A ASSESSMENT OF RISK FACTORS AND DETERMINATION OF VACCINE EFFICACY FOR MEASLES OUTBREAK DURING APRIL 2017 IN DHOK KAZIN, ISLAMABAD

Background: On 13th April 2017, 3 measles cases were reported in Dhok Kazin, Islamabad to National Institute of Health, Islamabad. Federal Disease Surveillance & Response Unit on request of Islamabad Capital Territory (ICT) health administration started disease outbreak investigation and active case finding. The study was aimed to identify risk factors associated with disease outbreak, to assess vaccine coverage and vaccine efficacy in the outbreak area, and to suggest control measures. Methods: To determine possible risk factors age and sex matched case-control study was conducted in April, 2017. A case was defined as "Any resident of Dhok Kazin, presented with fever and maculopapular rash with any of signs/symptoms like coryza, conjunctivitis, cough, otitis media or pneumonia after March 20 to April 30, 2017". For each case 04 matched controls were selected. A structured questionnaire prepared to collect data. Vaccine coverage survey was conducted. Uni and multivariate analyses and vaccine efficacy were calculated. Results: A total of 14 cases identified including 11 cases found on active search. Cases were compared with 57 matched controls. Mean age was 39 months (range 08- 132 months). Among cases male to female ratio observed was 1:2.5. Overall attack rate was 1.2%, while most severely affected age-group was <12 months (AR=10.3%). The most common complications were diarrhea n=8 (57.1%) and pneumonia n=1 (7.1%). On vaccine coverage survey in 230 households, 31(70.5%) out of 44 children checked were vaccinated. The un-vaccinated children had attack rate of 14.3% while vaccinated had attack rate of 6.7%. The vaccine efficacy calculated was 53%. Significant association found in risk factors were; contact with positive case [OR 19.5, 95% CI; 4.5-84, P=0.00], unvaccinated children [OR=10.0, 95%, CI;1.2.0-49.3, P= 0.003], Mother illiteracy [OR 10.2, 95% CI; 2.5-41, P=0.00], Misconception about vaccination [OR 13.2, 95%, CI;3.1-57.1, P=0.00), vaccinator not visited home as a part of outreach activity [OR=6.4, 95%CI;1.7-23.4, P=0.00]. Reasons for non-vaccination were found to be misconception about vaccination (OR=34.8, 95%CI=5.5-219.7) and mother's illiteracy (OR=6.4, 95%CI=1.2-34.8). Conclusion: Most severely affected age group was 12 months and below. Low immunization rates were the most probable cause of outbreak. Case contacts, partial vaccination, misconception of vaccination, no visit of vaccinator to home, and mother's education were risk factors significantly associated with Measles outbreak. Findings were shared with the district health authorities for implementation of control measures.

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[Investigation of a measles epidemic in Kouf, Tetouan Province, Morocco]

Eastern Mediterranean Health Journal ◽

10.26719/1997.3.3.493 ◽

1997 ◽

Vol 3 (3) ◽

pp. 493-500

Author(s):

I. Cherkaoui

Keyword(s):

Risk Factors ◽

Vaccine Efficacy ◽

Attack Rate ◽

School Attendance ◽

Vaccine Coverage ◽

Age Group ◽

Brothers And Sisters

The investigation of a measles epidemic that occurred in May 1995 in the locality of Kouf [Province of Tetouan] detected 64 cases of measles among 281 children below 15 years of age. The attack rate was 22.8%. The most affected age group was 1-3 years. Age, sex, sublocality, school attendance and number of brothers and sisters did not seem to be risk factors for measles in this epidemic. The vaccine coverage among children aged 9 to 59 months was 83.8% with or without vaccination document and 92.7% with document. The vaccine efficacy in children 9 months to 3 years of age was 40%. Further investigations would be needed in order to clarify the reasons for this low percentage

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MEASLES OUTBREAK IN A RURAL AREA OF A DEVELOPING COUNTRY: A CASE CONTROL STUDY

Pakistan Journal of Public Health ◽

10.32413/pjph.v7i4.78 ◽

2018 ◽

Vol 7 (4) ◽

pp. 197-201

Author(s):

Mir M Hassan Bullo ◽

Mirza Amir Baig ◽

Jawad Faisal Malik ◽

Ejaz Ahmad Khan ◽

Muazam Abbas Ranjha ◽

...

