Risk factors for measles death during an outbreak: Kyegegwa District, Uganda
Pan Afr. med. J - Conference Proceedings
; 1(1)2017.
Artigo
em Inglês
| AIM (África)
| ID: biblio-1268326
Biblioteca responsável:
CG1.1
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 (> 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 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
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Contexto em Saúde:
ODS3 - Saúde e Bem-Estar
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ODS3 - Meta 3.3 Acabar com as doenças tropicais negligenciadas e combater as doenças transmissíveis
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ODS3 - Meta 3.2 Reduzir as mortes de recém nascidos e crianças com menos de 5 anos
Problema de saúde:
Meta 3.3: Acabar com as doenças tropicais negligenciadas e combater as doenças transmissíveis
/
Meta 3.2: Reduzir as mortes de recém nascidos e crianças com menos de 5 anos
/
Sarampo
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Infecções
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Nutrição
Base de dados:
AIM (África)
Assunto principal:
Uganda
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Surtos de Doenças
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Sarampo
Tipo de estudo:
Estudo de etiologia
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Guia de prática clínica
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Estudo observacional
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Estudo prognóstico
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Fatores de risco
País/Região como assunto:
África
Idioma:
Inglês
Revista:
Pan Afr. med. J - Conference Proceedings
Ano de publicação:
2017
Tipo de documento:
Artigo