scholarly journals Measles outbreak in Western Uganda: a case-control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abel Wilson Walekhwa ◽  
Moses Ntaro ◽  
Peter Chris Kawungezi ◽  
Chiara Achangwa ◽  
Rabbison Muhindo ◽  
...  

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.

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e039456
Author(s):  
Leolin Katsidzira ◽  
Wisdom F Mudombi ◽  
Rudo Makunike-Mutasa ◽  
Bahtiyar Yilmaz ◽  
Annika Blank ◽  
...  

IntroductionThe epidemiology of inflammatory bowel disease (IBD) in sub-Saharan Africa is poorly documented. We have started a registry to determine the burden, phenotype, risk factors, disease course and outcomes of IBD in Zimbabwe.Methods and analysisA prospective observational registry with a nested case–control study has been established at a tertiary hospital in Harare, Zimbabwe. The registry is recruiting confirmed IBD cases from the hospital, and other facilities throughout Zimbabwe. Demographic and clinical data are obtained at baseline, 6 months and annually. Two age and sex-matched non-IBD controls per case are recruited—a sibling or second-degree relative, and a randomly selected individual from the same neighbourhood. Cases and controls are interviewed for potential risk factors of IBD, and dietary intake using a food frequency questionnaire. Stool is collected for 16S rRNA-based microbiota profiling, and along with germline DNA from peripheral blood, is being biobanked. The estimated sample size is 86 cases and 172 controls, and the overall registry is anticipated to run for at least 5 years. Descriptive statistics will be used to describe the demographic and phenotypic characteristics of IBD, and incidence and prevalence will be estimated for Harare. Risk factors for IBD will be analysed using conditional logistic regression. For microbial analysis, alpha diversity and beta diversity will be compared between cases and controls, and between IBD phenotypes. Mann-Whitney U tests for alpha diversity and Adonis (Permutational Multivariate Analysis of Variance) for beta diversity will be computed.Ethics and disseminationEthical approval has been obtained from the Parirenyatwa Hospital’s and University of Zimbabwe’s research ethics committee and the Medical Research Council of Zimbabwe. Findings will be discussed with patients, and the Zimbabwean Ministry of Health. Results will be presented at scientific meetings, published in peer reviewed journals, and on social media.Trial registration numberNCT04178408.


2021 ◽  
Vol 15 (7) ◽  
pp. e0009477
Author(s):  
Placide Mbala-Kingebeni ◽  
Florian Vogt ◽  
Berthe Miwanda ◽  
Tresor Sundika ◽  
Nancy Mbula ◽  
...  

Background Behavioural risk factors for cholera are well established in rural and semi-urban contexts, but not in densely populated mega-cities in Sub-Saharan Africa. In November 2017, a cholera epidemic occurred in Kinshasa, the Democratic Republic of the Congo, where no outbreak had been recorded for nearly a decade. During this outbreak, we investigated context-specific risk factors for cholera in an urban setting among a population that is not frequently exposed to cholera. Methodology/Principal findings We recruited 390 participants from three affected health zones of Kinshasa into a 1:1 matched case control study. Cases were identified from cholera treatment centre admission records, while controls were recruited from the vicinity of the cases’ place of residence. We used standardized case report forms for the collection of socio-demographic and behavioural risk factors. We used augmented backward elimination in a conditional logistic regression model to identify risk factors. The consumption of sachet water was strongly associated with the risk of being a cholera case (p-value 0.019), which increased with increasing frequency of consumption from rarely (OR 2.2, 95% CI 0.9–5.2) to often (OR 4.0, 95% CI 1.6–9.9) to very often (OR 4.1, 95% CI 1.0–16.7). Overall, more than 80% of all participants reported consumption of this type of drinking water. The risk factors funeral attendance and contact with someone suffering from diarrhoea showed a p-value of 0.09 and 0.08, respectively. No socio-demographic characteristics were associated with the risk of cholera. Conclusions/Significance Drinking water consumption from sachets, which are sold informally on the streets in most Sub-Saharan African cities, are an overlooked route of infection in urban cholera outbreaks. Outbreak response measures need to acknowledge context-specific risk factors to remain a valuable tool in the efforts to achieve national and regional targets to reduce the burden of cholera in Sub-Saharan Africa.