Keyword(s):

Risk Factors ◽

Vaccine Coverage ◽

Significant Risk ◽

Public Health Problem ◽

Maculopapular Rash ◽

Healthcare Facility ◽

Control Measures ◽

Major Public Health Problem ◽

District Health ◽

Active Case

Background: Measles is highly contagious vaccine preventable disease (VPD), and a major public health problem considered as leading cause of morbidity and mortality in developing countries like Pakistan. An outbreak of measles was reported in Sharifabad Islamabad on 15th of April 2017, and an investigation was launched to assess the magnitude of outbreak, evaluate risk factors and recommend control measures. Methods: A comprehensive house to house active case search along with vaccine coverage survey was conducted from April 19-22, 2017. A case was defined as "onset of maculopapular rash with fever in a resident of Sharifabad with at least one of the following signs/ symptoms, Coryza, Conjunctivitis, Cough, Otitis media or Pneumonia present in between 19 March to 22nd April 2017". Four age & sex matched controls were selected from the neighborhood. Data was collected through interview method using structured questionnaire and vaccination coverage was determined by using Epi survey form. Blood samples were sent for laboratory confirmation. Results: A total of eight cases were identified through active case finding while three were reported by local practitioner. Mean age of cases were 20 months (range 8-36 months). Severely affected age-group was 1-2 years with attack rate of 46%. Around two-third (64%) of cases and a few (16%) of controls were unvaccinated against measles. Contact with measles patient [OR 25.2, CI 3.9-160.1, P=0.00], unvaccinated children [OR 9.2 CI 2.12-40.4, P=0.000], social misconception regarding vaccination [OR 7.8 CI 1.42-42.6, P=0.00], and distance from healthcare facility [OR 5.7 CI 1.15-28.35, P=0.02] were significant risk factors. Vaccine efficacy was 90%. Conclusion: Main reasons of the outbreak were contact with the cases, and low vaccination status. We recommended comprehensive measles vaccination and community awareness sessions. On our recommendations district health authority Islamabad carried out mop up of whole area.

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The role of young children in a community-wide outbreak of hepatitis A

Epidemiology and Infection ◽

10.1017/s0950268897007462 ◽

1997 ◽

Vol 118 (3) ◽

pp. 243-252 ◽

Cited By ~ 68

Author(s):

P. F. SMITH ◽

J. C. GRABAU ◽

A. WERZBERGER ◽

R. A. GUNN ◽

H. R. ROLKA ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Relative Risk ◽

Jewish Community ◽

Attack Rate ◽

Odds Ratio ◽

Hepatitis A ◽

Age Group ◽

Recurrent Hepatitis

An Hasidic Jewish community has experienced recurrent hepatitis A outbreaks since 1980. To assess risk factors for illness during a 1985–6 outbreak, the authors reviewed case records and randomly selected 93 households for an interview and serologic survey. In the outbreak, 117 cases of hepatitis A were identified, with the highest attack rate (4·2%) among 3–5 year olds. Among the survey households, the presence of 3–5 year olds was the only risk factor that increased a household's risk of hepatitis A (indeterminant relative risk, P=0·02). Furthermore, case households from the outbreak were more likely to have 3–5 year olds than were control households from the survey (odds ratio=16·4, P<0·001). Children 3–5 years old were more likely to have hepatitis A and may have been the most frequent transmitters of hepatitis A in this community. Hepatitis A vaccination of 3–5 year olds can protect this age group and might prevent future outbreaks in this community.

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Measles outbreak: preliminary report on a case series of the first 8,070 suspected cases, Manaus, Amazonas state, Brazil, February to November 2018

Eurosurveillance ◽

10.2807/1560-7917.es.2019.24.2.1800663 ◽

2019 ◽

Vol 24 (2) ◽

Cited By ~ 6

Author(s):

Guilherme Almeida Elidio ◽

Giovanny Vinícius Araújo de França ◽

Flávia Caselli Pacheco ◽

Marinélia Martins Ferreira ◽

Jair dos Santos Pinheiro ◽

...

