Conference abstract

Risk factors associated with statewide measles outbreak three months after measles supplemental immunization in Sokoto, Nigeria, 2016

Pan African Medical Journal - Conference Proceedings. 2018:8(71).09 Dec 2018.
doi: 10.11604/pamj-cp.2018.8.71.653

Contact the corresponding author
Keywords: Measles, outbreak, non-vaccination, Sokoto State
Opening ceremony

Risk factors associated with statewide measles outbreak three months after measles supplemental immunization in Sokoto, Nigeria, 2016

Abayomi Akintunde Olufemi1,&, Ummulkhulthum Bajoga1, Mohammed Yahaya1, Ibrahim Baffa1, Mahmood Dalhat1, Godwin Gana1, Abdullahi Shehu1

1Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria

&Corresponding author
Abayomi Akintunde Olufemi, Nigeria Field Epidemiology and Laboratory Training Programme, Asokoro, Abuja, Nigeria

Abstract

Introduction: measles is a highly contagious viral disease associated with high morbidity and mortality. It is the fifth leading cause of death among under-five children worldwide. On February 12, 2016, an outbreak of Measles was reported from Sokoto State, Nigeria. This measles outbreak occurred despite a Measles supplemental immunization three months earlier. Studies have shown that hospitals may play an important role in the community transmission of Measles. We investigated to confirm the outbreak, describe the socio-demographic characteristics, and identify risk factors for the outbreak.

Methods: we conducted a 1:1 unmatched case-control study. We defined a case as any person less than 10 years of age with Measles according to standard case definition while a control was any child less than 10 years without history of Measles residing in affected communities of Sokoto State from 1st February to 30th March 2016. We conducted active case search, reviewed health facilities records and line-listed 984 suspected cases. A standard questionnaire was administered to collect information on possible risk factors associated with the Measles outbreak. We conducted univariate, bivariate, and multivariate analysis using Epi info 7.2.

Results: of the 984 cases line listed 505 (51.6%) were males, 726 (73.8%) of cases were < 5 years old. Out of the 886 cases whose vaccination status were recorded, 726 (81.9%) were not vaccinated. Significant risk factors after bivariate analysis were father not being civil servant [OR = 5.6; (95% CI = 2.2 - 14.4)], non-vaccination [OR = 2.0; (95% CI = 1.2 - 3.4)], uneducated mother [OR = 2.0; (95% CI = 1.1 - 3.7)], and visiting a health facility 7 - 28 days prior to onset of symptoms [OR = 32.3; (95% CI = 14.7 - 71.1)]. Visiting a health facility during the outbreak remained the only significant independent risk factor after multiple logistic regression.

Conclusion: the measles outbreak may have been exacerbated by visiting a health facility during the outbreak. This finding underpins the importance of improving hospital infection control practices.