Measles Outbreak Propagated by Children Congregating at Water Collection Points in Mayuge District, Eastern Uganda, July–October, 2016

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dc.contributor.authorMajwala, Robert Kaos
dc.contributor.authorNakiire, Lydia
dc.contributor.authorKadobera, Daniel
dc.contributor.authorArio, Alex Riolexus
dc.contributor.authorKusiima, Joy
dc.contributor.authorAtuhairwe, Joselyn Annet
dc.contributor.authorMatovu, Joseph K. B.
dc.contributor.authorZhu, Bao-Ping
dc.date.accessioned2018-10-17T07:02:42Z
dc.date.available2018-10-17T07:02:42Z
dc.date.issued2018-08-20
dc.descriptionThe research article is about investigation of measles outbreak to determine its scope, identify risk factors for transmission, evaluate vaccination coverage and vaccine effectiveness, and recommend evidence-based control measures.en_US
dc.description.abstractBackground On 12 October, 2016 a measles outbreak was reported in Mayuge District, eastern Uganda. We investigated the outbreak to determine its scope, identify risk factors for transmission, evaluate vaccination coverage and vaccine effectiveness, and recommend evidence-based control measures. Methods We defined a probable case as onset of fever (≥3 days) and generalized rash, plus ≥1 of the following: conjunctivitis, cough, and/or runny nose in a Mayuge District resident. A confirmed case was a probable case with measles-specific IgM (+) not explained by vaccination. We reviewed medical records and conducted active community case-finding. In a case-control investigation involving probable case-persons and controls matched by age and village, we evaluated risk factors for transmission for both cases and controls during the case-person’s likely exposure period (i.e., 7–21 days prior to rash onset). We estimated vaccine effectiveness (VE) using the formula: VE ≈ (1-ORprotective) × 100. We calculated vaccination coverage using the percentage of controls vaccinated. Results We identified 62 probable case-persons (attack rate [AR] = 4.0/10,000), including 3 confirmed. Of all age groups, children < 5 years were the most affected (AR = 14/10,000). The epidemic curve showed a propagated outbreak. Thirty-two percent (13/41) of case-persons and 13% (21/161) of control-persons visited water-collection sites (by themselves or with parents) during the case-persons’ likely exposure period (ORM-H = 5.0; 95% CI = 1.5–17). Among children aged 9–59 months, the effectiveness of the single-dose measles vaccine was 75% (95% CI = 25–92); vaccination coverage was 68% (95% CI = 61–76). Conclusions Low vaccine effectiveness, inadequate vaccination coverage and congregation at water collection points facilitated measles transmission in this outbreak. We recommended increasing measles vaccination coverage and restriction of children with signs and symptoms of measles from accessing public gatherings.en_US
dc.identifier.citationMajwala, Robert Kaos Nakiire, Lydia Kadobera, Daniel Ario, Alex Riolexus Kusiima, Joy Atuhairwe, Joselyn Annet Matovu, Joseph K. B. Zhu, Bao-Ping, 2018. Measles outbreak propagated by children congregating at water collection points in Mayuge District, eastern Uganda, July–October, 2016. BMC Infectious Diseases, 18:412. https://doi.org/10.1186/s12879-018-3304-5en_US
dc.identifier.issn14712334
dc.identifier.urihttps://hdl.handle.net/20.500.11951/574
dc.language.isoenen_US
dc.publisherBMC Infectious Diseasesen_US
dc.subjectDisease outbreaksen_US
dc.subjectMeaslesen_US
dc.subjectRisk factorsen_US
dc.subjectUgandaen_US
dc.titleMeasles Outbreak Propagated by Children Congregating at Water Collection Points in Mayuge District, Eastern Uganda, July–October, 2016en_US
dc.typeArticleen_US
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