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Epidemiological analysis of notified measles cases and review of surveillance system during an outbreak in Tabuk, Saudi Arabia.

AbstractPURPOSE:
In response to a measles outbreak occurred in Tabuk, Saudi Arabia, we conducted a case-based active-surveillance, and analyzed all surveillance data to identify the epidemiology of notified measles cases and to review the surveillance system.
METHODS:
Suspected and confirmed measles cases were defined according to World Health Organization (WHO) guidelines. Household-based investigation was conducted for all suspected cases using standard measles notification form. Enzyme-linked immunosorbent assay was carried out on serum samples collected from all suspected cases to detect measles specific immunoglobulin M (IgM) antibodies. Surveillance system was assessed by preselected performance indicators consistent with WHO guidelines. Logistic regression was used to calculate crude and adjusted odds ratios from the surveillance data.
RESULTS:
Of 242 suspected measles cases notified between 3rd and 48th calendar weeks of the study-year, laboratory result was IgM-positive for 46% cases, IgM-negative for 49% cases, and unknown for 5% cases. Suspected and confirmed cases separately showed urban-predominance (>77%), male-majority (>51%), and high-proportion among Saudis (>92%). The highest proportion (93%) of suspected cases that received "at least one dose" of measles-containing vaccine (MCV) was found among those aged 12-17 years, whereas the lowest proportion (17%) was observed among the adult individuals (> or =18 years). Elderly (> or =18 years) individuals were significantly less likely to be vaccinated than younger (1-5 years) children (adjusted odds ratio [OR] = 15.92, 95% confidence interval [CI] = 4.82-52.56). The vaccine failure rate for "at least one dose" of MCV was 35%. The individuals vaccinated with "at least one-dose" of MCV were at 3.6 times lower risk of contracting measles than the nonvaccinated group (adjusted OR = 3.6, 95% CI = 1.55-8.38). Of five surveillance performance indicators, three were found as per WHO target.
CONCLUSIONS:
More efforts are essential to prevent future outbreaks and to reach the goal of measles elimination in the country.
AuthorsAli M Al-Arabi Al-Ghamdi, Mustafa Hassan Al-Faraj, Hamza M Ibrahim, Mohammad Al Mamun
JournalAnnals of epidemiology (Ann Epidemiol) Vol. 21 Issue 4 Pg. 262-71 (Apr 2011) ISSN: 1873-2585 [Electronic] United States
PMID21376273 (Publication Type: Journal Article)
CopyrightCopyright © 2011 Elsevier Inc. All rights reserved.
Topics
  • Adolescent
  • Adult
  • Child
  • Disease Notification
  • Disease Outbreaks
  • Female
  • Humans
  • Male
  • Measles (diagnosis, epidemiology, prevention & control)
  • Middle Aged
  • Population Surveillance
  • Saudi Arabia
  • Vaccination
  • Young Adult

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