Measles Outbreak in Anbar Province During 2023-2024. Demographic Distribution and Vaccination Status
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Keywords
Measles, age, gender, vaccination status, Anbar province
Abstract
Background: This is the first public study covering all cities in Anbar Province regarding the measles outbreaks occurred in 2023 and 2024. Aim: To estimate the demographic distribution of measles among infected children (age, gender, residence) in Anbar Province and to study the effectiveness of the measles vaccine for each patient on infection. Methods: A retrospective analytic cross-sectional study was conducted across all sectors of Anbar Province. The patients included those who were admitted, diagnosed, and treated in various hospitals during the measles outbreak in 2023, and 2024 years. The data was recorded in files of the Anbar Public Health Directorate, which included information on age, gender, residence, clinical manifestations, and vaccination status for each patient. Results: A total of 1,663 cases was 1663 patients with a male-to-female ratio of 1.2:1. Among the patients, 203 (12.2%) were less than one year old, 595 (35.8%) were between one to two years old, and 865 (52%)were more than two years. Of the cases, 259 (15.6%) were unvaccinated, 944 (56.8%) had received single dose of the measles vaccine, and 460 (27.6%) had received two or more doses. The most commonly reported clinical features were fever, skin rash, conjunctivitis, coryza, and cough, while lymphadenopathy was the least reported. Conclusions: A high percentage of cases were diagnosed with measles in Anbar Province, and a significant number of patients contracted the infection despite being vaccinated.
References
2. Laksono BM, de Vries RD, McQuaid S, Duprex WP, de Swart RL. Measles virus-host invasion and pathogenesis. Viruses. 2016;8(8):210.
3. Leung AKC, Hon KL, Leong KF, et al. Measles: a disease often forgotten but not gone. Hong Kong Med J. 2018;24(5):512–520.
4. Cetorelli V, Shabila NP. Expansion of health facilities in Iraq a decade after the US-led invasion, 2003–2012. Confl Health. 2014;8(1):1–7.
5. Liu Y, Lu P, Hu Y, et al. Cross-sectional surveys of measles antibodies in Jiangsu Province, China, 2008–2010: effect of high coverage with two doses of measles vaccine. PLoS One. 2013;8:e66771.
6. Mokaya EN, Isaac Z, Anyuon NA. Measles outbreak investigation in Aweil East County, South Sudan. Pan Afr Med J. 2021;40:1.
7. Comfort H, Lafta RK, Flaxman AD, Hagopian A, Duber HC. Association between subnational vaccine coverage, migration, and incident cases of measles, mumps, and rubella in Iraq, 2001–2016. Front Public Health. 2022;9:689458.
8. Kulsoom S, Soomro S, Junejo S, et al. Clinical presentation, complications, and outcome of measles in pediatric population at a tertiary care hospital. Pak J Health Sci. 2023;50–53.
9. Stein-Zamir C, Shoob H, Abramson D. Measles clinical presentation, hospitalization, and vaccination status among children in a community-wide outbreak. Vaccine. 2023;41:2764–2768.
10. Pandey A, Tejan N, Tripathi R, Chaturvedi R, Dhole TN. Prevalence of measles virus infection among vaccinated and nonvaccinated children in Northern India. Int J Pharm Sci Res. 2019;10(4):1953–1958.
11. Danhash HY, Al-Ani RK, Khalee MS. Modes of transmission of brucellosis in Anbar Governorate, Iraq. Anb Med J. 2022;18(1):5–9.
12. Al-Ani RK, Dawud HGF, Khalaf KTN. Kala-azar among children in Anbar Province, Iraq: a retrospective study. Int Med J. 2025;32(2):75–78.
13. Ramalingam S, Shankari D, Maniyappa M, et al. Measles epidemic in South India in 2024. Int J Epidemiol Health Sci. 2024;5:1–6.
14. Pegorie M, Shankar K, Welfare WS, et al. Measles outbreak in Greater Manchester, England, October 2012 to September 2013: epidemiology and control. Euro Surveill. 2014;19:20982.
15. Dominguez A, Plans P, Costa J, et al. Seroprevalence of measles, rubella, and mumps antibodies in Catalonia, Spain. Eur J Clin Microbiol Infect Dis. 2006;25:310–317.
16. Kontio M, Palmu AA, Syrjänen RK, et al. Similar antibody levels in 3-year-old children vaccinated against measles, mumps, and rubella at 12 or 18 months of age. J Infect Dis. 2016;213:2005–2013.
17. Bolotin S, Severini A, Hatchette T, et al. Assessment of population immunity to measles in Ontario, Canada. Hum Vaccin Immunother. 2019;15:2856–2864.
18. Green MS, Schwartz N, Peer V. Gender differences in measles incidence rates in high-income countries. BMC Infect Dis. 2022;22(1):358.
19. Mishra A, Mishra S, Lahariya C, et al. Practical observations from an epidemiological investigation of a measles outbreak in India. Indian J Community Med. 2009;34(2):117–121.
20. Mathew JL, Wagner AL, Ratho RK. Maternally transmitted anti-measles antibodies and susceptibility among infants in Chandigarh, India. PLoS One. 2023;18(10):e0287110.
21. Muhammad Z, Khan S, Ahmad A. Frequency of measles in infants younger than 9 months of age. J Med Sci. 2018;26(2):115–119.
22. Crawshaw AF, Goldsmith LP, Deal A. Driving delivery and uptake of catch-up vaccination among migrants in UK general practice. BMC Med. 2024;22(1):186.
23. Rehman WU, Rehman SU, Ibrahim M, Haris M. Prevalence of measles in vaccinated and unvaccinated children: a cross-sectional study. Res Sq [Preprint]. 2024 Dec 23. doi:10.21203/rs.3.rs-5650818/v1.
24. Zahoor MA, Rasool MH, Waseem M, et al. Prevalence of measles in vaccinated and non-vaccinated children. EXCLI J. 2015;14:504–507.
25. Kadim MA, Abdulhasan AF, Abdulrasol ZA, Obaid AF. Dropout of vaccination among Iraqi children. South Asian J Soc Sci Humanit. 2022;3(6):163–171.
26. Alhaddad AR, Ahmadnezhad E, Fotouhi A. Vaccination coverage in under-5 children in Nasiriyah, Iraq before and during COVID-19. Epidemiol Health. 2022;44:e2022035.
27. Halboot KMMJ, Lami SA, Mohammed AJ, et al. Epidemiological trends and clinical characteristics of measles in Iraq (2023–2024). Res Sq [Preprint]. 2024. doi:10.21203/rs.3.rs-5234424/v1.
28. Sosale VS, Devadas S, Chinnappa GD, et al. Clinical and sociodemographic profile of measles in children admitted to a tertiary care center. Cureus. 2024;16(7):e65843.
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