Measles outbreak in Burkina Faso, 2009: A case–control study to determine risk factors and estimate vaccine effectiveness

Abstract Background: Measles is a highly infectious viral disease. In August 2017, Lyantonde District, Uganda reported a measles outbreak to Uganda Ministry of Health. We investigated the outbreak to assess the scope, factors facilitating transmission, and recommend control measures. Methods: We defined a probable case as sudden onset of fever and generalized rash in a resident of Lyantonde, Lwengo, or Rakai Districts from 1 June-30 September 2017, plus ≥1 of the following: coryza, conjunctivitis, or cough. A confirmed case was a probable case with serum positivity of measles-specific IgM. We conducted a neighborhood- and age-matched case-control study to identified exposure factors, and used conditional logistic regression to analyze the data. We estimated vaccine effectiveness and vaccination coverage. Findings: We identified 81 cases (75 probable, 6 confirmed); 4 patients (4.9%) died. In the case-control study, 47% of case-patients and 2.3% of controls were hospitalized at Lyantonde Hospital pediatric department for non-measles conditions 7-21 days before case-patient’s onset (OR adj =34, 95%CI: 5.1-225). Estimated vaccine effectiveness was 95% (95%CI: 75-99%) and vaccination coverage was 76% (95%CI: 68-82%). During the outbreak, an “isolation” ward was established inside the general pediatric ward where there was mixing of both measles and non-measles patients. Conclusions This outbreak was amplified by nosocomial transmission and facilitated by low vaccination coverage. We recommended moving the isolation ward outside of the building, supplemental vaccination, and vaccinating pediatric patients during measles outbreaks.

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Rotavirus Vaccine Effectiveness and Case-control Study on Risk Factors for Breakthrough Infections in Germany, 2010–2011

The Pediatric Infectious Disease Journal ◽

10.1097/inf.0b013e3182720b71 ◽

2013 ◽

Vol 32 (2) ◽

pp. e82-e89 ◽

Cited By ~ 41

Author(s):

Cornelia Adlhoch ◽

Marina Hoehne ◽

Martina Littmann ◽

Andreas Mas Marques ◽

Almuth Lerche ◽

...

Keyword(s):

Risk Factors ◽

Case Control Study ◽

Case Control ◽

Vaccine Effectiveness ◽

Rotavirus Vaccine ◽

Control Study

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Measles Outbreak Amplified in a Pediatric Ward: Lyantonde District, Uganda, August 2017

10.21203/rs.2.12738/v1 ◽

2019 ◽

Author(s):

Claire Biribawa ◽

Joselyn Annet Atuhairwe ◽

Lilian Bulage ◽

Denis Othuba Okethwangu ◽

Benon Kwesiga ◽

...

Keyword(s):

Vaccination Coverage ◽

Case Control Study ◽

Conditional Logistic Regression ◽

Case Control ◽

Vaccine Effectiveness ◽

Pediatric Ward ◽

Probable Case ◽

Measles Outbreak ◽

Isolation Ward ◽

Control Study

Abstract Background Measles is a highly infectious viral disease. In August 2017, Lyantonde District, Uganda reported a measles outbreak to Uganda Ministry of Health. We investigated to assess the outbreak scope, factors facilitating transmission, and recommend control measures. Methods We defined a probable case as sudden onset of fever and generalized rash in a resident of Lyantonde, Lwengo, or Rakai Districts from 1 June-30 September 2017, plus ≥1 of the following: coryza, conjunctivitis, or cough. A confirmed case was a probable case with serum positivity of measles-specific IgM. We conducted a neighborhood- and age-matched case-control study to identified exposure factors, and used conditional logistic regression to analyze the data. We estimated vaccine effectiveness and vaccination coverage. Findings We identified 81 cases (75 probable, 6 confirmed); 4 patients (4.9%) died. In the case-control study, 47% of case-patients and 2.3% of controls were hospitalized at Lyantonde Hospital pediatric department for non-measles conditions 7-21 days before case-patient’s onset (ORadj=34, 95%CI: 5.1-225). Estimated vaccine effectiveness was 95% (95%CI: 75-99%) and vaccination coverage was 76% (95%CI: 68-82%). During the outbreak, an “isolation” ward was established inside the pediatric ward. Measles and non-measles patients were mixed in regular pediatric wards. Conclusion This outbreak was amplified by nosocomial transmission and facilitated by low vaccination coverage. We recommended moving the isolation ward outside of the building, supplemental vaccination, and vaccinating pediatric patients during measles outbreaks.

