An Outbreak of Measles in Tanzanian Refugee Camps

Abstract

, four camps in Kibondo District, Tanzania, hosting refugees from Burundi reported 1062 cases of measles, a highly infectious and potentially lethal disease. Of 1062 case-patients, 225 (21%) were !9 months old, 286 (27%) were 9 months to 5 years, 324 (31%) were 6-15 years, and 227 (21%) were у16 years old. No deaths were reported. Although, in accordance with Sphere Project guidelines for humanitarian emergencies, camp policy was to vaccinate all new arrivals aged 6 months to 15 years against measles, 152 (72%) of 210 newly arrived refugees in this age group were unvaccinated; 143 (94%) of the 152 had lived in the camp у1 month before rash onset. This investigation supports Sphere Project recommendations for wide age group vaccination and suggests that in some circumstances vaccination of refugees 115 years old may be beneficial.

Vaccine-preventable diseases in humanitarian emergencies among refugee and internally-displaced populations

“…6 We reviewed articles related to measles outbreaks among displaced populations in Tanzania, Ivory Coast, Darfur, Ethiopia, Somalia and Kenya. [8][9][10][11] Movement of new arrivals into a refugee camp may introduce measles transmission. For example, initial cases in concurrent measles outbreaks in the Dollo Ado refugee camp in Ethiopia and the Dadaab refugee camp in Kenya during 2010 and 2011 were likely new arrivals from Somalia, a country that was also experiencing an ongoing measles outbreak.…”

“…9 Therefore, priority should be placed on disease surveillance to camp areas with the newest refugee arrivals where timely and reliable disease reporting is likely to be weakest. 6 Although camp conditions are common risk factors for measles transmission, movement between camp and host populations also contributes to measles outbreaks.…”

“…6 Although camp conditions are common risk factors for measles transmission, movement between camp and host populations also contributes to measles outbreaks. [9][10][11]13 Close interactions between Liberian refugees and Ivorian host community in the urban setting of Abidjan contributed to an outbreak of measles and rubella in 2003 and 2004 in transit camps within Ivory Coast. 10 When both the displaced and host communities have apparent immunity gaps for VPDs, it is therefore recommended to vaccinate both groups of susceptibles, as was done in the mass measles vaccination efforts of both refugee and non-displaced populations in Abidjan.…”

Clinicoepidemiological Study of Measles at Sir Ronald Ross Institute of Tropical and Communicable Diseases: A Retrospective Study

“…However, diarrhea was the most common complication similar to other studies (Ashok Mishra et al). [13][14][15][16][17][18][19] Large scale surveys as well as hospital based studies are needed to provide the valuable data for prevention and control of measles in future.…”

Challenges of poor surface water drainage and wastewater management in refugee camps

“…Various approaches have been used by humanitarian agencies and organisations such as UNHCR, Oxfam, ActionAid and many other organisations in controlling illnesses, infections and diseases in refugee camps. Such approaches include provision of portable water supply facilities such as boreholes and water tanks, sanitation and hygiene facilities (toilets and latrines) [15]; scientific approaches such as administering vaccinations to refugees against known diseases [11] and social science approach by educating the refugees on behavioural change [16]. However, little has been done in using engineered approaches such as providing effective surface water drainage systems and wastewater management infrastructure to prevent and control diseases and ensure sustainable use of water by re-using and recycling wastewater.…”