Factors associated with a measles outbreak in children admitted at Mahosot Hospital, Vientiane, Laos

Mayxay, Mayfong; Khomthilat, Tiengthong; Souvannasing, Phoutthalavanh; Phounesavath, Khamphouvanh; Vorasane, Banlieng; Keomany, Sommay; Douangdala, Phouvieng; Philavong, Khamseng; Srour, Leila; Newton, Paul N.

doi:10.1186/1471-2458-7-193

Cited by 5 publications

(9 citation statements)

References 8 publications

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“…24 In 2001, it was estimated that 41% of Lao children were stunted, 25 and in Luangnamtha (where 6/12 of the noma patients came from) and Sekong, 74% and 63%, respectively, of children 3-15 years of age were stunted. 26 Measles and malaria remain important in Laos, [27][28][29] and there is evidence that these infections may be associated with noma. 3 A recent weekly epidemiologic surveillance report described 77 cases of clinical measles from Luangnamtha province, including 48 from Nalae District and 29 from Muang Sing District.…”

Section: Discussionmentioning

confidence: 99%

Noma in Laos: Stigma of Severe Poverty in Rural Asia

Srour¹,

Watt²,

Phengdy³

et al. 2008

The American Journal of Tropical Medicine and Hygiene

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Noma, or cancrum oris, is a debilitating necrotizing ulcerative stomatitis that destroys the mouth and face. It usually starts in early childhood and is associated with severe poverty, malnutrition, and infections. It is most frequently described from sub-Saharan Africa but is under-reported. There have been very few reports from Asia. We describe the clinical and social features of a series of 12 patients with noma from remote poor villages in rural Lao People's Democratic Republic (Laos). Noma is an ominous stigma of severe poverty and the description of this disease emphasizes the importance of poverty reduction and nutritional improvement in Lao development. In the meantime, more awareness of the problem and the importance of early therapy in acute noma by primary health care workers may reduce mortality and prevent progression to severe disfigurement.

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Section: Discussionmentioning

confidence: 99%

Noma in Laos: Stigma of Severe Poverty in Rural Asia

Srour¹,

Watt²,

Phengdy³

et al. 2008

The American Journal of Tropical Medicine and Hygiene

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“…Thus, the goal of measles elimination was not met in WHO Europe Region (WHO/EUR) by 2010 9 . Similarly, outbreaks of measles frequently occur in WHO Western Pacific Region (WHO/WPR), a region with high measles vaccination coverage 10, 11, 12, 13…”

Section: Introductionmentioning

confidence: 99%

Timeliness and completeness of measles vaccination among children in rural areas of Guangxi, China: A stratified three-stage cluster survey

Tang

Geater

McNeil

et al. 2017

Journal of Epidemiology

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BackgroundLarge-scale outbreaks of measles occurred in 2013 and 2014 in rural Guangxi, a region in Southwest China with high coverage for measles-containing vaccine (MCV). This study aimed to estimate the timely vaccination coverage, the timely-and-complete vaccination coverage, and the median delay period for MCV among children aged 18–54 months in rural Guangxi.MethodsBased on quartiles of measles incidence during 2011–2013, a stratified three-stage cluster survey was conducted from June through August 2015. Using weighted estimation and finite population correction, vaccination coverage and 95% confidence intervals (CIs) were calculated. Weighted Kaplan–Meier analyses were used to estimate the median delay periods for the first (MCV1) and second (MCV2) doses of the vaccine.ResultsA total of 1216 children were surveyed. The timely vaccination coverage rate was 58.4% (95% CI, 54.9%–62.0%) for MCV1, and 76.9% (95% CI, 73.6%–80.0%) for MCV2. The timely-and-complete vaccination coverage rate was 47.4% (95% CI, 44.0%–51.0%). The median delay period was 32 (95% CI, 27–38) days for MCV1, and 159 (95% CI, 118–195) days for MCV2.ConclusionsThe timeliness and completeness of measles vaccination was low, and the median delay period was long among children in rural Guangxi. Incorporating the timeliness and completeness into official routine vaccination coverage statistics may help appraise the coverage of vaccination in China.

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“…[10,12] It is critical to note that no supplementary immunization activities like MMR during the outbreak were done and the case patients themselves took the treatment from different specialized centers. Traditional beliefs and barriers about the German measles/measles do not foster healthy behaviors [13,14] in the population, more so in the cases of Bengali colony slums, Sperrah, and Gargoon village, reducing the diet intake to the minimum with Seul rich diet and VANNAN bushes movement as part of help seeking behavior before or with modern medicines later on forms the mainstay of the treatment. The diet rich in seul (a herbal plant with small granules), thought to be hot in nature by the local community members and they are supposed to facilitate the eruption of measles; these granules are also roasted for eating as well as smoked fumes are placed underneath the cot of the ailing patients.…”

Section: Discussionmentioning

confidence: 99%

German measles outbreak bursts in two unvaccinated border hilly districts of Northern Himachal Pradesh, India

Gupta¹,

Gupta²,

Neki

2012

Ann Trop Med Public Health

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Background:We investigated German measles outbreak as a suspected one of measles to confirm diagnosis and recommend for control and prevention. Materials and Methods: We defined a case of German measles as the occurrence of febrile rash in any resident of the eight villages from 20 th October to 16 th January, 2007. Case patients were line listed and information on age, sex, residence, date of onset, symptoms, signs, traveling, treatment history, vaccination status, and pregnancy status were collected. The outbreak was described by time, place, and person characteristics. Diagnosis was confirmed clinically, epidemiologically, and serologically; first to measles, scrub typhus and later to German measles viruses. Results: We identified 116 cases in eight villages (112/116 clinically and 04/116 laboratory confirmed). The overall attack rate (AR) was 11%; highest in the age group of 11-20 years (range 13% to 44%). Sex specific AR for male was 12%. All case patients were <20 years of age with a median age of 12 years. Complication rate was 05%, but no death reported on account of German measles. No pregnant woman was found to be affected. None of them were immunized against rubella. Four tested positive for immunoglobulin M (IgM) antibodies to rubella out of eight samples. Thirty three percent (38/116) had their treatment of choice to the modern medicine. Conclusion: German measles outbreak was confirmed in unvaccinated populations, which was possibly due to the frequent traveling of Bengali colony vendors' case patients to other areas. We advised the local health authorities to provide MR vaccination to the unexposed in eight affected and neighboring villages.

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Factors associated with a measles outbreak in children admitted at Mahosot Hospital, Vientiane, Laos

Abstract: Background: In 2002 and 2003 there were large outbreaks of measles in many provinces of Laos, including in Vientiane. We therefore conducted a study to determine risk factors associated with measles amongst children admitted at Mahosot Hospital, Vientiane.

Cited by 5 publications

References 8 publications

Noma in Laos: Stigma of Severe Poverty in Rural Asia

Noma in Laos: Stigma of Severe Poverty in Rural Asia

Timeliness and completeness of measles vaccination among children in rural areas of Guangxi, China: A stratified three-stage cluster survey

German measles outbreak bursts in two unvaccinated border hilly districts of Northern Himachal Pradesh, India

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