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Measles Outbreak Amplified in a Pediatric Ward: Lyantonde District, Uganda, August 2017

10.21203/rs.2.12738/v2 ◽

2019 ◽

Author(s):

Claire Biribawa ◽

Joselyn Annet Atuhairwe ◽

Lilian Bulage ◽

Denis Othuba Okethwangu ◽

Benon Kwesiga ◽

...

Keyword(s):

Vaccination Coverage ◽

Case Control Study ◽

Conditional Logistic Regression ◽

Case Control ◽

Vaccine Effectiveness ◽

Pediatric Ward ◽

Probable Case ◽

Measles Outbreak ◽

Isolation Ward ◽

Control Study

Abstract Background: Measles is a highly infectious viral disease. In August 2017, Lyantonde District, Uganda reported a measles outbreak to Uganda Ministry of Health. We investigated to assess the outbreak scope, factors facilitating transmission, and recommend control measures. Methods: We defined a probable case as sudden onset of fever and generalized rash in a resident of Lyantonde, Lwengo, or Rakai Districts from 1 June-30 September 2017, plus ≥1 of the following: coryza, conjunctivitis, or cough. A confirmed case was a probable case with serum positivity of measles-specific IgM. We conducted a neighborhood- and age-matched case-control study to identified exposure factors, and used conditional logistic regression to analyze the data. We estimated vaccine effectiveness and vaccination coverage. Findings: We identified 81 cases (75 probable, 6 confirmed); 4 patients (4.9%) died. In the case-control study, 47% of case-patients and 2.3% of controls were hospitalized at Lyantonde Hospital pediatric department for non-measles conditions 7-21 days before case-patient’s onset (ORadj=34, 95%CI: 5.1-225). Estimated vaccine effectiveness was 95% (95%CI: 75-99%) and vaccination coverage was 76% (95%CI: 68-82%). During the outbreak, an “isolation” ward was established inside the pediatric ward. Measles and non-measles patients were mixed in regular pediatric wards. Conclusion:This outbreak was amplified by nosocomial transmission and facilitated by low vaccination coverage. We recommended moving the isolation ward outside of the building, supplemental vaccination, and vaccinating pediatric patients during measles outbreaks.

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Epidemiology, vaccine effectiveness, and risk factors for mortality for pneumococcal disease among hospitalised adults in Singapore: a case-control study

10.21203/rs.2.13072/v4 ◽

2020 ◽

Author(s):

Tyson Chan ◽

Min Zhi Tay ◽

Win Mar Kyaw ◽

Angela Chow ◽

Hanley J Ho

Keyword(s):

