Risk factors for measles mortality and the importance of decentralized case management during an unusually large measles epidemic in eastern Democratic Republic of Congo in 2013.

Thursday, 3rd of May 2018

PLoS One. 2018 Mar 14;13(3):e0194276. doi: 10.1371/journal.pone.0194276. eCollection 2018.

Risk factors for measles mortality and the importance of decentralized case management during an unusually large measles epidemic in eastern Democratic Republic of Congo in 2013.

Gignoux E¹ Polonsky J¹ Ciglenecki I² Bichet M²³ Coldiron M¹ Thuambe Lwiyo E² Akonda I⁴ Serafini M² Porten K¹.

Author information

1

Epicentre Paris France.

2

Médecins Sans Frontières Geneva Switzerland.

3

Médecins Sans Frontières Paris France.

4

Ministère de la Santé Publique Kinshassa République Démocratique du Congo.

Abstract

In 2013 a large measles epidemic occurred in the Aketi Health Zone of the Democratic Republic of Congo. We conducted a two-stage retrospective cluster survey to estimate the attack rate the case fatality rate and the measles-specific mortality rate during the epidemic. 1424 households containing 7880 individuals were included. The estimated attack rate was 14.0% (35.0% among children aged <5 years). The estimated case fatality rate was 4.2% (6.1% among children aged <5 years). Spatial analysis and linear regression showed that younger children those who did not receive care and those living farther away from Aketi Hospital early in the epidemic had a higher risk of measlesrelated death. Vaccination coverage prior to the outbreak was low (76%) and a delayed reactive vaccination campaign contributed to the high attack rate. We provide evidences suggesting that a comprehensive case management approach reduced measles fatality during this epidemic in rural inaccessible resource-poor setting.

PMID:  29538437 PMCID: PMC5851624

 DOI: 10.1371/journal.pone.0194276