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Investigation of measles outbreak in Bangue health district: Challenges of control in an urban setting, Cameroon 2019

2020; Elsevier BV; Volume: 101; Linguagem: Inglês

10.1016/j.ijid.2020.09.817

1878-3511

M.N. Nanga Dampand, Adrienne Vanessa Kouatchouang, Tatiana Djikeussi, J. Lontsi, Serge Clotaire Billong,

Immune responses and vaccinations

Background: Measles is a highly contagious viral disease under surveillance in Cameroon. An analysis of surveillance data epidemic week 9–16 of 2019 reported 11 suspected cases of measles recorded with a cluster of 7 cases registered in the Logbessou1 health area at Bangue health district (BHD). Investigations were carried out without financial help, to confirm the epidemic, to assess vaccination coverage and establish control measures. Methods and materials: We conducted a cross-sectional descriptive study. We reviewed registers of districts health facilities and created a line listing of variables of interest; sociodemographic characteristics, clinical symptoms, measles vaccine status, sample collection for reference laboratory, treatment received. A suspected case (SC) was any patient presenting with fever and generalized rash in the HDB between February 25th and June 16th 2019. A confirmed case (CC) was defined as any suspected case with immunoglobulin M positive serology. A randomized vaccination coverage (VC) survey was conducted in Logbessou1 health area following WHO guidelines. Data were analyzed using Epi info. Results: A total of 18 suspected cases were recorded in the district, 11 (61.1%) cases reported in Logbessou1 health area. Of the 9 samples sent to the reference laboratory, 3 (33.3%) were confirmed. The Median age was 3, 5 years [11month–39 years] with a sex ratio M/F: 1, 25. Among the SC, all were fever with maculo-papular rash, 10 (55.6%) had rhinitis, 9 (50%) cough and 8 (44.4%) conjunctivitis. Ought of the 18 SC, 12 (66.7%) were vaccinated with at least first dose of measles vaccine (MV). VC survey found 74% (40/54) of vaccinated children in logbessou1 health area, under the 85% coverage expected. Analysis of VC in 2017 and 2018 showed respectively 68% and 72%. Conclusion: A measles outbreak was confirmed in BDH in a context of non-optimal VC. Half of the cases were under 3.5 years old. Organizing a mass measles vaccination campaign in BHD is critical to address the outbreak in this urban district and the integration of a second dose of measles vaccine into the expanded program on immunization too.