Published: 2021-10-27

The risk factors of measles outbreak in Dollo zone Somali region, Ethiopia

Abdisalan M. Ali, Mohammed A. Maalin


Background: Measles is a highly contagious acute viral illness with the possibility of severe and dangerous complications. Measles occurrence is related to urbanization because of high entry of migrants and high population density; cities have become important hubs for the spread of infectious diseases. The African region is a crucial player in the global fight against measles and has made tremendous progress in its effort to immunize children and to control the disease. Despite the accessibility of safe and cost-effective vaccine, measles has remained endemic with persistent periodic outbreaks in the horn of Africa.

Methods: We reviewed the measles cases line lists in Dollo zone from January 2017 to March 2018. There was a total of 771-line listed cases in 2017 and 326 line-listed in 2018. Measles case investigations on alerts were also reviewed when there is an alert rumors verification case investigation done. The line list included variables on vaccination status, age, sex, treatment modality, date of onset the rash, date seen health facility, diagnosis, outcome (alive or dead), locations from place cases came from, contact history and travel history were reviewed.

Results: We found that the measles outbreak affected different age groups in Dollo zone and most affected age group were between the ages of 15 years to 30 years and most of the cases have no history of immunization.

Conclusions: The outbreak affected all age groups, which may show the continuous low routine immunization coverage over several years and the gathering of the susceptible population in the older age group that may have led to the current outbreak.


Dollo, Ethiopia, Measles, Risk factors, Somali

Full Text:



Sartorius B, Cohen C, Chirwa T, Ntshoe G, Puren A, Hofman K. Identifying High Risk Areas for Sporadic Measles Outbreaks: Lessons from South Africa. Bull World Health Organ. 2013;91(3):174-83.

Mersha AM, Braka F, Gallagher K, Tegegne AA, Argay AK, Mekonnen MA, et al. Measles burden in urban settings: characteristics of measles cases in Addis Ababa city administration, Ethiopia, 2004-2014. Pan Afr Med J. 2017;27(2):11.

Tramuto F, Maida CM, Pojero F, Colomba GME, Casuccio A, Restivo V, et al. Case-based surveillance of measles in Sicily during 2012-2017: The changing molecular epidemiology and implications for vaccine strategies. PLoS One. 2018;13(4):1-14.

Getahun M, Beyene B, Ademe A, Teshome B, Tefera M, Afework A, et al. Epidemiology of laboratory confirmed measles virus cases in the southern nations of Ethiopia, 2007-2014. BMC Infect Dis. 2017;17(1):1-8.

Deribew A, Tessema GA, Deribe K, Melaku YA, Lakew Y, Amare AT, et al. Trends, causes, and risk factors of mortality among children under 5 in Ethiopia, 1990-2013: findings from the Global Burden of Disease Study 2013. Popul Health Metr. 2016;14(1):42.

Manakongtreecheep K, Davis R. A review of measles control in Kenya, with focus on recent innovations. Pan Afr Med J. 2017;27(3):15.

Beyene B, Ademe A, Teshome B, Tefera M, Asha A, Afework A, et al. Epidemiology of laboratory confirmed measles virus cases in Amhara Regional State of Ethiopia, 2004-2014. BMC Infect Dis. 2016;16(1):133.

Belda K, Tegegne AA, Mersha AM, Bayenessagne MG, Hussein I, Bezabeh B. Measles outbreak investigation in Guji zone of Oromia Region, Ethiopia. Pan Afr Med J. 2017;27(2):9.

Endriyas M, Solomon T, Belayhun B, Mekonnen E. Poor quality data challenges conclusion and decision making: timely analysis of measles confirmed and suspected cases line list in Southern Nations Nationalities and People’s Region, Ethiopia. BMC Infect Dis. 2018;18(1):77.

Donadeu M, Lightowlers MW, Fahrion AS, Kessels J, Abela-Ridder B. Weekly epidemiological record: relevé épidémiologique hebdomadaire. Week Epidemiol Rec. 2009;III(47):445-52.

Talley L, Salama P. Short report: assessing field vaccine efficacy for measles in famine-affected rural Ethiopia. Am J Trop Med Hyg. 2003;68(5):545-6.

Verguet S, Johri M, Morris SK, Gauvreau CL, Jha P, Jit M. Controlling measles using supplemental immunization activities: a mathematical model to inform optimal policy. Vaccine. 2015;33(10):1291-6.

Driessen J, Olson ZD, Jamison DT, Verguet S. Comparing the health and social protection effects of measles vaccination strategies in Ethiopia: An extended cost-effectiveness analysis. Soc Sci Med. 2015;139:115-22.

Portnoy A, Jit M, Helleringer S, Verguet S. Impact of measles supplementary immunization activities on reaching children missed by routine programs. Vaccine. 2018;36(1):170-8.

Mohammed Y, Alemu AN. Measles Outbreak Investigation and Response in Jarar Zone of Ethiopian Somali Regional State, Eastern Ethiopia. Int J Microbiol Res. 2017;8(3):86-91.

Belete Akalu H. Review on measles situation in Ethiopia; past and present. J Trop Dis. 2016;04(02):2-7.

Mbabazi WB, Tabu CW, Chemirmir C, Kisia J, Ali N, Corkum MG, et al. Innovations in communication technologies for measles supplemental immunization activities: lessons from Kenya measles vaccination campaign, November 2012. Health Policy Plan. 2015;30(5):638-44.

Kouadio IK, Kamigaki T, Oshitani H. Measles outbreaks in displaced populations: a review of transmission, morbidity and mortality associated factors. BMC Int Health Hum Rights. 2010;10:5. Available

Pomerai KW, Mudyiradima RF, Gombe NT. Measles outbreak investigation in Zaka, Masvingo Province, Zimbabwe, 2010. BMC Res Notes. 2012;5(1):1.

Kurchatova A, Krumova S, Vladimirova N, Nikolaeva-Glomb L, Stoyanova A, Kantardjiev T, et al. Preliminary findings indicate nosocomial transmission and Roma population as most affected group in ongoing measles B3 genotype outbreak in Bulgaria, March to August 2017. Eurosurveillance. 2017;22(36):1-6.

Lakew Y, Bekele A, Biadgilign S. Factors influencing full immunization coverage among 12-23 months of age children in Ethiopia: evidence from the national demographic and health survey in 2011. BMC Public Health. 2015;15:728.

Pulcini C, Massin S, Launay O, Verger P. Knowledge, attitudes, beliefs and practices of general practitioners towards measles and MMR vaccination in southeastern France in 2012. Clin Microbiol Infect. 2014;20(1):38-43.