ANALYSIS OF MEASLES CASE BASED AND LINE LIST SURVEILLANCE DATA - ETHIOPIA, 2004-2012

Background: In 1980, before widespread vaccination, measles caused an estimated 2.6 million deaths each year and it remains one of the leading causes of death among young children globally with more than 95% of measles deaths occur in low-income countries including Ethiopia with weak health infrastructures, despite the availability of a safe and effective vaccine. This analysis was undertaken to describe proportion of confirmed measles cases and assess factors associated with measles in Ethiopia to recommend best practice to control measles.

Methods: Measles Case based that is an ongoing and rapid identification of identifiable cases using laboratory and line list format to collect detail information using line list reporting format (address, age, sex, date of onset...) data were extracted from the national database for the period 2004-2012 was conducted, assessing trends in proportion of confirmed measles cases and determine factors associated with measles. Data were analyzed using SPSS version 16.0 statistical software. Chi-square test and multivariate analysis were employed.

Result: A total of 40,455 suspected measles cases were reported between 2004 and 2012. Of these cases; 50.6% were confirmed for measles by laboratory or epidemiologically linked with laboratory confirmed cases while 49.4% were negative for measles by laboratory. The average estimated annual incidence and proportion of confirmed measles cases for the calendar years 2004 to 2012 was 5.3/100,000 and 17.0% respectively. Compared to under five year; age group >= 15 years were more likely to develop measles (AOR= 1.9; 95%CI: 1.77- 2.07). Cases from rural residency were more likely to develop measles cases compared to urban residency (AOR= 1.7; 95%CI: 1.63-1.84) and unvaccinated, unknown vaccination status and who received one dose for measles were more likely to develop measles compared to those vaccinated with two or more doses (AOR= 5.8; 95%CI: 5.07-6.63), (AOR= 2.3; 95% CI: 2.05-2.67) and (AOR= 1.6; 95%CI: 1.37-1.80) respectively.

Conclusion and Recommendations: Factors associated with the occurrence of measles includes age group >=15 years, unvaccinated or unknown vaccination status and rural residency. Improving the routine immunization needs of children and initiating second dose of measles containing vaccine at school age could be an important step towards breaking the vicious cycle of measles.