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Rubella Outbreak Investigation at General Tadesse Biru Primary School, Addis Ababa, Ethiopia 2018

Received: 28 June 2021     Accepted: 15 July 2021     Published: 22 July 2021
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Abstract

Background: In African countries, rubella is widely under-recognized public health problem, and information on its epidemiology is very limited. In Ethiopia, rubella is not prioritized disease under surveillance and its vaccine has not been introduced into infant vaccination schedule. Rumor of suspected rubella outbreak received on January 26/2018. The purpose of investigation was to establish rumor existence, describe cases epidemiologically, identify causative agent and source of the outbreak to support outbreak control activities. Methods: A1:2 unmatched case-control study conducted at General Tadesse Biru Primary School, Addis Ababa, Ethiopia from February 3-25/2018. Total of 41 cases and 82 controls included. Controls selected conveniently from same school and data collected using structured questioner. Data analysis done using Epi-info software version7.2.1.0. Result: Total of 41 rubella cases identified. Index case and source of outbreak were not identified. Rubella sample positivity rate was 20%. First case seen on 5th January and last case on 19th February/2018. Most 23 (56.1%) cases were females and 17 (41.46%) among grade 1 and 2 students. Median age of cases was 10 years (IQR=4). Overall attack rate in the school was 1.39% and case fatality rate zero. All cases were complaining rash and 80.49% had fever. Educational status of grade 5-6 and 7-8 had 0.13- and 0.12-time reduced risk of developing rubella disease than grade 1-2 at P-value less than 0.05, respectively. Conclusion: Although index case and source of infection not identified, the outbreak might be driven by contact and sharing transportation service. Late notification causes late investigation and control. Provision of health education at school and community increase people’s awareness on rubella that contribute to control the outbreak.

Published in European Journal of Clinical and Biomedical Sciences (Volume 7, Issue 4)
DOI 10.11648/j.ejcbs.20210704.11
Page(s) 53-59
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Rubella Outbreak Investigation, School, Addis Ababa, Ethiopia, 2018

References
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[3] BestbJMb (2007). "Rubella". Semin Fetal Neonatal Med. 12 (3): 182–92. doi: 10.1016/j.siny.2007.01.017. PMID 17337363.
[4] Vijayalakshmi P, Anuradha R, Prakash K, Narendran K, Ravindran M, et al. (2004) Rubella serosurveys at three Aravind Eye Hospitals in Tamil Nadu, India. Bull World Health Organization 82: 259-264.
[5] Lanzieri TM, Segatto C, Siqueira MM, De Oliveria Santos EC, Jin L, et al. (2003) Burden of congenital rubella syndrome after a community- wide rubella outbreak, Rio Branco, Acre, Brazil, 2000 to 2001. Pediatr Infect Dis J 22: 323 329. (try 8)
[6] Donald G. McNeil Jr. (April 29, 2015). "Rubella Has Been Eliminated from the Americas, Health Officials Say". The New York Times.
[7] Global Programme for Vaccines and Immunization, EPI. Immunization Policy. Geneva: EPI WHO, 1996.
[8] Robertson SE, Cutts FT, Samuel R, Diaz-Ortega JL. Control of rubella and congenital rubella syndrome (CRS) in developing countries, part 2: vaccination against rubella. Bull WHO 1997; 75: 69-80.
[9] Lawn JE, Reef S, Baffoe-Bonnie B, Adadevoh S, Caul EO, Griffin GE. Unseen blindness, unheard deafness, and unrecorded death and disability: congenital rubella in Kumasi, Ghana. Am J Public Health 2000; 90: 1555–61.
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[14] Negga Asamene Abera, Rajiha Abuboker, Amete Mihret and Degefu Beyene. Reaserch Article Rubella Outbreak Investigation in Wombera and Dibate District, Metekel Zone, Benshangul Gumuz Region, January, 2013.
[15] Getachew Dinede, Abigiya Wondimagegnehu and Fikre Enquselassie. Rubella outbreak in the school children, Addis Ababa, Ethiopia: February–April 2018.
[16] C. Ziebold, B. Hassenpflug, H. WegnerBröse, K. Wegner, H. J. Schmitt. Clinical and Epidemiological Study. An Outbreak of Rubella aboard a Ship of the German Navy, 1996.
[17] Annamercy Chenaimoyo Makoni, Milton Chemhuru, Donewell Bangure, &, Notion Tafara Gombe, Mufuta Tshimanga. Rubella outbreak investigation, Gokwe North District, Midlands province, Zimbabwe, 2014 - a case control study. Department of Community Medicine, University of Zimbabwe, Ministry of Health and Child Care, Zimbabwe, 2014.
[18] Kassahun Mitiku, Tesfaye Bedada, Balcha Masresha, Wendemagegn Kegne, Fatoumata Nafo-Traore´, Neghist Tesfaye, and Berhane Beyene. The Epidemiology of Rubella Disease in Ethiopia: Data from the Measles Case-Based Surveillance System. JID 2011: 204.
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    Kefyalew Amene Bogale, Tesfahun Abiye Meshesha, Mukemil Hussein Mohammed, Tigist Abera Seyoum, Abiy Girmay. (2021). Rubella Outbreak Investigation at General Tadesse Biru Primary School, Addis Ababa, Ethiopia 2018. European Journal of Clinical and Biomedical Sciences, 7(4), 53-59. https://doi.org/10.11648/j.ejcbs.20210704.11

