Measles Outbreak Investigation in Guradamole District, Bale Zone, South-eastern Ethiopia: Case-Control Study 2021.

  • Vaccine preventable diseases
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Measles is a highly contagious viral illness and globally, 142,300 people died from measles in 2018. On 25 March
2021, an outbreak of measles was reported from Guradamole dis-trict, Bale Zone in South-eastern Ethiopia.
Hence, we investigated to determine the existence of the outbreak and to identify the associated factors.
Descriptive and 1:2 unmatched case-control study was conducted from March 25 to April 9/2021 in Guradamole
district. Five serum samples were taken and an IgM test was done to confirm cases. Cases were any person with
fever, rash and cough, coryza or conjunctivitis. For the descriptive part, all 98 cases were identified through
active case searching. For the case control part, 60 cases were recruited by computer-generated simple random
sampling and 120 controls were selected from neighbors of cases. An interviewer-administered structured questionnaire
was used to collect data from mothers of cases and controls. We measured weight for height to identify
acute malnutrition. Multivariate logistic regression analysis at P-value <0.05 declared statistical significance.
Overall, 98 patients were identified with an attack rate of 12/1000 population and a case fatality rate (CFR) of, 7%.
The highest attack rate (38/1000 population) and CFR (57%) were among children aged <59 months. Vaccination
effectiveness among cases was 82.6%. Being un-vaccinated for measles (AOR=2.61, 95% CI; 1.07-6.39), contact
with patient (AOR=3.24, 95% CL; 1.03-10.17), moderate acute malnutrition (AOR=3.21, 95% CL; 1.29-7.96) and
distance from health facility > 30 minute (AOR=4.58, 95%CL; 1.39-15.19) were shown significant associa-tion.
The attack and fatality rate of the outbreak was high. Vaccine effectiveness low among cases. Being unvaccinated
for measles, distant from the health facility, contact history with cases and malnutrition was associated
with this outbreak. We recommend, conducting catch-up campaigns, strengthening routine immunization programs,
and interventions for malnutrition to reduce future measles outbreaks.

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