{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T16:56:12Z","timestamp":1794243372173,"version":"4.9.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T00:00:00Z","timestamp":1624320000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T00:00:00Z","timestamp":1624320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Measles outbreaks are prevalent throughout sub-Saharan Africa despite the preventive measures like vaccination that target under five-year-old children and health systems strengthening efforts like prioritizing the supply chain for supplies. Measles immunization coverage for Kasese district and Bugoye HC III in 2018 was 72 and 69%, respectively. This coverage has\u00a0been very low and always marked red in the Red categorization (below the national target\/poor performing) on the national league table indicators. The aim of this study was to assess the scope of the 2018\u20132019 measles outbreak and the associated risk factors among children aged 0\u201360\u2009months in Bugoye sub-county, Kasese district, western Uganda.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We conducted a retrospective unmatched case-control study among children aged 0\u201360\u2009months with measles (cases) who had either a clinical presentation or a laboratory confirmation (IgM positivity) presenting at Bugoye Health Centre III (BHC) or in the surrounding communities between December 2018 and October 2019.. Caregivers of the controls (whose children did not have measles) were selected at the time of data collection in July 2020. A modified CDC case investigation form was used in data collection. Quantitative data was collected and analyzed using Microsoft excel and STATA version 13. The children\u2019s immunization cards and health registers at BHC were reviewed to ascertain the immunization status of the children before the outbreak.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>An extended measles outbreak occurred in Bugoye, Uganda occured between\u00a0December 2018 and October 2019. All 34 facility-based measles cases were documented to have\u00a0had maculopapular rash, conjunctivitis, and cough. Also, the majority had fever (97%), coryza (94.1%), lymphadenopathy (76.5%), arthralgias (73.5%) and Koplik Spots (91.2%) as documented in the clinical registers. Similar symptoms were reported among 36 community-based cases. Getting infected even after immunized, low measles vaccination coverage were identified as the principal risk factors for this outbreak.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Measles is still a significant problem. This study showed that this outbreak was associated with under-vaccination. Implementing a second routine dose of measles-rubella vaccine would not only increase the number of children with at least one dose but also boost the immunity of those who had the first dose.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-021-06213-5","type":"journal-article","created":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T15:44:46Z","timestamp":1624376686000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Measles outbreak in Western Uganda: a case-control study"],"prefix":"10.1186","volume":"21","author":[{"given":"Abel Wilson","family":"Walekhwa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses","family":"Ntaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Chris","family":"Kawungezi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Achangwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabbison","family":"Muhindo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Baguma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Matte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Migisha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"Reyes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peyton","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross M.","family":"Boyce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar M.","family":"Mulogo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,22]]},"reference":[{"issue":"6227","key":"6213_CR1","doi-asserted-by":"publisher","first-page":"1240","DOI":"10.1126\/science.aaa3438","volume":"347","author":"S Takahashi","year":"2015","unstructured":"Takahashi S, Metcalf CJE, Ferrari MJ, Moss WJ, Truelove SA, Tatem AJ, et al. Reduced vaccination and the risk of measles and other childhood infections post-Ebola. Science. 2015;347(6227):1240\u20132. https:\/\/doi.org\/10.1126\/science.aaa3438.","journal-title":"Science"},{"issue":"15","key":"6213_CR2","doi-asserted-by":"publisher","first-page":"1584","DOI":"10.1001\/jama.2015.1889","volume":"313","author":"AE Thompson","year":"2015","unstructured":"Thompson AE. Recognizing measles. Jama. 2015;313(15):1584. https:\/\/doi.org\/10.1001\/jama.2015.1889.","journal-title":"Jama"},{"key":"6213_CR3","unstructured":"Control CfD, Prevention: national notifiable diseases surveillance system (NNDSS). Morbidity and Mortality Weekly Report Data available at https:\/\/data.cdc.gov\/. Accessed 20 Oct 2020."},{"issue":"11","key":"6213_CR4","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.3390\/v11111017","volume":"11","author":"M Ferren","year":"2019","unstructured":"Ferren M, Horvat B, Mathieu C. Measles encephalitis: towards new therapeutics. Viruses. 2019;11(11):1017. https:\/\/doi.org\/10.3390\/v11111017.","journal-title":"Viruses"},{"key":"6213_CR5","doi-asserted-by":"crossref","unstructured":"Mahase E. Measles cases rise 300% globally in first few months of 2019. BMJ. 2019;365.","DOI":"10.1136\/bmj.l1810"},{"issue":"1","key":"6213_CR6","doi-asserted-by":"publisher","first-page":"15585","DOI":"10.1038\/ncomms15585","volume":"8","author":"S Takahashi","year":"2017","unstructured":"Takahashi S, Metcalf CJE, Ferrari MJ, Tatem AJ, Lessler J. The geography of measles vaccination in the African Great Lakes region. Nat Commun. 2017;8(1):15585. https:\/\/doi.org\/10.1038\/ncomms15585.","journal-title":"Nat Commun"},{"key":"6213_CR7","unstructured":"WHO: More than 140,000 die from measles as cases surge worldwide. 2019."},{"key":"6213_CR8","unstructured":"Measles key facts [https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/measles]. 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Measles vaccines: WHO position paper - April 2017. Weekly Epidemiol Record. 2017;92(17):205\u20138.","journal-title":"Weekly Epidemiol Record"},{"key":"6213_CR14","doi-asserted-by":"crossref","unstructured":"Melenotte C, Cassir N, Tessonnier L, Brouqui P. Atypical measles syndrome in adults: still around. BMJ Case Rep. 2015;2015:bcr2015211054.","DOI":"10.1136\/bcr-2015-211054"},{"issue":"12","key":"6213_CR15","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1007\/s11908-015-0506-5","volume":"17","author":"C Abad","year":"2015","unstructured":"Abad C, Safdar N. The reemergence of measles. Curr Infect Dis Rep. 2015; 17(12):51. https:\/\/doi.org\/10.1007\/s11908-015-0506-5.","journal-title":"Curr Infect Dis Rep"},{"key":"6213_CR16","volume-title":"Quarterly disease surveillance report in","author":"HMIS","year":"2019","unstructured":"HMIS. Quarterly disease surveillance report in. 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BMC Infect Dis. 2020;20(1):1\u20137.","journal-title":"BMC Infect Dis"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06213-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-021-06213-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06213-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T15:45:32Z","timestamp":1624376732000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-021-06213-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,22]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["6213"],"URL":"https:\/\/doi.org\/10.1186\/s12879-021-06213-5","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,22]]},"assertion":[{"value":"12 November 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 May 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 June 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All methods were carried out in accordance with relevant guidelines and regulations. Informed consent was obtained from all study participants since the study targeted caregivers who were above 18\u2009years but if subjects are under 18, permission was sought from a parent and\/or legal guardian.Permission was also sought from Mbarara University of science and Technology research ethics committee (MUST-REC) reference number MUREC 1\/7 and also from Uganda National Council of Science and Technology (reference number HS760ES).Also written permission to conduct the study was obtained from Kasese District Local Government through the office of the District Health Officer.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Ross M Boyce is an Associate Editor of BMC-infectious diseases.All authors declare no form of competing interest financial and non-financial in this project. No other relationships or activities that could appear to have influenced the submitted work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"596"}}