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
Richardson Mafigiri, Uganda Public Health Fellowship Program, Kampala, Uganda
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.
we conducted active community case-finding to identify probable measles patients,
defined as a Kyegegwa District resident with fever (> 39°C) 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
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
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.
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.
Dates: 11 Dec 2015
Venue: Golf Course Hotel, Kampala
Organizers: Ministry of Health and Makerere University School of Public Health
Contact person: Dr. Alex Riolexus Ario (email@example.com)