Trend in mortality from a recent measles outbreak in Cameroon: a retrospective analysis of 223 measles cases in the Benakuma Health District.
BACKGROUND
Measles is a highly contagious viral infection with high mortality in poorly vaccinated regions. We sought to establish the trend in mortality and the factors that favoured the recent measles outbreak that occurred in Benakuma, in the North west region of Cameroon from the 21/06/2015 to 26/09/2015.


METHODS
We carried out a retrospective register analysis of 223 measles cases. Time trends were established using the Mann-Kendall test while survival was assessed using the Kaplan-Meier survival analysis and log rank test for comparisons.


RESULTS
We had a case fatality of 8.5% and the mortality decreased significantly (p = 0.01) after the following public health interventions were instituted: community sensitisation and education; outbreak response immunisation and the use of a clinician in controlling the outbreak. Furthermore, the number of cases (p < 0.01) and the duration from onset of illness to consultation at a health facility (p < 0.01) decreased significantly after the institution of the aforementioned interventions. Also, survival during the outbreak was better in females (p = 0.02) and in those treated in health facilities (p < 0.01).


CONCLUSIONS
The poor vaccination status in Benakuma coupled with negative cultural beliefs; poor socioeconomic and environmental factors and inadequate public health policies predisposed the region to a measles outbreak and favoured the spread of the virus. Public health policies should be revisited, modified and intensified to scale up vaccination coverage in measles endemic zones in Cameroon to help eliminate the disease and facilitate the overall attainment of the Sustainable Development Goals.
Regional Hospital Bamenda, Bamenda, North west region, Cameroon; Health and Human Development (2HD) Research Group, Douala, Cameroon.
Tsi
T
Njim
District Hospital Benakuma, Benakuma, North west region, Cameroon.
Kimbong
K
Agyingi
School of Public Health, Faculty of Medicine & Biomedical Sciences, University of Queensland, Brisbane, Australia; Clinical Research Education, Networking and Consultancy, Douala, Cameroon.
Leopold Ndemnge
LN
Aminde
District Hospital Benakuma, Benakuma, North west region, Cameroon.
Edwin Fon
EF
Atunji
D000293:Adolescent; D002163:Cameroon / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D005260:Female; D006291:Health Policy; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D008457:Measles / Q000453:epidemiology / Q000401:mortality*; D008458:Measles Vaccine / Q000008:administration & dosage*; D011634:Public Health; D012189:Retrospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors; D013997:Time Factors
D008458:Measles Vaccine
Cameroon; Measles; mortality; outbreak response immunisation; sustainable development goals