2021 ◽  
Vol 7 (1) ◽  
pp. 59-64
Author(s):  
St. Malka ◽  
Musni Musni ◽  
Sitti Fatimah

ABSTRACT EARLY PREGNANCY, ANTENATAL CARE, ESCLUSIVE BREASTFEEDING AND NUTRITIONAL KNOWLEDGE TO STUNTING IN CHIDREN UNDER FIVE Background: stuntingis a major nutritional problem that will have an impact on social and economic life in society. Stunting is a problem because it is associated with an increased risk of illness and death, suboptimal brain development, resulting in delayed motor development and stunted mental growth. Bone is one of the district in south Sulawesi high prevalence of stunting compared with province and national.Purpose  To determine risk factors early pregnancy, antenatal care, esclusive breastfeeding and nutritional knowledge on stunting among children 12-59 months old.Mathods:The study used is quantitative witch a designed  case-control study. It was conducted in Kading health centre, Bajoe health centre, and Usa health centre.  with the research time May-Juli 2020. The subjects were children between 12-59 month. The sample in this study were 120 consisting of 40 stunted and 80 normal with gender matching. Subject were chosen by purposive sampling methode. The risk factor were early pregnancy, antenatal care, esclusive breastfeeding, and nutritional knowledge. Data were analyzed by univariate, bivariate with chis-quare test and odds ratio with 95% confidence interval   Results: The results showed that factors associated with stunting were early pregnancy (P = 0.003) and antenatal care with (P = 0.033), while exclusive breastfeeding (P = 0.892) and maternal nutritional knowledge (P = 0.404) were not associated with stunting in under-five. . Early pregnancy variable is the dominant variable in the occurrence of stunting in children under five. Early childhood pregnancy has a 5.00 times higher risk of stunting in children under five compared to mothers who are pregnant at adulthood, and mothers not antenatal care during pregnancy have 2.68 times the risk of stunting compared to mothers antenatal care visit during pregnancy.Conclusion: The risk factors for stunting  were early pregnancy and antenatal careSuggestion It is hoped that the government will be even more stringent on the implementation of early marriage, so that there will be no more early marriages and can prevent stunting in toddlers. Keywords: stunting, early pregnancy,  antenatal care ABSTRAK Latar belakang :Stunting adalah masalah gizi utama yang akan berdampak pada kehidupan sosial dan ekonomi dalam masyarakat.  Stunting menjadi permasalahan karena berhubungan dengan menungkatnya risiko terjadinya kesakitan dan kematian, perkembangan otak suboptimal sehingga perkembangan motoric terlambat  dan terhambatnya pertumbuhan Kabupaten Bone meruapakan salah satu kabupaten di Sulawesi Selatan dengan angka stunting yang cukup signifikan melebihi prevalensi stunting provinsi dan nasional.Tujuan: untuk menganalisis factor risiko kehamilan usia dini, antenatal care, ASI eksklusif dan pengetahuan gizi ibu terhadap stunting pada balita usia 12 – 59 bulanMetode : Penelitian yang digunakan adalah penelitian kuantitatif dengan pendekatan Case Control Study. Penelitian dilakukan di tiga puskesmas yaitu Puskesmas Kading, Puskesmas Bajoe dan Puskesmas Usa. Penelitian dilakukan pada bulan Mei-Juli 2020. dengan subjek adalah anak umur 12 – 59 bulan. Sampel dalam penelitian ini sebanyak 120 balita yang terdiri dari 40 kasus (balita stunting) dan 80 kontrol (balita normal/tidak stunting) dengan Matching jenis kelamin. Metode penarikan sampel yang digunakan adalah purposive sampling. Factor risiko yang diukur adalah kehamilan usia dini, antenatal care (ANC), ASI eksklusif dan pengetahuan gizi ibu. Data dianalisis dengan chi square dan Odds Ratio (OR) 95% CI.Hasil :  Hasil penelitian menunjukkan faktor yang berhubungan dengan stunting adalah kehamilan usia dini (P=0,003) dan antenatal care dengan (P=0.033), sedangkan ASI eksklusif  (P=0,892) dan pengetahuan gizi ibu (P=0,404) tidak berhubungan dengan stunting pada balita. Variabel kehamilan usia dini merupakan variable dominan terjadinya stunting pada balita. Kehamilan usia dini memiliki risiko 5,00 kali lebih tiinggi untuk mengalami stunting pada balita dibandingkan ibu yang hamil pada usia dewasa, ibu yang tidak melakukan antenatal care memiliki risiko 2,68 kali mengalami stunting dibanding ibu yang melakukan pemeriksaan antenatal care. Kesimpulan: kehamilan usia dini dan antenatal care merupakan factor risiko terjadinya stunting pada balitaSaran Diharapkan pemeritah lebih ketat lagi terhadap pelaksanaan pernikahan usia dini, agar tidak ada lagi pernikahan usia dini dan bisa mencegah terjadinya stunting pada balita Kata kunci : stunting, kehamilan Dini, antenatal care  


2010 ◽  
Vol 138 (9) ◽  
pp. 1292-1297 ◽  
Author(s):  
W. LIU ◽  
R. V. GIBBONS ◽  
K. KARI ◽  
J. D. CLEMENS ◽  
A. NISALAK ◽  
...  

