dc.contributor.author |
McMorrow, Meredith L.
|
|
dc.contributor.author |
Gebremedhin, Goitom
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|
dc.contributor.author |
Van den Heever, Johann
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|
dc.contributor.author |
Kezaala, Robert
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dc.contributor.author |
Harris, Bernice Nerine
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dc.contributor.author |
Nandy, Robin
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|
dc.contributor.author |
Strebel, Peter
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dc.contributor.author |
Jack, Abdoulie
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dc.contributor.author |
Cairns, K. Lisa
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|
dc.date.accessioned |
2009-06-29T13:46:30Z |
|
dc.date.available |
2009-06-29T13:46:30Z |
|
dc.date.issued |
2009-05 |
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dc.description.abstract |
OBJECTIVES: Measles was virtually eliminated in South Africa following control activities in 1996 / 7. However, from July 2003 to November 2005, 1 676 laboratory-confirmed measles cases were reported in South Africa. We investigated the outbreak's cause and the role of HIV.
DESIGN: We traced laboratory-confirmed case-patients residing in the Johannesburg metropolitan (JBM) and O R Tambo districts. We interviewed laboratory- or epidemiologically confirmed case-patients or their caregivers to determine vaccination status and, in JBM, HIV status. We calculated vaccine effectiveness using the screening method.
SETTING: Household survey in JBM and O R Tambo districts.
OUTCOME MEASURES: Vaccine effectiveness, case-fatality rate, and hospitalisations.
RESULTS: In JBM, 109 case-patients were investigated. Of the 57 case-patients eligible for immunisation, 27 (47.4%) were vaccinated. Fourteen (12.8%) case-patients were HIV infected, 46 (42.2%) were HIV uninfected, and 49 (45.0%) had unknown HIV status. Among children aged 12 - 59 months, vaccine effectiveness was 85% (95% confidence interval (CI) : 63, 94) for all children, 63% for HIV infected, 75% for HIV uninfected, and 96% for children with unknown HIV status. (Confidence intervals were not calculated for sub-groups owing to small sample size.) In O R Tambo district, 157 case-patients were investigated. Among the 138 case-patients eligible for immunisation, 41 (29.7%) were vaccinated. Vaccine effectiveness was 89% (95% CI 77, 95).
CONCLUSIONS: The outbreak's primary cause was failure to vaccinate enough of the population to prevent endemic measles transmission. Although vaccine effectiveness might have been lower in HIV-infected than in uninfected children, population vaccine effectiveness remained high. |
en_US |
dc.identifier.citation |
McMorrow, ML, Gebremedhin, G, Van den Heever, J, Kezaala, R, Harris, BN, Nandy, R, Strebel, P, Jack, A, & Cairns, KL 2009, 'Measles outbreak in South Africa, 2003 - 2005', South African Medical Journal, vol. 99, no. 5, pp. 314-319. [www.samj.org.za] |
en_US |
dc.identifier.issn |
0038-3469 |
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dc.identifier.uri |
http://hdl.handle.net/2263/10544 |
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dc.language.iso |
en |
en_US |
dc.publisher |
Health and Medical Publishing Group |
en_US |
dc.rights |
Health and Medical Publishing Group |
en_US |
dc.subject |
Measles |
en_US |
dc.subject |
South Africa |
en_US |
dc.subject.lcsh |
Measles -- South Africa |
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dc.subject.lcsh |
HIV infections -- Complications |
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dc.subject.lcsh |
Vaccination |
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dc.subject.mesh |
Vaccination |
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dc.title |
Measles outbreak in South Africa, 2003 - 2005 |
en_US |
dc.type |
Article |
en_US |