Factors associated with a measles outbreak in children admitted at Mahosot Hospital, Vientiane, Laos

Factors associated with a measles outbreak in three health districts of Cameroon in 2019: a cross-sectional study

Introduction

measles is an infectious viral disease that affects susceptible individuals of all ages. It is a leading cause of death among young children globally due to suboptimal vaccination coverage. In 2019, measles outbreaks affected several parts of the world, including three health districts (HDs) of Cameroon's South West Region (SWR) experiencing armed conflict. Herein, we assessed the factors associated with the outbreak in the SWR.

Methods

we conducted a comparative study from March to August 2020. Data on study participants were compared between the three HDs that experienced a measles outbreak and three other HDs of the region that reported a case of measles but did not get into an outbreak. Records on vaccination between 2015 and 2019 were reviewed.

Results

information was obtained from 56 participants with known measles status, 32 from outbreak districts, and 24 from non-outbreak districts. The population in the outbreak group was more likely to have traveled from an area in a measles outbreak (OR 2, 95%CI 1.1-11.20). There was a suboptimal availability of measles vaccines in both categories of districts compared to the needs, and there was a downward trend in vaccination coverage in both groups. In addition, vaccines were more exposed to extreme temperatures in HDs with the outbreak (P<0.01) from 2015 to 2019. We found no statistically significant difference between both groups concerning the preexisting comorbidities of participants.

Conclusion

there is an urgent need to improve the cold chain and intensify vaccination activities in these districts.

Measles outbreaks and Supplemental Immunization Activities (SIAs): the Gwagwalada experience, Abuja 2015

Introduction

In November 2015 a measles outbreak was detected in several clustered settlements during the Northern Measles Supplementary Immunization Activities (SIAs) campaign in Gwagwalada, Nigeria, a measles outbreak was detected. Six weeks later another outbreak with 17 cases was reported in a different settlement in the same area council in December 2015 and January 2016. An outbreak investigation was initiated to characterize the outbreak in terms of time and person and implement prevention and control measures.

Methods

Suspected cases were defined as any person in Gwagwalada with onset of fever and rash between 1st November 2015 and 12th January 2016. Probable cases were defined as suspected cases with 3 days of rash or known exposure to someone with laboratory-confirmed measles. Confirmed case patients were defined as suspected or probable cases with Koplik spots or positive titer for immunoglobulin (Ig) M antibody. We conducted house to house case search, contact tracing and reviewed hospital records at the health facilities to determine the socio-demographic characteristics, clinical presentation and vaccination status of the cases.

Results

Active case search between November 2015 and January 2016 as well as record review from January 2015 to January 2016 showed that there were 109 suspected and 10 confirmed case patients. We identified 66 cases during the first reported outbreak with a case fatality rate of 6% (4 deaths) while 17 cases were identified 6 weeks later. The epidemic curve indicated a person-to-person transmission.

Conclusion

There had been cases of measles from January 2015 to November 2015 prior to the reported measles outbreak. However there was an unusual increase in the number of measles cases during the measles SIAs in communities where children were missed. Vaccination of all eligible children in the affected wards was carried out. The area council authorities and primary healthcare team need to create awareness on the importance of measles vaccination and ensure that these communities are targeted and covered during subsequent SIAs.

Analysing the characteristics of a measles outbreak in Houaphanh province to guide measles elimination in the Lao People's Democratic Republic

INTRODUCTION

In recent years, the incidence of measles has declined in the Lao People's Democratic Republic. However, an outbreak was reported in August 2014 in Houaphanh province, which was the biggest outbreak in the country since 2008. We describe the characteristics of this outbreak and outline critical interventions for the Lao People's Democratic Republic to achieve measles elimination.

METHODS

Fever and rash cases in the Khouan and Samtai districts with an onset date from 1 September to 25 October 2014 were investigated. Active case finding and health facility record reviews were carried out. Appropriate samples from the individuals with suspected measles were tested to confirm the diagnosis.

RESULTS

A total of 265 suspected cases including 12 deaths were reported from eight villages in the Khouan and Samtai districts. Forty-five individuals tested positive for measles IgM. Most of the confirmed patients were male (n = 28, 62%), less than 5 years old (n = 23, 51%) and from the Hmong ethnic community (n = 44, 98%). The majority of the people with suspected measles (n = 213, 80%) and all the confirmed ones were unvaccinated. A measles vaccination campaign conducted in the eight affected villages resulted in 76% coverage of the targeted population.

DISCUSSION

Low routine coverage and measles occurrence among unvaccinated individuals indicate underimmunized areas. The geographical and sociodemographic characteristics of this outbreak highlight the need for tailored vaccination strategies to close the immunity gap. A sensitive surveillance system that is able to detect, notify, investigate and guide response measures, including a second measles dose in the routine immunization schedule, will be essential for the Lao People's Democratic Republic to attain its measles elimination status.

Timeliness and completeness of measles vaccination among children in rural areas of Guangxi, China: A stratified three-stage cluster survey

Background

Large-scale outbreaks of measles occurred in 2013 and 2014 in rural Guangxi, a region in Southwest China with high coverage for measles-containing vaccine (MCV). This study aimed to estimate the timely vaccination coverage, the timely-and-complete vaccination coverage, and the median delay period for MCV among children aged 18–54 months in rural Guangxi.

Methods

Based on quartiles of measles incidence during 2011–2013, a stratified three-stage cluster survey was conducted from June through August 2015. Using weighted estimation and finite population correction, vaccination coverage and 95% confidence intervals (CIs) were calculated. Weighted Kaplan–Meier analyses were used to estimate the median delay periods for the first (MCV1) and second (MCV2) doses of the vaccine.

Results

A total of 1216 children were surveyed. The timely vaccination coverage rate was 58.4% (95% CI, 54.9%–62.0%) for MCV1, and 76.9% (95% CI, 73.6%–80.0%) for MCV2. The timely-and-complete vaccination coverage rate was 47.4% (95% CI, 44.0%–51.0%). The median delay period was 32 (95% CI, 27–38) days for MCV1, and 159 (95% CI, 118–195) days for MCV2.

Conclusions

The timeliness and completeness of measles vaccination was low, and the median delay period was long among children in rural Guangxi. Incorporating the timeliness and completeness into official routine vaccination coverage statistics may help appraise the coverage of vaccination in China.

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The timeliness and completeness of measles vaccination was low.

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The median delay period of measles vaccination was long among Guangxi children.

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Regions with higher measles incidence had higher rates of untimely coverage.