Investigation of measles outbreak in Bangue health district: Challenges of control in an urban setting, Cameroon 2019

The current World Health Organization recommendations for response during measles epidemics focus on case management rather than outbreak response vaccination (ORV) campaigns, which may occur too late to impact morbidity and mortality and have a high cost per case prevented. Here, we explore the potential impact of an ORV campaign conducted during the 2003–2004 measles epidemic in Niamey, Niger. We measured the impact of this intervention and also the potential impact of alternative strategies. Using a unique geographical, epidemiologic and demographic dataset collected during the epidemic, we developed an individual-based simulation model. We estimate that a median of 7.6% [4.9–8.9] of cases were potentially averted as a result of the outbreak response, which vaccinated approximately 57% (84 563 of an estimated 148 600) of children in the target age range (6–59 months), 23 weeks after the epidemic started. We found that intervening early (up to 60 days after the start of the epidemic) and expanding the age range to all children aged 6 months to 15 years may lead to a much larger (up to 90%) reduction in the number of cases in a West African urban setting like Niamey. Our results suggest that intervening earlier even with lower target coverage (approx. 60%), but a wider age range, may be more effective than intervening later with high coverage (more than 90%) in similar settings. This has important implications for the implementation of reactive vaccination interventions as they can be highly effective if the response is fast with respect to the spread of the epidemic.

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Distribution and factors associated with urogenital schistosomiasis in the Tiko Health District, a semi-urban setting, South West Region, Cameroon

Infectious Diseases of Poverty ◽

10.1186/s40249-021-00827-2 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Adeline Enjema Green ◽

Judith Kuoh Anchang-Kimbi ◽

Godlove Bunda Wepnje ◽

Vicky Daonyle Ndassi ◽

Helen Kuokuo Kimbi

Keyword(s):

Urban Setting ◽

Health District ◽

Egg Load ◽

Urogenital Schistosomiasis ◽

Water Contact ◽

Factors Associated ◽

West Region ◽

South West ◽

Increased Risk ◽

South West Region

Abstract Background Increased risk of schistosomiasis in peri-urban and urban towns is not uncommon. An epidemiological survey was carried out in the Tiko Health District (THD), an unmapped transmission focus for urogenital schistosomiasis (UGS), to assess the distribution, intensity, and risk factors associated with the occurrence of UGS. Methods In this cross-sectional survey, 12 communities were purposively selected from four health areas (HAs) (Likomba, Holforth, Holforth-Likomba, and Mutengene) in South West Region of Cameroon between June and August 2018. Consenting individuals were enrolled using a convenient sampling technique and administered a semi-structured questionnaire to document information on socio-demographic and water contact behaviour. Urine samples were examined for Schistosomahaematobium infection using test strip, filtration, and microscopy methods. Bivariate and binary logistic regression analyses were used to identify predictors of infection. Results The overall prevalence of UGS in Likomba, Holforth-Likomba and Holforth was 31.5% [95% confidence interval (CI): 28.3–34.8] with geometric mean (GM) egg count of 28.7 (range: 2–450) eggs per 10 ml of urine. S.haematobium infection was not found in Mutengene HA. Infection was unevenly distributed among the HAs, Holforth-Likomba and Holforth being the most and least affected, respectively. The prevalence of infection varied (P < 0.001) among the affected communities, ranging from 12.0 to 56.9%. Infection status of the community related positively (P < 0.001) with proximity to stream (< 100 m), the degree of contact with water and number of improved water sources. Younger age group (5–14 years) [adjusted odds ratio (aOR): 3.7, 95% CI: 1.1–12.2] and intense water contact (degree II) (aOR: 5.2, 95% CI: 3.4–8.1) were associated with increased risk of infection. Similarly, significantly higher egg load was observed among younger aged groups (P = 0.02) and those who carried out intense water contact activities (P < 0.001). Conclusions Generally, THD is a moderate risk endemic focus for UGS but prevalence higher than 50.0% was observed in some communities. These findings warrant immediate mass chemotherapy with praziquantel to reduce morbidity. Provision of portable water and health education are proposed measures to reduce and eventually eliminate transmission in the area. Graphic abstract

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A locally initiated and executed measles outbreak response immunization campaign in the nylon health district, Douala Cameroon 2011

BMC Research Notes ◽

10.1186/1756-0500-6-100 ◽

2013 ◽

Vol 6 (1) ◽

Cited By ~ 2

Author(s):

Gerald Etapelong Sume ◽

André Arsène Bita Fouda ◽

Marie Kobela ◽

Salomé Nguelé ◽

Irène Emah ◽

...