Keyword(s):

Measles Virus ◽

Vaccine Coverage ◽

Case Series ◽

Control Measures ◽

Measles Outbreak ◽

Current Scenario ◽

Current Outbreak ◽

Prevention And Control Measures ◽

Amazonas State ◽

And Control

We report an ongoing measles outbreak in Manaus, Amazonas state, Brazil. As at 3 November 2018, 1,631 cases were confirmed corresponding to an incidence of 75.3 per 100,000 inhabitants; all five sanitary districts presented confirmed cases. Reintroduction of measles virus in Manaus is likely related to the current outbreak in Venezuela and due to recent decline in measles vaccine coverage. Given the current scenario, prevention and control measures should target individuals aged 15–29 years.

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Contaminated Pond Water Favors Cholera Outbreak at Haibatpur Village, Purba Medinipur District, West Bengal, India

Journal of Tropical Medicine ◽

10.1155/2014/764530 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

Dilip Kumar Biswas ◽

Rama Bhunia ◽

Dipankar Maji ◽

Palash Das

Keyword(s):

Risk Factors ◽

Attack Rate ◽

Stool Specimen ◽

West Bengal ◽

Health Workers ◽

Pond Water ◽

Underground Water ◽

Control Measures ◽

Cholera Outbreak ◽

Epidemic Curve

Health workers reported an increased number of diarrhea cases at Haibatpur village on June 17, 2012. This outbreak was investigated with the followingobjectives: to confirm the existence of diarrhea outbreak, to find out the risk factors, and propose control measures. Cases were listed; spot map and epidemic curve were drawn. Attack rate was calculated by age and sex and risk factors were found out by calculating odds ratio (OR) with 95% confidence interval (CI). Rectal swabs were taken and water specimens were collected for laboratory test. Forty-one cases of patients were identified with overall attack rate (AR) was 5% (41/780). AR among men was higher 6% (25/404) than women. There was no death.V. cholerae01 Eltor Ogawa was isolated from one (1/4) stool specimen. Spot map showed cases clustered around two ponds which were contaminated with coliform organisms. The underground water was a bit saline in nature. Using pond water for preparation of fermented rice (Panta Bhat) (OR 4.73, 95% CI 1.69–13.51), washing utensil in pond water (OR 7.31, 95% CI 1.77–42.29) were associated with cholera outbreak. Health education was done to villagers. Disinfection of two ponds with bleaching powder was done. We proposed supplying of safe drinking water and repairing defective deep tube well to village.

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Epidemiology of fractures in indoor patients at a tertiary care centre in India: a study of 3000 cases

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20214958 ◽

2021 ◽

Vol 8 (1) ◽

pp. 39

Author(s):

Mohan M. Desai ◽

Deven R. Kuruwa ◽

Easwar Elango ◽

Roshan Wade

Keyword(s):

Road Traffic ◽

Tertiary Care ◽

Age Groups ◽

Control Measures ◽

Age Group ◽

Care Centre ◽

Tertiary Care Centre ◽

Treatment Protocols ◽

Female Ratio ◽

Femur Fractures

Background: Implementing appropriate fracture control measures and treatment protocols is crucial to maximizing health and development gains. This requires an in depth understanding of age-specific, sex-specific and cause-specific injury patterns at the national and subnational levels. No such study on fracture epidemiology has been undertaken in the Indian population.Methods: Study was conducted in a tertiary care centre (KEM hospital, Mumbai) which is one of the highest volume trauma centres in the country. Data of 3000 patients was obtained from the medical records department for the year 2016-2019. Patients were segregated with respect to their genders and into three age groups. Etiology of fracture was noted, and fractures classified according to the anatomical area. Whether the patient received conservative or operative management was also recorded.Results: 43.83% of the fractures occurred in 18-50 years age group. 41.33% in the above 50 group and only 14.73% in the below 18 age group. Overall male to female ratio was 1.4: 1. Vehicular accident was the most common mode of injury (47.07%) followed by fall from height (21.03%). Proximal femur fractures were the most common accounting for 19.57% of all fractures followed by forearm (10.53%), tibia diaphysis (8.10%). Talus was the least common. 81.07% cases were managed operatively and 18.93% conserved.Conclusions: Our study highlights that Indian epidemiology is unique from our Western counterparts. Population affected is much younger, old age males are affected more than females. Lower limb fractures are more prevalent and road traffic accidents are responsible for almost half the fractures.

