Hospital exposure as a risk factor for the transmission of measles: A case-control study in Turkey.

Yıl 2016, Cilt 14, Sayı 1, 13 - 22, 04.05.2016

Serap ÇETİN ÇOBAN Selmur TOPAL Fehminaz TEMEL Muharrem ÖNCÜL Bao-ping ZHU Levent AKIN

https://doi.org/10.20518/thsd.67473

Cited By: 1

Öz

Objective: During a nationwide measles epidemic in 2013, we conducted an investigation in Sanliurfa province to assess risk factors for measles infections. Methods: In a case-control design, we compared the history of hospital exposures for 189 randomly selected laboratory-confirmed patients (aged <15 years) residing in the central district and control-individuals matched for neighbourhood and age. We estimated the effectiveness of the vaccine (VE). Results:For infants from 0-11 months, 53.8% of the case and 23.8% of the controls had visited a hospital during one the month prior to the onset of the case’s rash (ORadj=3.7, 95% CI=1.6–8.6). For children from 1–6 years, 48.2% of the cases  and 14.3% of the controls visited a hospital during one month prior to the onset case’s rash (ORadj=5.5,95% CI=2.5–12.8) and  59.7% of cases had not completed one dose of measles vaccine  by 12 months, compared with 

14.7% of controls (ORadj=7.4,95% CI=2.1–26.9; VE=86%,95% CI=52-96%). For children from 7– 14 years, 53.8% of the cases had not completed one dose of measles vaccination by age 12 months, compared with 15.4%  of controls (ORadj=6.7,95% CI=1.7–26.6; VE=85%, 95% CI=41-96%). Conclusion: We conclude that the hospitals facilitated measles transmission during this epidemic. We recommend triage febrile patients and patients with a rash in healthcare settings, and strengthening measles vaccination programme..

Keywords: Measles; Measles Vaccine; Nosocomial Infections; Risk Factors; Case Control Study

 

Anahtar Kelimeler

Measles, Measles vaccine, Nosocomial infections, Case-control studies

Kızamık bulaşında bir risk faktörü olarak hastane maruziyeti: Vaka-kontrol çalışması, Türkiye

Öz

Özet

Amaç: Türkiye’de 2013 yılında kızamık vakalarında artış görülmüştür. Bu çalışma, vakaların en sık görüldüğü Şanlıurfa ilinde kızamık hastalığını etkileyen risk faktörlerini değerlendirmek için yapılmıştır. Yöntem: Bu vaka-kontrol çalışmasında, merkez ilçede yaşayan ve rasgele seçilen, 15 yaş altı, laboratuvarda doğrulanmış 189 vaka ile komşu ve yaş eşleştirmesi yapılan kontrolleri karşılaştırılmıştır. Aşı etkililiği (AE) hesaplanmıştır. Bulgular: Döküntü başlamadan bir ay öncesinde herhangi bir sağlık kuruluşuna başvuranlar; 0–11 aylık yaş grubunda vakaların %53.8’i, kontrollerin %23.8’i (TRR_adj=3.7, %95 GA=1.6–8.6) 1–6 yaş grubunda vakaların % 48.2’i, kontrollerin %14.3 (TRR_adj=5.5, %95 GA=2.5–12.8),  7–14 yaş grubunda ise vakaların %22.5’i, kontrollerin %12.8’idir (TRR_adj=1.9, %95 GA=0.5–8.3). 12. aydaki kızamık aşı dozunu yaptırmayanlar; 1–6 yaş grubunda vakaların %59.7’si, kontrollerin %14.7’si (TRR_adj=7.4, 95% GA=2.1–26.9; AE=%86, %95 GA=%52-96), 7– 14 yaş grubunda ise vakaların %53.8’i, kontrollerin %15.4’üdür (TRR_adj=6.7,%95 GA=1.7–26.6; AE=%85, %95 GA=%41-96). Sonuç: Bu salgında hastanelerin kızamık bulaşını kolaylaştırdığı saptanmıştır. Çalışma sonuçlarına göre; ateş ve döküntülü vakalara triaj uygulanması ve kızamık aşı programının güçlendirilmesi önerilmiştir.

Anahtar kelimeler: Kızamık, kızamık aşısı, hastane kaynaklı enfeksiyonlar, risk faktörleri, vaka kontrol çalışması.

Anahtar Kelimeler

Kızamık, kızamık aşısı, hastane kaynaklı enfeksiyonlar, risk faktörleri, vaka kontrol çalışması

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