@Article{info:doi/10.2196/10593,
author="Ismail, Muhammad
and Khan, A.",
title="Measles Outbreak Investigation in Village Bara, Khyber Agency, Pakistan-February 2017: Case Control Study",
journal="iproc",
year="2018",
month="Mar",
day="29",
volume="4",
number="1",
pages="e10593",
abstract="Background: Measles is highly contagious and remains a leading cause of childhood mortality. Outbreaks of Measles were reported from various parts of Pakistan, particularly tribal areas. In February 2017 Measles outbreak was reported from Bara, Khyber Agency. Objective: To confirm the outbreak, assess its magnitude, identify risk factors and to implement prevention and control activities to stop spread of the outbreak. Methods: A case was defined as Rash with fever and cough, coryza or conjunctivitis in a child younger than 14 years of age, resident of Bara, during 3rd February to 15th March, 2017. Active search of cases done. Data was collected using a pretested structured questionnaire and analyzed using Epi Info version 7.1. Descriptive analysis was done followed by age {\&} sex matched case control study. Case fatality rate, attack rate, vaccine efficacy, and secondary infectivity rates were calculated. Results: Total 42 cases were identified. The Epi curve ranges from 3rd February to 15th March with a bi-modal peak on 23rd Feb and 5th March. Mean age of the cases was 37 months (range 1-120 months). Males were 52.38{\%} (n=22). Socioeconomic status of parents was poor (28.57{\%}laborers, 38.10{\%} earn below 10000 PKR/month, 59{\%}fathers were literate while all mothers were illiterate). Case Fatality rate was 7.14{\%} (n=3). Vaccination showed protective effect [OR 0.12 (95{\%} CI: 0.03-0.40; P<.05)]. Vaccination coverage survey showed 46.3{\%} coverage for Measles-1. Secondary infectivity was high in houses where children were more than 7 in number [OR 8.67 (95{\%} CI: 1.76-42.6, P<.05). Distance from health facility (>3kms) showed higher odds of getting the illness [OR 2.89 (95{\%}CI: 1.22-6.84); P<.05]. Conclusions: This study in a post-conflict repatriated population showed relationship of low socioeconomic status, low vaccination coverage, distance from health facility and overcrowding with the disease. Awareness sessions and mop-up vaccination in the area contributed in controlling the outbreak. ",
issn="2369-6893",
doi="10.2196/10593",
url="http://www.iproc.org/2018/1/e10593/",
url="https://doi.org/10.2196/10593"
}