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Demographic Factors of Suicide in Chittagong

Chattagram Maa-O-Shishu Hospital Medical College Journal ◽

10.3329/cmoshmcj.v16i2.37286 ◽

2018 ◽

Vol 16 (2) ◽

pp. 14-16

Author(s):

Kazal Kanti Barua ◽

M Jalal Uddin ◽

Sumon Mutsuddy ◽

AYM Masud Reza Khan ◽

Ashim Barua

Keyword(s):

Risk Factors ◽

High Risk ◽

Secondary Data ◽

Descriptive Study ◽

Professional Group ◽

Age Group ◽

Female Ratio ◽

High Risk Factors ◽

The World ◽

Male Female Ratio

Background: Suicide is a devastating problem. It is to some extent preventable if we are aware of its factors. These factors vary according to community, cast and creed. Many studies were conducted at many places of the world but there is none in Chittagong. To know the high risk factors of suicide in Chittagong we have conducted the study.Methods : It was a descriptive study. Secondary data were used. All suicidal reports of Chittagong mortuary in 2012 were studied. Collected data were managed manually. Results were contrasted with recent studies of home & abroad.Results: Total 165 reports were studied. Majority of the victims 128(78%) were of 15-45 years age group. Male female ratio was 49: 51. Married victims were 109(66%). Muslims 125(76%). Majority of the victims 104(63%) were poorly literate (<SSC). Commonest profession of the victims was ‘housewife’57(35%). Next professional group was lower subordinate staffs 49(30%). Commonest method of suicide was Hanging 83(50%). Family feud was the commonest cause of suicide and it was 72(44%).Conclusion: Commonest demographic factor of suicide in Chittagong is ‘Family Feud’ It is mostly manageable and thus we can prevent suicide occurrence significantly. So, everybody should come forward to remove causes of family feud and others for a noble humanitarian cause.Chatt Maa Shi Hosp Med Coll J; Vol.16 (2); July 2017; Page 14-13

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Risk factors for measles outbreak in Ataq and Habban districts, Shabwah governorate, Yemen, February to May 2018

BMC Infectious Diseases ◽

10.1186/s12879-021-06207-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Abdulkareem Ali Hussein Nassar ◽

Mohammed Abdullah Al Amad ◽

Mohammed Qasim ◽

Fekri Dureab

Keyword(s):

Risk Factors ◽

Vaccination Campaign ◽

Immunization Coverage ◽

Case Definition ◽

Control Measures ◽

Surveillance Program ◽

Contributing Factors ◽

Measles Outbreak ◽

Surveillance And Response ◽

Immunization Services

Abstract Background Recent conflict and war in Yemen lead to collapse of the health system, decrease of immunization coverage and spread of many outbreaks. On May 22, 2018, the surveillance officer in Shabwah governorate reported an increased number of suspected measles. On May 24, 2018, a team from Yemen-Field Epidemiology Training Program was sent to investigate. The aims were to describe the outbreak, determine the risk factors for measles infection and recommend control measures. Methodology A descriptive followed by case-control study design (1:2 ratio) were performed. National Measles Surveillance Program case definition and predesigned questionnaire were used to collect data from 73 cases and 146 controls. Attack rate (AR), adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) were calculated. P value < 0.05 was considered as the cut point for significant. Epi info version 7.2 was used. Results A total of 73 suspected cases were found. Almost 53% were from Habban district, 63% were males and 56% were among age group < 5 years. The overall AR was 82/100,000 population. Measles was significantly associated with contact with case (aOR = 27.3, 95% CI:1.3–551.7), malnourished children aged 6–60 months (aOR = 24.9, 95% CI;1.9–329.6) and unvaccinated children (aOR = 17.2, 95% CI:2.9–100.7). The six collected blood samples found to be positive for measles IgM. Conclusions Measles outbreak in Ataq and Habban districts was confirmed. Contact with measles cases, malnutrition and un-vaccination were the potential contributing factors of measles outbreak in Shabwah governorate. An urgent vaccination campaign with health education interventions are highly recommended. Reactivation of the outreach immunization services and strengthening surveillance and response systems are top priority to take place at district and governorate levels.

