Measles outbreak investigation in Otodogbame Community, Eti-Osa LGA, Lagos State, Nigeria, February 2016

Introduction : measles is a highly contagious vaccine preventable viral infection with high mortality and morbidity. Immunisation coverage as low as 20% were reported in Nigeria. Suspected Measles outbreak was reported in Otodogbame Community. We investigated to verify, characterize and determine risk factors associated with the mortality. Methods : we conducted unmatched case-control study using IDSR case definition of Measles from December to February 2016 residing in Otodogbame Community. We interviewed 82 cases and 246 controls using an interviewer-administered questionnaire on socio-demographic information and risk factors for Measles. Anthropometric measurements of assessing children were taken. Malnutrition was defined as ≤2 standard deviation away from the WHO recommended Z-score table of weight for height. Independent risk factor for Measles mortality was determined by bivariate and multivariate analysis. Results : a total of 82 cases and 246 controls were interviewed. Median ages for cases and controls were 42 months (range: 10-156) and 36 months (range: 9 - 108), Mortality was 30%, 269 (82%) were malnourished [OR = 2.9; 95% CI: 1.1 - 3.3)], failure to achieve DPT3 immunization [OR = 2.3; (95% CI: 1.4 - 3.7)], lack of formal education [OR = 1.9; (95% CI: 1.1-3.1)],maternal age 500 naira on transport per vaccination visit [OR = 2.3; (95% CI: 1.3-4.1)] and family income 500 naira (>$2) per vaccination visit [AOR = 2.4; (95% CI: 1.2 - 4.6)] as independent risk factors for Measles disease. Conclusion : acute malnutrition, lack of easy access to a health facility, financial limitations in the family and low immunization coverage led to the high mortality. Effective RI delivery, improving the socio-economic status could reduce Measles mortality.