Risk Factors ◽

Pneumococcal Disease ◽

Case Control Study ◽

Pneumococcal Vaccination ◽

Case Control ◽

Vaccine Effectiveness ◽

Adjusted Relative Risk ◽

Factors Associated ◽

Icu Admission ◽

Control Study

Abstract Background: Streptococcus pneumoniae infections can lead to severe morbidity and mortality, especially in patients with invasive pneumococcal disease (IPD). This study evaluated factors associated with pneumococcal disease, pneumococcal vaccine effectiveness, and risk factors for all-cause mortality in hospitalised adults with pneumococcal disease in Singapore. Methods: Retrospective case-control study of patients tested for pneumococcal disease with streptococcal urinary antigen testing and at least one sterile site culture, during their admission to a tertiary hospital in Singapore from 2015-2017. Patients were defined as cases of IPD or non-IPD, or as controls, based on laboratory results and clinical diagnoses. Multivariable models were constructed to determine factors associated with IPD/non-IPD, and risk factors for mortality from pneumococcal disease. Vaccine effectiveness against IPD/non-IPD was estimated using a variation of the test-negative design. Results: We identified 496 pneumococcal disease cases, of whom 92 (18.5%) had IPD. The mean age of cases was 69.1±15.4yrs, and 65.5% were male. Compared with controls (N=9,181), IPD patients were younger (mean age 61.5±16.3yrs, vs 72.2±16.1yrs in controls; p<0.001) and with less co-morbidities [median Charlson’s score 1 (IQR 0-4), vs 3 (1-5) in controls; p<0.001]. IPD patients also had the highest proportions with intensive care unit (ICU) admission (20.7%), inpatient mortality (26.1%) and longest median length of stay [9 (IQR 8-17) days]. On multivariable analysis, IPD was negatively associated with prior pneumococcal vaccination (adjusted relative risk ratio=0.20, 95%CI 0.06–0.69; p=0.011). Risk factors for mortality among pneumococcal disease patients were ICU admission, diagnosis of IPD, age ≥85yrs and Charlson’s score >3.Conclusion: Patients with pneumococcal disease (especially IPD) were younger and had less co-morbidities than controls, but had higher risk of severe clinical outcomes and mortality. Pneumococcal vaccination effectiveness against IPD was estimated to be about 80%, and should be encouraged among high-risk patients.

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Measles outbreak in Western Uganda: a case-control study

BMC Infectious Diseases ◽

10.1186/s12879-021-06213-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Abel Wilson Walekhwa ◽

Moses Ntaro ◽

Peter Chris Kawungezi ◽

Chiara Achangwa ◽

Rabbison Muhindo ◽

...

Keyword(s):

Risk Factors ◽

Data Collection ◽

Case Control Study ◽

Health Centre ◽

Case Control ◽

Health Systems Strengthening ◽

Sub Saharan Africa ◽

Measles Outbreak ◽

Western Uganda ◽

Control Study

Abstract Background Measles outbreaks are prevalent throughout sub-Saharan Africa despite the preventive measures like vaccination that target under five-year-old children and health systems strengthening efforts like prioritizing the supply chain for supplies. Measles immunization coverage for Kasese district and Bugoye HC III in 2018 was 72 and 69%, respectively. This coverage has been very low and always marked red in the Red categorization (below the national target/poor performing) on the national league table indicators. The aim of this study was to assess the scope of the 2018–2019 measles outbreak and the associated risk factors among children aged 0–60 months in Bugoye sub-county, Kasese district, western Uganda. Methods We conducted a retrospective unmatched case-control study among children aged 0–60 months with measles (cases) who had either a clinical presentation or a laboratory confirmation (IgM positivity) presenting at Bugoye Health Centre III (BHC) or in the surrounding communities between December 2018 and October 2019.. Caregivers of the controls (whose children did not have measles) were selected at the time of data collection in July 2020. A modified CDC case investigation form was used in data collection. Quantitative data was collected and analyzed using Microsoft excel and STATA version 13. The children’s immunization cards and health registers at BHC were reviewed to ascertain the immunization status of the children before the outbreak. Results An extended measles outbreak occurred in Bugoye, Uganda occured between December 2018 and October 2019. All 34 facility-based measles cases were documented to have had maculopapular rash, conjunctivitis, and cough. Also, the majority had fever (97%), coryza (94.1%), lymphadenopathy (76.5%), arthralgias (73.5%) and Koplik Spots (91.2%) as documented in the clinical registers. Similar symptoms were reported among 36 community-based cases. Getting infected even after immunized, low measles vaccination coverage were identified as the principal risk factors for this outbreak. Conclusion Measles is still a significant problem. This study showed that this outbreak was associated with under-vaccination. Implementing a second routine dose of measles-rubella vaccine would not only increase the number of children with at least one dose but also boost the immunity of those who had the first dose.

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