RESUMO
Objective: This study aimed at verifying the outbreak, preventing further transmission, and identifying the risk factors for the outbreak. Method: A case-control study design was conducted from March 4, 2020 to April 30, 2020, in Kasoshekumer kebele of Sinana district. Thirty-seven carer-patient pairs and 74 controls were recruited in a 1:2 case-control ratio. Patients were selected using a national standard case definition of the Ministry of Health. Controls were selected from neighbors of patients and interviewed after the second incubation period from the last patient of the outbreak by a structured questionnaire similar to patients. All cases were included while controls were selected purposively for their exposure status. Vaccine efficacy, attack rate, and case fatality rate were conducted as a descriptive epidemiology. Multivariate analysis was used to identify associated factors. Result: Out of 109 study participants, there were 37 cases and 72 controls. The mean age was 58.8 months with ±54 standard deviation. Thirty-one (83.8%) of the cases had a known contact history and 23 (62.2%) were unvaccinated. The age-specific attack rate was 36/1000 in <5 years and 53/100,000 in >15 years. The estimated vaccine efficacy was 73.7%. Having any type of socialization behavior (adjusted odds ratio = 6.8, confidence interval: 4.25, 11.4), maternal poor knowledge of measles prevention (adjusted odds ratio = 4.152, confidence interval: 1.226, 8.058), and being unvaccinated (adjusted odds ratio = 7.79, confidence interval: 2.281, 12.63) were associated factors for measles infection. Conclusion: Poor knowledge of the parents on vaccination and the less effort taken to deliver good attitude toward vaccination are resulting in measles outbreak. However, herd immunity can prevent the outbreak; if not, the community will continue to suffer from mortality and morbidity. A resilient immunization program with sustainable and equitable supply, delivery, monitoring, and evaluation is a fundamental action in prevention of measles outbreak. Increased awareness of vaccination and other prevention measures are also crucial to end the outbreaks.
RESUMO
Background: Globally, more than 19 million children have not received all of their vaccination benefits, resulting in an estimated one million deaths worldwide each year. Vaccine-preventable diseases are becoming more common in Ethiopia, despite the fact that official vaccination coverage is sufficient to develop herd immunity locally for some diseases such as measles. This mistrust of the official report prompted us to conduct a community survey and compare it to other areas where there have been no reports of vaccine-preventable disease. Methods: A community-based comparative cross-sectional study was conducted from 20/01-20/02/2021 in Sinana and Mettu districts. Probability proportional to estimate size was used to select 23 clusters. We recruited 228 from Mettu and 436 from Sinana by systematic random sampling. We used a structured questionnaire to collected data from mother-child pair using card and history. We conducted independent t-tests to test coverage differences between districts. We identified determinants of full vaccination status by multivariate logistic regression analysis after bivariate candidate selection. Results: Fully vaccinated children accounted for 62.7% in Sinana and 91.6% in Mettu, demonstrating a significant coverage difference (p<0.001). Being a resident of Mettu (AOR: 3.5, 95% CI [1.5, 6.9]), intended pregnancy (AOR 5.9, 95% CI [2.4, 11.3]), 4 or more antenatal care visits (AOR: 2.09, 95% CI [1.4, 3]), having postnatal care (AOR: 3.5, 95% CI [1.6, 7.9]), younger child age (AOR: 0.87, 95% CI [0.8, 0.9]), having up to three children (AOR 3, 95% CI [1.13, 8]) and good knowledge of vaccine schedule (AOR: 2.4, 95% CI [1.4, 4]) were associated positively with full vaccination status. Conclusion: Full vaccination status was 91.6% in Mettu and 62.7% in Sinana district. Place of residence, ANC, PNC, pregnancy intention, child number, age of child and knowledge of vaccination schedule were significantly associated with vaccination status of the children.