title: Measles vaccine effectiveness and risk factors for measles in Dhaka, Bangladesh.
abstract: OBJECTIVE
  To evaluate vaccine effectiveness and to assess risk factors for measles in Dhaka, Bangladesh.
  
  
  METHODS
  A case-control study, involving 198 cases with 783 age-matched neighbourhood controls and 120 measles cases with 365 age-matched hospital controls, was conducted in 1995-96 in three large hospitals in Dhaka.
  
  
  RESULTS
  Measles vaccine effectiveness was estimated at 80% (95% confidence interval (CI) = 60-90%) using neighbourhood controls; very similar results were obtained using hospital controls. Visits to a health facility 7-21 days before onset of any symptoms were associated with increased risk of measles compared with neighbourhood (adjusted odds ratio (OR) = 7.0, 95% CI = 4.2-11.6) or hospital (adjusted OR = 1.7, 95% CI = 1.01-2.8) controls. Cases were more likely than controls to come from a household where more than one child lived (adjusted OR = 1.6, 95% CI = 1.1-2.5 versus neighbourhood controls; adjusted OR = 1.8, 95% CI = 1.02-3.0 versus hospital controls).
  
  
  CONCLUSIONS
  To improve measles control in urban Dhaka missed immunization opportunities must be reduced in all health care facilities by following WHO guidelines. For measles elimination, more than one dose of vaccine would be required.
authors.affiliation: Clinical Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B): Centre for Health and Population Research, Dhaka, Bangladesh. azaman@mrc.gm
authors.forename: Syed M
authors.initials: SM
authors.lastname: Akramuzzaman
authors.forename: Felicity T
authors.initials: FT
authors.lastname: Cutts
authors.forename: Md J
authors.initials: MJ
authors.lastname: Hossain
authors.forename: Obaidullah K
authors.initials: OK
authors.lastname: Wahedi
authors.forename: Nazmun
authors.initials: N
authors.lastname: Nahar
authors.forename: Darul
authors.initials: D
authors.lastname: Islam
authors.forename: Narayan C
authors.initials: NC
authors.lastname: Shaha
authors.forename: Dilip
authors.initials: D
authors.lastname: Mahalanabis
mesh_terms: D001459:Bangladesh / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008457:Measles / Q000453:epidemiology / Q000517:prevention & control*; D008458:Measles Vaccine / Q000627:therapeutic use*; D016017:Odds Ratio; D012111:Residence Characteristics; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D008458:Measles Vaccine