Measles outbreak investigation in Tocha district, southwestern Ethiopia: an unmatched case–control study

BackgroundMeasles 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,...

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Main Authors: Simon Fikadu Tefera, Nigatu Admasu, Habtamu Abebe, Gemechu Chemeda Feyisa, Gachana Midaksa
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-04-01
Series:Frontiers in Public Health
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2024.1331798/full
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author Simon Fikadu Tefera
Nigatu Admasu
Habtamu Abebe
Gemechu Chemeda Feyisa
Gachana Midaksa
author_facet Simon Fikadu Tefera
Nigatu Admasu
Habtamu Abebe
Gemechu Chemeda Feyisa
Gachana Midaksa
author_sort Simon Fikadu Tefera
collection DOAJ
description BackgroundMeasles 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.MethodsWe 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.ResultsThe 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.ConclusionThe 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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spelling doaj.art-3d3f914b97884ae8a90c348db1d5867c2024-04-16T15:03:39ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-04-011210.3389/fpubh.2024.13317981331798Measles outbreak investigation in Tocha district, southwestern Ethiopia: an unmatched case–control studySimon Fikadu Tefera0Nigatu Admasu1Habtamu Abebe2Gemechu Chemeda Feyisa3Gachana Midaksa4Ethiopian Field Epidemiology Laboratory Training Program (FETP), Jimma University, Jimma, EthiopiaEthiopian Field Epidemiology Laboratory Training Program (FETP), Jimma University, Jimma, EthiopiaLecturer of Biostatistics, Department of Epidemiology, Jimma University, Jimma, EthiopiaEthiopian Field Epidemiology Laboratory Training Program (EFETP), Jimma University, Jimma, EthiopiaSchool of Public Health, College of Medicine and Health Science, Mizan–Tepi University, Mizan, EthiopiaBackgroundMeasles 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.MethodsWe 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.ResultsThe 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.ConclusionThe 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.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1331798/fullmeaslesoutbreakTochaSWEDawuro
spellingShingle Simon Fikadu Tefera
Nigatu Admasu
Habtamu Abebe
Gemechu Chemeda Feyisa
Gachana Midaksa
Measles outbreak investigation in Tocha district, southwestern Ethiopia: an unmatched case–control study
Frontiers in Public Health
measles
outbreak
Tocha
SWE
Dawuro
title Measles outbreak investigation in Tocha district, southwestern Ethiopia: an unmatched case–control study
title_full Measles outbreak investigation in Tocha district, southwestern Ethiopia: an unmatched case–control study
title_fullStr Measles outbreak investigation in Tocha district, southwestern Ethiopia: an unmatched case–control study
title_full_unstemmed Measles outbreak investigation in Tocha district, southwestern Ethiopia: an unmatched case–control study
title_short Measles outbreak investigation in Tocha district, southwestern Ethiopia: an unmatched case–control study
title_sort measles outbreak investigation in tocha district southwestern ethiopia an unmatched case control study
topic measles
outbreak
Tocha
SWE
Dawuro
url https://www.frontiersin.org/articles/10.3389/fpubh.2024.1331798/full
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AT habtamuabebe measlesoutbreakinvestigationintochadistrictsouthwesternethiopiaanunmatchedcasecontrolstudy
AT gemechuchemedafeyisa measlesoutbreakinvestigationintochadistrictsouthwesternethiopiaanunmatchedcasecontrolstudy
AT gachanamidaksa measlesoutbreakinvestigationintochadistrictsouthwesternethiopiaanunmatchedcasecontrolstudy