Proceedings of The 1st Uganda National Field Epidemiology Conference (Kampala, 2017)

Oral presentation

Risk factors for measles death during an outbreak: Kyegegwa District, Uganda

Cite this: Pan African Medical Journal - Conference Proceedings. Aug 2017; 1(1): 8. doi:10.11604/pamj.cp.2017.1.8.2

Submitted: 01 Aug 17   Accepted: 08 Aug 17   Published: 11 Aug 17

Key words: Measles death, outbreak, Uganda

© Richardson Mafigiri et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.proceedings.panafrican-med-journal.com/conferences/2017/1/8/abstract

Corresponding author: Richardson Mafigiri, Uganda Public Health Fellowship Program, Kampala, Uganda (rmafigiri@musph.ac.ug)

This abstract is published as part of the proceedings of The 1st Uganda National Field Epidemiology Conference(UGANDA, )

Risk factors for measles death during an outbreak: Kyegegwa District, Uganda

Richardson Mafigiri1,&, Fred Nsubuga1, Alex Riolexus Ario1

 

1Uganda Public Health Fellowship Program, Kampala, Uganda

 

 

&Corresponding author
Richardson Mafigiri, Uganda Public Health Fellowship Program, Kampala, Uganda

 

 

Abstract

Introduction: on 18 August 2015, Kyegegwa District reported 8 deaths during a suspected measles outbreak. We investigated this cluster of deaths to verify the cause, identify risk factors, and inform public health interventions.

 

Methods: we conducted active community case-finding to identify probable measles patients, defined as a Kyegegwa District resident with fever (> 39C) and generalized rash during 1 February - 15 September, plus ≥ one of the following: coryza, conjunctivitis, and cough. A deceased measles case was defined as death to a probable measles patient. In a case-control study, we compared risk factors between 16 deceased measles cases and 48 probable measles patients who survived (i.e., controls), matched by age ( 4 years) and village of residence. Blood specimens from probable measles patients were tested for measles-specific IgM.

 

Results: we identified 94 probable measles patients. Children aged < 5 years accounted for 68% (64/94) of probable measles patients and all 16 deaths (case fatality ratio = 25%, 16/64). In the case-control study, 63% (10/16) of deceased measles cases and 33% (16/48) of controls received no vitamin A supplementation during illness (ORM-H = 7.1; 95% CI = 1.3-37); 31% (5/16) of deceased measles cases and 2.1% (1/48) of controls were not treated according to guidelines (adjORML = 8; 95% CI = 80-8); 6.3% (1/16) of deceased measles cases and 46% (22/48) of controls were vaccinated against measles (adjORML = 0.0; 95% CI = 0.0-0.33). Of blood specimens collected from probable measles patients, 71% (10/14) were positive for measles-specific IgM.

 

Conclusion: no vaccination, lack of vitamin A supplementation and inappropriate treatment increased risk for measles deaths. The one-dose measles vaccination currently in the national EPI schedule, although providing inadequate protection against infection, did protect against measles death. We recommended enhancing measles vaccination, providing universal vitamin A supplementation, and enforcing treatment guidelines.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The 1st Uganda National Field Epidemiology Conference (Kampala)

The one-day Field Epidemiology Conference took place on December 11th, 2015 at Golf Course Hotel, Kampala. At this conference, Fellows presented investigations and epidemiologic studies they conducted since they joined the Fellowship in January 2015. Through these investigations and studies, important public health problems facing the nation were unveiled and strategies to address them proposed. This conference presented opportunity for national and international experts to discuss and propose solutions. This was the first Field Epidemiology Conference in Uganda and was attended by important dignitaries from the key partner institutions including Ministry of Health, UN agencies, Embassies, University officials, representatives from districts as well as other national and international delegates.

Country: UGANDA

Dates: 11 Dec 2015

Venue: Golf Course Hotel, Kampala

Organizers: Ministry of Health and Makerere University School of Public Health

Secretariat: info@uphfp.org

Contact person: Dr. Alex Riolexus Ario (riolexus@musph.ac.ug)