Keyword(s):

Health District ◽

Outbreak Response ◽

Measles Outbreak ◽

Outbreak Response Immunization ◽

Immunization Campaign

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Distribution and Factors Associated With Urogenital Schistosomiasis in Tiko Health District, A Semi-urban Setting, South West Region, Cameroon

10.21203/rs.3.rs-101263/v1 ◽

2020 ◽

Author(s):

Adeline Enjema Green ◽

Judith Kuoh Anchang-Kimbi ◽

Godlove Bunda Wepnje ◽

Vicky Daonyle Ndassi ◽

Helen Kuokuo Kimbi

Keyword(s):

Urban Setting ◽

Health District ◽

Egg Load ◽

Cross Sectional Survey ◽

Urogenital Schistosomiasis ◽

Water Contact ◽

Cross Sectional ◽

Factors Associated ◽

Increased Risk ◽

Contact Behaviour

Abstract Background: Increased risk of schistosomiasis in peri-urban and urban towns is not uncommon. An epidemiological survey was carried out in the Tiko Health District (THD), an unmapped transmission focus for urogenital schistosomiasis (UGS), to assess the distribution, intensity and risk factors associated with the occurrence of UGS in the District. Methods: In this cross-sectional survey, 1029 individuals were enrolled from twelve communities purposively selected from four health areas (Likomba, Holforth, Holforth-Likomba and Mutengene) between June and August 2018. A semi-structured questionnaire was used to collect information on sociodemographic and water contact behaviour. Urine samples were examined for S. haematobium infection using test strip, filtration and microscopy methods. Bivariate and binary logistic regression analyses were used to identify predictors of infection. Results: The overall prevalence of UGS in the Likomba, Holforth-Likomba and Holforth was 31.5% (95% CI: 28.3 – 34.8). Schistosoma haematobium infection was not found in Mutengene HA. Infection was unevenly distributed among the HAs, Holforth-Likomba and Holforth being the most and least affected, respectively. The prevalence of infection varied (p < 0.001) among the affected communities, ranging from 0 – 56.9%. Infection status of the community related positively (p < 0.001) with proximity to stream (< 100m), the degree of contact (II) with water and number of improved water sources. Younger age group (5 – 14 years) (aOR = 3.6, 95% CI: 1.1 – 12.0) and intense water contact (Degree II) (aOR = 5.2, 95% CI: 3.4 – 8.1) were associated with increased risk of infection as well as higher worm egg load excretion. Conclusion: Generally, THD is a moderate risk endemic focus for UGS but prevalence higher than 50% was observed in some communities. These findings warrant immediate mass chemotherapy with praziquantel to reduce morbidity. Provision of portable water and health education are proposed measures to reduce and eventually eliminate transmission in the area.

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Measles outbreak investigation in a highly vaccinated community in the Centre region of Cameroon

Journal of Public Health in Africa ◽

10.4081/jphia.2021.1775 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Eposi C. Haddison ◽

Randolph A. Ngwafor ◽

Benjamin M. Kagina

Keyword(s):

Action Plan ◽

Vaccination Campaign ◽

Health District ◽

Outbreak Investigation ◽

Contact Tracing ◽

Routine Immunisation ◽

Measles Outbreak ◽

Outbreak Investigations ◽

Centre Region ◽

History Of

Background: Measles remains a threat in many African settings due to sub-optimal routine immunisation and catchup campaigns. The Global Vaccine Action Plan goal to eliminate measles by 2020 remains unmet as several countries reported an increase in cases in 2019. In Cameroon, a measles-rubella vaccination campaign was organised in 2019 to reduce the cohort of susceptible children. However, in 2020, eleven suspected cases of measles were notified in the Sa’a Health District and five were confirmed. Objective: This report summarizes a measles outbreak investigation and contact tracing in a highly vaccinated community residing in the Sa’a Health District of Cameroon. Methods: Outbreak investigations were carried out in the Sa’a, Nlong-Onambele and Nkolmgbana health areas from 18 to 21 February 2020. A register review from December 2019 to February 2020 was carried out in all health facilities of the affected health areas. followed by contact tracing in the community. Results: Thirty households were visited in four neighbourhoods. Six missed Epidemiologically-linked cases were discovered in the community, bringing the total number of suspected and confirmed cases to 17. Thirty-five percent of the cases had not received any measles-containing vaccine; 35% of the cases were aged 5 years or older; 53% had history of travel. Community transmission only occurred in the Sa’a health area through a breakthrough case. Conclusions: This outbreak investigation portrayed the role that adequate vaccination coverage plays in preventing widespread outbreaks. Nonetheless, community sensitisation and routine immunisation require strengthening in order to erase pockets of susceptible children.

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