A low-cost, community-based measles outbreak investigation with follow-up action

An outbreak of measles in Kampala, Uganda, in 1990 raised concern about the effectiveness of the measles vaccine that was used. The Uganda EPI programme and the medical office of the Kampala City Council therefore conducted a community-based investigation, with door-to-door interviews in two selecte...

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Bibliographic Details
Published in:	Bulletin of the World Health Organization Vol. 70; no. 3; pp. 317 - 321
Main Authors:	WEEKS, R. M, BARENZI, J. F. Z, WAYIRA, J. R. M
Format:	Journal Article
Language:	English
Published:	Genève Organisation mondiale de la santé 01-05-1992 World Health Organization
Subjects:	Biological and medical sciences Child Child, Preschool Children Disease Outbreaks Epidemiologic Methods Evaluation Health aspects Health Education - standards Health Knowledge, Attitudes, Practice Health Services Accessibility Human viral diseases Humans Immunization Immunization of children Infant Infectious diseases Measles - epidemiology Measles - prevention & control Measles Vaccine Medical sciences Mothers - education Population Program Evaluation Tropical medicine Uganda - epidemiology Viral diseases Viral diseases of the respiratory system and ent viral diseases Uganda Africa Human Infectious focus Immunoprotection Immunization Vaccination Inquiry Epidemiology Infection Prevention Viral disease Measles Child Public health Community Surveys Measurement Eastern Africa Health Services Age Factors Organization And Administration Viral Diseases Data Collection Delivery Of Health Care Research Methodology English Speaking Africa Sampling Studies Incidence Population Characteristics Population Demographic Factors Interviews Programs Evaluation Health Africa Cost Benefit Analysis Quantitative Evaluation Diseases Studies Surveys Epidemiologic Methods Uganda Developing Countries Primary Health Care Africa South Of The Sahara Program Evaluation
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Summary:	An outbreak of measles in Kampala, Uganda, in 1990 raised concern about the effectiveness of the measles vaccine that was used. The Uganda EPI programme and the medical office of the Kampala City Council therefore conducted a community-based investigation, with door-to-door interviews in two selected communities. They revealed 68 measles cases ranging in age from 5 months to 12 years; the highest age-specific attack rate (32%) was found in children aged 12 to 23 months. BCG immunization coverage was high (85%), but measles immunization coverage was moderate (48%). One community, served by a mobile clinic, presented a vaccine efficacy of only 55%. Responses by mothers revealed that many had failed to have their children completely immunized because of a lack of information, and not because of difficulties in access to the service. In a follow-up, community leaders initiated monthly checking of immunization cards of both children and mothers. The low vaccine efficacy found in one of the communities resulted in a thorough assessment of the city's cold chain. This community-based approach proved to be cost-effective and practical for identifying the obstacles to effective immunization delivery.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0042-9686 1564-0604