Measles Outbreak Investigation in Guradamole District of Bale Zone, South Eastern Ethiopia, 2021

Figures & data

Table 1 Sample Size Calculation for the Study Using Double Population Proportion

Variable	% In Unexposed	AOR	CI	Power	Ratio	Sample Size	Reference
Contact	23	2.72	95	80	1:2	180	31
Family size	47	2.74	95	80	1:2	168	31
Distance >1 hour from facility	36.47	4.4	95	80	1:2	104	32
Mothers Age	22	3.8	95%	80	1:2	105	28

Table 2 Table Showing Age Specific Attack Rate of the Outbreak

S. No	Age Category by Month	Measles Cases	Population at Risk	Attack Rate AR/1000
1	0–59	66	1743	37.88
2	60–108	15	1980	7.58
3	109–168	9	1873	4.81
4	169–228	5	1067	4.69
5	229–288	2	818	2.45
6	289–348	1	865	1.16
7	Total	98	8345	11.74

Table 3 Table Showing Attack Rate of the Outbreak by Kebeles of the District

S. No	Kebele	Number of Cases	Percent (%)
1	Hokoltu	76	77.6
2	Funale Kusi	9	9.2
3	Alhashana	4	4.1
4	Engoye Ilani	6	6.1
5	Yubdo Sere	3	3
	Total	98	100

Figure 1 Measles cases by age category, Guradamole District, Bale Zone, Southeastern Ethiopia, 2021.

Figure 2 Epi curve showing date of onset symptom and number of measles cases reported in Guradamole District, Bale Zone, Southeastern Ethiopia, 2021.

Table 4 Table Showing Percent of Measles Cases with Signs and Symptoms

S. No	Type of Symptom	Develop Symptoms
		Number	Percent
1	Rash	98	100
2	Fever	98	100.0
3	Cough	98	100.0
4	Diarrhea	18	18.4
5	Pneumonia	12	12.2
6	Conjunctivitis	68	69.4
7	Coryza	55	56.1
8	Otitis media	8	8

Figure 3 Graph showing vaccination status of cases Guradamole District, Bale Zone, Southeastern Ethiopia, 2021.

Table 5 Table Showing Sociodemographic Characteristic of Cases and Controls

Variables	Category	Cases N (%)	Controls N (%)	Sig.	COR
Age of the child	<12 months	19 (31.6)	29 (24)	0.549	1
	12–59 months	31 (51.6)	67 (56)	0.343	1.416
	60–168 months	10 (16.6)	24 (20)	0.344	1.572
Sex of the child	Male	34 (57)	51 (42.5)	0.073	1.333
	Female	26 (43)	69 (57.5)	0.741	0.848
Family’s ethnic group	Oromo	49 (82)	109 (91)	0.199	0.522
	Somali	11 (18)	11 (9)	0.880	1
Marital Status of mother/care giver	Married	45 (75)	104 (82)	0.442	1
	Divorced	5 (8.4)	6 (5)	0.685	0.720
	Widow	6 (10)	4 (3)	0.599	0.696
	Single	4 (6.6)	6 (5)	0.119	0.341
Religion of mother/care giver	Muslim	60 (100)	120 (100)
Occupation of the mother/care giver	Pastoralist	41 (68)	68 (57)	0.118	1
	Farmer	15 (25)	35 (29)	0.147	1.719
	Housewife	4 (7)	17 (14)	0.109	6.136
Family size	<4	33 (55)	73 (61)		1
	>5	27 (45)	47 (39)	0.478	0.782
Educational status of the mother/care giver	No formal education	41 (68)	60 (50)	0.118	1
	Primary 1–8	18 (30)	52 (43)	0.147	1.719
	Secondary 9–12	1 (2)	8 (7)	0.109	6.136

Table 6 Table Showing Candidate Variables in Bivariate Logistic Regression for the Multivariate Analysis

Variable	Category	Status		Sig.	COR	95%CI
		Cases N (%)	Controls N (%)			Lower	Upper
Contact history	Yes	35 (58)	26 (22)	0.00*	5.062	2.584	9.915
	No	25 (42)	94 (78)	1
Travel history before 14 days	Yes	32 (53)	26 (22)	0.00*	4.132	2.119	8.056
	No	28 (47)	94 (78)	1
Knowledge about measles is vaccine preventable	Yes	17 (28)	63 (52)	0.002*	0.358	0.184	0.696
	No	43 (72)	57 (48)	1
Visited mosque within 10 days	Yes	30 (50)	17 (9)	0.00*	6.059	2.947	12.456
	No	30 (50)	103 (57)	1
Knowledge about measles transmission	Yes	26 (43)	38 (21)	0.085*	1.65	0.871	3.127
	No	34 (57)	82 (79)	1
Nutritional status	Moderate acute malnutrition	27 (15)	19 (11)	0.00*	4.349	2.146	8.814
	Normal	33 (18)	101 (56)	1
Vaccination status	Unvaccinated	41 (68.3)	61 (51)	0.025*	5.667	1.244	25.813
	Vaccinated	17 (28.3)	55 (46)	1
	Unknown	2 (3.3)	5 (4.2)	0.128	3.4	0.703	16.436
Distance from health center	30 minutes	19 (31.5)	16 (13.3)	1
	31–60 minutes	13 (21.5)	28 (23.3)	0.018*	3.663	1.248	10.755
	> One hour	28 (47)	76 (63.3)	0.002*	4.344	1.687	11.187
Previous measles infection	YES	4	17	0.14*	0.541	0.218	1.339
	No	56	103	1
Presence of heath facility	Yes	26 (14)	59 (33)	0.055*	0.791	0.424	1.475
	No	34 (20)	61 (34)	1
Presence of measles case in the family	Yes	29 (16)	27 (15)	0.665	3.222	1.66	6.255
	No	31 (17)	93 (52)	1
Sick with other disease	Yes	33 (18)	28 (15.6)	0.00*	4.016	2.072	7.782
	No	27 (15)	92 (51)	1.00
Vaccine doses	One dose	11 (6)	11 (6)	0.095*	1.25	0.358	4.363
	Two doses	8 (4.4)	10 (5.6)	1

Notes: 1=reference variable, *significant at P-value 0.25.

Table 7 Variables Independently Associated with Measles Infection in Multivariate Logistic Regression

Variable	Category	Status		P-value	AOR	95%CI
		Cases N (%)	Controls N (%)			Lower	Upper
Vaccination Status	Unvaccinated	41 (68, 3)	61 (51)	0.034	2.619	1.077	6.369
	Vaccinated	17 (28.3)	55 (46)	1*
	Unknown	2 (3.3)	5 (4.2)	0.066	7.103	0.881	57.247
Nutritional status	Moderate acute malnutrition	22 (36.6)	18 (15)	0.012	3.214	1.297	7.969
	Normal	33 (55)	91 (76)	1*
Distance from health facility	30 minutes	19 (31.5)	16 (13)	1*
	31–60 minutes	13 (21.5)	28 (23)	0.045	3.913	1.031	14.860
	>60 minutes	28 (47)	76 (63)	0.012	4.585	1.391	15.112
Travel before 14 days	Yes	32 (53)	26 (22)	0.015	3.996	1.310	12.191
	No	28 (47)	94 (78)	1*
Contact history	Yes	17 (28)	10 (8)	0.044	3.243	1.034	10.175
	No	43 (72)	110 (92)	1*

Notes: −1= shows reference variable, *Significant at P-value 0.05.

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