SUMMARYJapanese encephalitis (JE) has been found to be endemic in Bali, Indonesia. A case-control study was conducted to identify factors associated with JE infection. All 94 serologically confirmed JE cases (cases) and 163 cases of encephalitis or aseptic meningitis without JE (controls) identified in Bali during 2001–2004 were included in the study. Potential risk factors were surveyed at hospital admission. Univariate analyses revealed the following factors to be associated with JE: older age, referral from sub-district health centre or private hospital, playing outdoors after dinner, use of mosquito repellent or spraying, proximity of the residence to rice fields, and pig ownership by the family or next-door neighbours. Multivariate analysis identified proximity to rice fields (OR 2·93, 95% CI 1·57–5·45), pig ownership (OR 2·24, 95% CI 1·17–4·26), and older age (OR 1·21, 95% CI 1·09–1·33) as being independently associated with the risk of JE. Because rice cultivation and pig rearing are essential to the economy of Bali, JE immunization is the best intervention for prevention of JE in Bali.


Vaccine ◽  
2012 ◽  
Vol 30 (33) ◽  
pp. 5000-5008 ◽  
Author(s):  
Sarah Kidd ◽  
Bassirou Ouedraogo ◽  
Chantal Kambire ◽  
Jean Ludovic Kambou ◽  
Huong McLean ◽  
...  

PLoS ONE ◽  
2014 ◽  
Vol 9 (11) ◽  
pp. e112299 ◽  
Author(s):  
Justus Kafunjo Barageine ◽  
Nazarius Mbona Tumwesigye ◽  
Josaphat K. Byamugisha ◽  
Lars Almroth ◽  
Elisabeth Faxelid

Rheumatology ◽  
2020 ◽  
Vol 59 (12) ◽  
pp. 3807-3816 ◽  
Author(s):  
Tiphaine Lenfant ◽  
Sawsen Salah ◽  
Gaëlle Leroux ◽  
Elodie Bousquet ◽  
Véronique Le Guern ◽  
...  

Abstract Objective HCQ is an essential medication in SLE, proven to lengthen survival and reduce flares. Its use, however, is limited by its rare but severe ophthalmological complications. Here, we aimed to analyse factors associated with HCQ retinopathy including HCQ blood levels. Methods This case–control study compared SLE patients with and without HCQ retinopathy, defined by abnormal results for at least two of the following ophthalmological tests: automated visual fields, spectral-domain optical coherence tomography (SD-OCT), multifocal electroretinogram (mfERG) and fundus autofluorescence. We compared clinical and laboratory findings to assess risk factors for HCQ retinopathy. Results The study included 23 patients with confirmed retinopathy (cases) and 547 controls. In the univariate analysis, age (P < 0.001), height (P = 0.045), creatinine clearance (P < 0.001), haemoglobin concentration (P = 0.01), duration of HCQ intake, (P < 0.001), higher cumulative HCQ dose (P < 0.001) and geographical origin (West Indies and sub-Saharan Africa) (P = 0.007) were associated with the risk of retinopathy, while HCQ blood levels were not. In the multivariate analysis, only cumulative dose (P = 0.016), duration of intake (P = 0.039), creatinine clearance (P = 0.002) and geographical origin (P < 0.0001, odds ratio 8.7) remained significantly associated with retinopathy. Conclusion SLE patients on HCQ should be closely monitored for retinopathy, especially those from the West Indies or sub-Saharan Africa, or with renal insufficiency, longer HCQ intake or a high cumulative dose. Although reducing the daily dose of HCQ in patients with persistently high HCQ blood levels seems logical, these concentrations were not associated with retinopathy in this study with controls adherent to treatment.


2001 ◽  
Vol 120 (5) ◽  
pp. A442-A442
Author(s):  
B AVIDAN ◽  
A SONNENBERG ◽  
T SCHNELL ◽  
G CHEJFEC ◽  
A METZ ◽  
...  

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