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Measles outbreak in Western Uganda: a case-control study.

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Low measles vaccination coverage fueled a 2018-2019 outbreak in Uganda, highlighting the need for enhanced immunization strategies. This outbreak underscores the persistent threat of measles in regions with suboptimal vaccine uptake.

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Area of Science:

  • Epidemiology
  • Public Health
  • Infectious Diseases

Background:

  • Measles outbreaks persist in sub-Saharan Africa despite vaccination efforts.
  • Measles immunization coverage in Kasese district was critically low (72% and 69% in 2018).
  • Suboptimal coverage placed the region in the lowest performance category nationally.

Purpose of the Study:

  • To assess the scope of the 2018-2019 measles outbreak in Bugoye sub-county.
  • To identify risk factors associated with measles in children aged 0-60 months.
  • To inform public health interventions for measles control in western Uganda.

Main Methods:

  • Retrospective unmatched case-control study.
  • Included children aged 0-60 months with confirmed or clinical measles (cases) and controls without measles.
  • Data collected via modified CDC forms, reviewed immunization cards and health registers.

Main Results:

  • An extended measles outbreak occurred from December 2018 to October 2019.
  • Common symptoms included rash, conjunctivitis, cough, fever, and coryza.
  • Low measles vaccination coverage and post-immunization infection were identified as key risk factors.

Conclusions:

  • Measles remains a significant public health concern in the study area.
  • The outbreak was strongly associated with under-vaccination.
  • Implementing a second measles-rubella vaccine dose is recommended to improve population immunity.