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    ACS Style

    Kefyalew Amene Bogale; Tesfahun Abiye Meshesha; Mukemil Hussein Mohammed; Tigist Abera Seyoum; Abiy Girmay. Rubella Outbreak Investigation at General Tadesse Biru Primary School, Addis Ababa, Ethiopia 2018. Eur. J. Clin. Biomed. Sci. 2021, 7(4), 53-59. doi: 10.11648/j.ejcbs.20210704.11

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    AMA Style

    Kefyalew Amene Bogale, Tesfahun Abiye Meshesha, Mukemil Hussein Mohammed, Tigist Abera Seyoum, Abiy Girmay. Rubella Outbreak Investigation at General Tadesse Biru Primary School, Addis Ababa, Ethiopia 2018. Eur J Clin Biomed Sci. 2021;7(4):53-59. doi: 10.11648/j.ejcbs.20210704.11

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  • @article{10.11648/j.ejcbs.20210704.11,
      author = {Kefyalew Amene Bogale and Tesfahun Abiye Meshesha and Mukemil Hussein Mohammed and Tigist Abera Seyoum and Abiy Girmay},
      title = {Rubella Outbreak Investigation at General Tadesse Biru Primary School, Addis Ababa, Ethiopia 2018},
      journal = {European Journal of Clinical and Biomedical Sciences},
      volume = {7},
      number = {4},
      pages = {53-59},
      doi = {10.11648/j.ejcbs.20210704.11},
      url = {https://doi.org/10.11648/j.ejcbs.20210704.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejcbs.20210704.11},
      abstract = {Background: In African countries, rubella is widely under-recognized public health problem, and information on its epidemiology is very limited. In Ethiopia, rubella is not prioritized disease under surveillance and its vaccine has not been introduced into infant vaccination schedule. Rumor of suspected rubella outbreak received on January 26/2018. The purpose of investigation was to establish rumor existence, describe cases epidemiologically, identify causative agent and source of the outbreak to support outbreak control activities. Methods: A1:2 unmatched case-control study conducted at General Tadesse Biru Primary School, Addis Ababa, Ethiopia from February 3-25/2018. Total of 41 cases and 82 controls included. Controls selected conveniently from same school and data collected using structured questioner. Data analysis done using Epi-info software version7.2.1.0. Result: Total of 41 rubella cases identified. Index case and source of outbreak were not identified. Rubella sample positivity rate was 20%. First case seen on 5th January and last case on 19th February/2018. Most 23 (56.1%) cases were females and 17 (41.46%) among grade 1 and 2 students. Median age of cases was 10 years (IQR=4). Overall attack rate in the school was 1.39% and case fatality rate zero. All cases were complaining rash and 80.49% had fever. Educational status of grade 5-6 and 7-8 had 0.13- and 0.12-time reduced risk of developing rubella disease than grade 1-2 at P-value less than 0.05, respectively. Conclusion: Although index case and source of infection not identified, the outbreak might be driven by contact and sharing transportation service. Late notification causes late investigation and control. Provision of health education at school and community increase people’s awareness on rubella that contribute to control the outbreak.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Rubella Outbreak Investigation at General Tadesse Biru Primary School, Addis Ababa, Ethiopia 2018
    AU  - Kefyalew Amene Bogale
    AU  - Tesfahun Abiye Meshesha
    AU  - Mukemil Hussein Mohammed
    AU  - Tigist Abera Seyoum
    AU  - Abiy Girmay
    Y1  - 2021/07/22
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ejcbs.20210704.11
    DO  - 10.11648/j.ejcbs.20210704.11
    T2  - European Journal of Clinical and Biomedical Sciences
    JF  - European Journal of Clinical and Biomedical Sciences
    JO  - European Journal of Clinical and Biomedical Sciences
    SP  - 53
    EP  - 59
    PB  - Science Publishing Group
    SN  - 2575-5005
    UR  - https://doi.org/10.11648/j.ejcbs.20210704.11
    AB  - Background: In African countries, rubella is widely under-recognized public health problem, and information on its epidemiology is very limited. In Ethiopia, rubella is not prioritized disease under surveillance and its vaccine has not been introduced into infant vaccination schedule. Rumor of suspected rubella outbreak received on January 26/2018. The purpose of investigation was to establish rumor existence, describe cases epidemiologically, identify causative agent and source of the outbreak to support outbreak control activities. Methods: A1:2 unmatched case-control study conducted at General Tadesse Biru Primary School, Addis Ababa, Ethiopia from February 3-25/2018. Total of 41 cases and 82 controls included. Controls selected conveniently from same school and data collected using structured questioner. Data analysis done using Epi-info software version7.2.1.0. Result: Total of 41 rubella cases identified. Index case and source of outbreak were not identified. Rubella sample positivity rate was 20%. First case seen on 5th January and last case on 19th February/2018. Most 23 (56.1%) cases were females and 17 (41.46%) among grade 1 and 2 students. Median age of cases was 10 years (IQR=4). Overall attack rate in the school was 1.39% and case fatality rate zero. All cases were complaining rash and 80.49% had fever. Educational status of grade 5-6 and 7-8 had 0.13- and 0.12-time reduced risk of developing rubella disease than grade 1-2 at P-value less than 0.05, respectively. Conclusion: Although index case and source of infection not identified, the outbreak might be driven by contact and sharing transportation service. Late notification causes late investigation and control. Provision of health education at school and community increase people’s awareness on rubella that contribute to control the outbreak.
    VL  - 7
    IS  - 4
    ER  - 

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Author Information
  • Department of Public Health Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia

  • Department of Public Health Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia

  • Department of Public Health Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia

  • Department of Traditional and Modern Medicine Research, Ethiopian Public Health Institute, Addis Ababa, Ethiopia

  • World Health Organization, Addis Ababa, Ethiopia

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