Ethiopian Field Epidemiology Training Program (EFETP) Compiled Body of Works in Field Epidemiology
No Thumbnail Available
Date
2014-04
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Ababa University
Abstract
Introduction: Tsegedea district is found in western Tigray region composed of 123,641 populations
and 25 kebelles. The health facility coverage is 100 %( 5) for health centers and 93 %( 23) for
health posts. Measles is an acute, highly contagious viral disease caused by measles virus.. As more
countries immunize more children, measles deaths have been reduced by 71 per cent—from an
estimated 548,000 in 2000 to 158,000 in 2011.However, according to the official report, an
outbreak of measles is occurring throughout the regions of Ethiopia. Among these regions, Tigray
region has reported 6 outbreaks of measles from, 2011-2013. We received 4 clinically suspected
measles cases from 2 kebelles of the district from 6-10/2/2014. We investigated this cluster to
confirm its etiology, describe its magnitude, identify potential risk factors and make
recommendations.
Methods: We investigated measles outbreak from 6-24/2/2014 in Tsegedea district by a casecontrol
study. We recruited 20cases and 40controls by simple random sampling having a structured
questionnaire. We entered the data to Epi-Info, version 7.6.1 and exported to SPSS, version 16 for
analysis. We have computed the BMI, overcrowdings, vaccine efficacy (1-OR)*100 and herd
immunity (from 2012-2014).
Results: we detected a prevalence of 0.23/1000(29) with 100 %( 7) IgM positive in Tsegede
district. It was higher in males 51.8 %( 15) than females 48.2 %( 14).The median age was 9years
(8month-30years) with ASAR of 0.277/1000(1) for <1 years and 0.22/1000(15) in >=15 years age.
Majority of the cases were in Alemgenet Kebelle( 2.19/1000(10)) compared to the other 6 kebelles
that ranges 0.1/1000-1.1/1000.We computed a herd immunity of 73.1% and a vaccine efficacy of
94.1% for one dose vaccinated Vs non-vaccinated .55% of the cases enrolled to the study were
underweight .The vaccination of 1 dose and >=2 dose were a protective factor for developing
measles infection(i.e for 1 dose, AOR =0.059,95%CI(0.008-0.44), P-value=0.0060 ,for
>=2,AOR=.061,95%CI(0.004-0.9) ,P-value=0.045). Overcrowding was also highly associated with
the occurrence of measles outbreak (AOR= 8.42, 95%CI (1.76-40.1), P-value= 0.007).
2
Conclusion: compared to the national measles vaccination policy, the herd immunity was low with
higher vaccine efficacy. The vaccination status and overcrowding had a strong relationship with
measles infection separately. The measles outbreak was a propagative that lied majority of the cases
in >= 15 years age and specific areas of the district. So, that, a selective vaccination campaign,
improvements on housing condition and nutritional status of the community should be
implemented.
Description
Keywords
Epidemiology