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Abstract
BackgroundMeasles is a vaccine preventable, highly transmissible viral infection that affects mostly children under five years. It has been ear marked for elimination and Nigeria adopted the measles elimination strategies of the World Health Organization (WHO) African region to reduce cases and deaths. This study was done to determine trends in measles cases in Bayelsa state, to describe cases in terms of person and place, identify gaps in the case-based surveillance data collection system and identify risk factors for measles infection.MethodsWe carried out a secondary data analysis of measles case-based surveillance data for the period of January 2014 to December 2018 obtained in Microsoft Excel from the State Ministry of Health. Cases were defined according to WHO standard case definitions. We calculated frequencies, proportions, estimated odds ratios (OR), 95% confidence intervals (CI) and multivariate analysis.ResultsA total of 449 cases of measles were reported. There were 245(54.6%) males and the most affected age group was 1–4 years with 288(64.1%) cases. Of all cases, 289(9.35%) were confirmed and 70 (48.27%) had received at least one dose of measles vaccine. There was an all-year transmission with increased cases in the 4th quarter of the year. Yenegoa local government area had the highest number of cases. Timeliness of specimen reaching the laboratory and the proportion of specimens received at the laboratory with results sent to the national level timely were below WHO recommended 80% respectively. Predictors of measles infection were, age less than 5 years (AOR: 0.57, 95% CI: 0.36–0.91) and residing in an urban area (AOR: 1.55, 95% CI:1.02–2.34).ConclusionsMeasles infection occurred all-year round, with children less than 5 years being more affected. Measles case-based surveillance system showed high levels of case investigation with poor data quality and poor but improving indicators. Being less than 5 years was protective of measles while living in urban areas increased risk for infection. We recommended to the state government to prioritize immunization activities in the urban centers, start campaigns by the 4th quarter and continue to support measles surveillance activities and the federal government to strengthen regional laboratory capacities.
Highlights
Measles is a vaccine preventable, highly transmissible viral infection that affects mostly children under five years
A total of 449 cases of measles were reported between January 2014 and December 2018
Of the 449 cases recorded within the five-year period, 289 (9.35%) were confirmed (Table 1) by laboratory diagnosis, epidemiological linkage and clinical compatibility (Table 2)
Summary
Measles is a vaccine preventable, highly transmissible viral infection that affects mostly children under five years. Despite achieving and sustaining global measles vaccination coverage of about 80% over the past decade, measles remains the fifth leading cause of mortality among children aged less than 5 years [3] It accounts for more than 30 million cases annually and 0.9 million deaths every year, with approximately half of these occurring in Africa [3]. Measles is transmission mainly occurs at the end of the rainy season and epidemics tend to be seen in the dry season (February, March and April) [1].It is considered a potentially eliminable disease because the reservoir is exclusively human, sensitive and specific diagnostic tests, as well as safe effective vaccines are available [4]. From 2000 to 2017, measles vaccination prevented an estimated 21.1 million deaths [8]
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