Risk factors associated with statewide measles outbreak three months after measles supplemental immunization in Sokoto, Nigeria, 2016

Introduction : measles is a highly contagious viral disease associated with high morbidity and mortality. It is the fifth leading cause of death among under-five children worldwide. On February 12, 2016, an outbreak of Measles was reported from Sokoto State, Nigeria. This measles outbreak occurred despite a Measles supplemental immunization three months earlier. Studies have shown that hospitals may play an important role in the community transmission of Measles. We investigated to confirm the outbreak, describe the sociodemographic characteristics, and identify risk factors for the outbreak. Methods : we conducted a 1:1 unmatched case-control study. We defined a case as any person less than 10 years of age with Measles according to standard case definition while a control was any child less than 10years without history of Measles residing in affected communities of Sokoto State from 1st February to 30th March 2016. We conducted active case search, reviewed health facilities records and line-listed 984 suspected cases. A standard questionnaire was administered to collect information on possible risk factors associated with the Measles outbreak. We conducted univariate, bivariate, and multivariate analysis using Epi info 7.2. Results : of the 984 cases line listed 505 (51.6%) were males, 726 (73.8%) of cases were Conclusion : the Measles outbreak may have been exacerbated by visiting a health facility during the outbreak. This finding underpins the importance of improving hospital infection control practices.