Risk Factors of Measles Outbreak Among Students of Mizan-Tepi University, Tepi Campus, Southwest Ethiopia

Abstract

Background: Measles is a serious respiratory disease that is spread easily through coughing and sneezing of the measles virus for which humans are the only reservoir. Even though prevention and elimination strategies had been implemented, the outbreaks of measles infection quietly occur in different parts of the world. As of November 2019 a suspected measles outbreak was reported from Tepi campus student's clinic. We investigated the outbreak to determine its possible sources, control measures and identify associated risk factors among students of Mizan-Tepi University. Methods: A facility based unmatched case-control study was conducted. An interviewer administered questionnaire was used to collect the data. Data were cleaned and entered to Epi-info7 and analyzed using SPSS-20. A logistic regression analysis was conducted to identify risk factors associated with measles outbreak at a p-value ≤0.05. Results: A total of 40 measles cases were reported during the investigation. The probable source of the outbreak was an index case who had a travel history to a district with the measles epidemic. Five samples were collected for confirmation of the diagnosis. No measles-related deaths were reported. The major risk factors for measles infection in Mizan-Tepi University were being unvaccinated [AOR = 5.21, 95% CI (1.938, 12.058)], being female [AOR = 4.21, 95% CI (1.426, 11.182)], age group of 18-20 [AOR = 0.123, 95% CI (0.041, 0.37)] and having a contact history [AOR = 0.149, 95% CI (0.041, 0.544)]. Conclusion: The findings of the present investigation indicated that being unvaccinated and having a contact history with confirmed or suspected cases increased the risk of measles infection. Reduction in the level of protective antibodies over time may accelerate transmission of measles in the campus. Strengthening case-based surveillance and supplemental measles vaccination are imperative.