Measles Outbreak Investigation in Pweto Health Zone—Haut-Katanga Province, DR of the Congo, 2018

Abstract

Background: Sub-Saharan Africa reports repeated outbreaks of measles, a vaccine-preventable disease, which is notifiable under the Integrated Disease Surveillance and Response (IDSR) strategy in Democratic Republic of Congo (DRC). DRC has reported several outbreaks of measles in the last three years. Poor immunization coverage and weak health systems have been related with measles and other vaccination-preventable diseases’ outbreaks. The DRC has committed to eliminating measles by 2020. In this respect, we investigated one of the outbreaks that occurred in Pweto health zone (HZ), Haut-Katanga province, to describe the outbreak and identify risk factors. Methods: A cross-sectional study was designed to investigate a measles outbreak in Pweto health zone (HZ), Haut-Katanga province. Data entry and analysis were performed using EPI-Info version 7.1.0.6 and MS-Microsoft Excel. Findings: In seven months’ time, four health areas affected by a measles outbreak in Pweto health zone reported 116-suspected cases and 13 deaths. The cumulative attack rate of 42.3/100,000 population and case fatality rate (CFR) of 11.2% were recorded. Of these, 112 (96.5%) cases were ≤15 years of age, and 93 (80.2%) were zero dose of measles vaccine. Although, all age groups were concerned, under five years old were the most affected with 84 cases (72.4%). In response to the outbreak, a response immunization was organized with the support of MSF at the week 25 of the epidemic, when the epidemic curve started to decline. A response immunization involving 46,205 children from 6 to 59 was implemented and overall coverage of 99% (range: 95% - 105%) was achieved. Case management with vitamin A supplementation, active case search, routine immunization improvement and health education were some of the activities carried out to curb the outbreak. Conclusion: This confirmed measles outbreak was caused by failure to vaccinate (80.2% unvaccinated cases). Poor surveillance sensitivity and the community attitude about measles contributed to its spreading. Strengthening routine immunization, improving surveillance system and communication for behaviour change are required.