2021: A descriptive cross-sectional study.

  • Vaccine preventable diseases
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Measles is a major public health problem particularly in countries with conflict and emergencies including
Afghanistan. One of the provinces with a high incidence of measles is Ghor located in the central part of
Afghanistan. The measles outbreaks frequently occurred over the last years in this province.
Purpose: To describe the epidemiology and clinical characteristics of the measles cases admitted in the Ghor
provincial hospital during an outbreak that occurred in June 2021.
A descriptive cross-sectional study was conducted to describe measles cases admitted in the Ghor provincial
hospital in June 2021. We used WHO measles case definitions, and all clinical and lab-confirmed (ELISA) cases
were line-listed. Anthropometric measurements and hemoglobin levels were also measured and recorded. Data
were analyzed using Epi info version 7.0. We considered HAZ <-2 for moderate or severe stunting and Hb <11
gr% was classified as anemia.
We were able to investigate 150 measles clinically and laboratory-confirmed cases. The median age of the cases
was 12 months (IQR 16months). While males and infants aged 2-18 months represented 84 (56%) and 97 (65%)
of cases respectively; 39 (26%) of the cases occurred among infants less than 9 months. Amongst the clinical
features, fever (99.6%), rash (99.3%), diarrhea (88%), pneumonia (80%), and conjunctivitis (58%) were seen in
the study population. Among 111 eligible cases, 59 (55%) were not received measles vaccination. Of 150 cases,
54 (36%; 95 % CI [28-44]) had moderate or severe stunting and 36 (24%; 95%CI [17-31]) had anemia. Overall, the
case fatality rate was 6 (4 %).
The low measles vaccine coverage rate leads the continuous measles outbreaks in Ghor province. Strategies to
improve the coverage of measles vaccination and address malnutrition should be undertaken. Further studies
are required to determine the risk factors and vaccine effectiveness in the province.

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