Abstract:
Abstract
Introduction: Measles is a highly infectious viral disease caused by a measles virus.
Despite the existence of a safe, effective, and inexpensive vaccine, measles outbreak is
common in Ethiopia, particularly in Amhara National Regional State. The pattern of the
disease occurrence is mostly different from place to place. Therefore, spotting the
occurrence of measles outbreak spatial variations result significant insights in to
patterns and risks of measles in the region and country as well.
Objective: The aim of this study was to identify the spatial patterns and risk factors of
measles outbreak in North Gondar Zone, northwest Ethiopia.
Methods: Retrospective unmatched case-control study design was used to identify the
possible risk factors for the occurrence of measles outbreaks and spatial variations in
2015. A total of 357 children (119 cases and 238 controls) were included in the study.
The spatial patterns of measles outbreak were analyzed using Geographical Information
System ArcGIS soft-ware version 10.2.2 and SaTScan software version 9.4. Bernoulli
probability model of spatial scan statistics was employed to identify spatial variations of
measles outbreak and binary multivariable logistic regression model was applied to
identify the risk factors.
Results: Measles outbreak in the zone had a spatial pattern having significant hotspot
layers on three woredas. Majorities of the hotspot cases were identified in the remote
borders of Jan amora, Misrak Belesa and Alefa. The overall vaccine efficacy (VE) in this
locations was 28% children in the age group between 9 and 12 months had the highest
VE of 79% there was highest attack rate of 38%. Access to road and health facility
[AOR: 3.9, CI :( 2.2, 6.9)] and [AOR:6.02, CI:(3.4,10.7)] respectively and season [AOR:
16.6, CI (4.6, 59.8)] were found to be determinants of risk of measles in the zone.
Conclusion and recommendation: vaccine efficacy in those places was low while
measles vaccine and vitamin A supplements were good so the cold chain practices
should be examined. Measles do not attack one person twice; therefore, focus on areas
not yet affected, but where the outbreak is likely to spread.