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Description of measles D4-Hamburg outbreak in Hamburg, Germany, December 2008 to June 2009, which disproportionally affected a local Roma community

Eurosurveillance ◽

10.2807/ese.17.24.20194-en ◽

2012 ◽

Vol 17 (24) ◽

Author(s):

G Hegasy ◽

K Kätzner ◽

M Helle ◽

A Mankertz ◽

S Baumgarte ◽

...

Keyword(s):

Influencing Factors ◽

Age Distribution ◽

Control Measures ◽

European Countries ◽

Federal State ◽

Age Group ◽

Measles Outbreak ◽

Stratified Analysis ◽

Epidemiological Characteristics

From December 2008 to June 2009 a measles outbreak occurred in the Federal State of Hamburg, Germany. The outbreak affected 216 persons and was caused by a new measles strain termed D4-Hamburg which led to consecutive outbreaks between 2009 and 2011 in at least 12 European countries. Here, we describe epidemiological characteristics of the outbreak and evaluate the control measures taken in Hamburg. In one of the seven boroughs of Hamburg a local Roma community comprised more than 50% of the notified cases. We compared in a stratified analysis the age distribution of these cases with cases of fellow citizens who did not belong to the Roma community. The age group of infants (0-11 months) comprised 33% among the non-Roma measles cases, while in the Roma community only 4% belonged to this stratum. In the stratum of 5-17 year-olds only 8% were affected among the non-Roma cases, whereas in the Roma community 50% belonged to this age group. We discuss the influencing factors that might have led to this difference in age distribution between the two groups.

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FACTORS ASSOCIATED WITH A MEASLES OUTBREAK IN DISTRICT SKARDU, GILGIT BALTISTAN, PAKISTAN

Pakistan Journal of Public Health ◽

10.32413/pjph.v9i1.220 ◽

2019 ◽

Vol 9 (1) ◽

pp. 30-33

Author(s):

Zakir Hussain ◽

Abdul Wali Khan

Keyword(s):

Risk Factors ◽

Vaccination Coverage ◽

Maculopapular Rash ◽

Control Measures ◽

Factors Associated ◽

Measles Outbreak ◽

History Of ◽

Measles Vaccination ◽

Associated Risk Factors ◽

Gilgit Baltistan

Background: In Pakistan, annually 20,000 children deaths reported due to measles. This outbreak was investigated with the objectives to identify the associated risk factors and recommend appropriate control measures to prevent future outbreaks. Methods: A case was defined as any child presented with fever, generalized maculopapular rash with one of the following symptoms; cough, coryza or conjunctivitis during March-April 2011 in Skardu district. Two healthy age and sex matched controls were selected for each case from the same neighborhood. Information was collected on demographics, date of onset of illness and possible risk factors. Results: A total of 29 suspected measles cases were identified. The overall attack rate was 19% and the most affected age group was 9-19 months (attack rates 16%). Measles vaccination was lower among children with measles (OR. 4, C.I 1.8-12.5, p<0.05). The proportion of parents who consider measles as dangerous was significantly higher among the parents of cases (OR 3.6, CI 1.4-9.3, P 0.006). Better educated mothers were more likely to get their child vaccinated (OR 4, CI, 2.1-7.9, p<0.05) and history of contact was found associated with the disease (OR 7.2, CI 3.5-12.7, p 0.002). Multivariate analysis yielded significant association of following risk factors; vaccination status (OR 3.8, CI 1.8-12.5, p 0.005) and history of contact (OR 3.2, CI 1.0-10.7, p<0.05) with the disease. Conclusion: Lower vaccination coverage and lack of awareness about measles among parents was the most probable cause of this outbreak. Improvement in routine vaccination coverage and health education on the safety of immunization was recommended.

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