Epidemiology of measles in the Central Region of Ghana: a five-year case review in three district hospitals

Abstract

Objective: As part of a national accelerated campaign to eliminate measles, we conducted a study, to define the epidemiology of measles in the Central Region.

Design: A descriptive survey was carried out on retrospective cases of measles.

Setting: Patients were drawn from the three district hospitals (Assin, Asikuma and Winneba Hospitals) with the highest number of reported cases in the region.

Subjects: Records of outpatient and inpatient measles patients attending the selected health facilities between 1996 and 2000. Data on reported measles cases in all health facilities in the three study, districts were also analysed.

Main outcome measures: The distribution of measles cases in person (age and sex), time (weekly, or monthly, trends) and place (residence), the relative frequency, of cases, and the outcome of treatment.

Results: There was an overall decline in reported cases of measles between 1996 and 2000 both in absolute terms and relative to other diseases. Females constituted 48%-52% of the reported 1508 cases in the hospitals. The median age of patients was 36 months. Eleven percent of cases were aged under nine months; 66% under five years and 96% under 15 years. With some minor variations between districts, the highest and lowest transmission occurred in March and September respectively. Within hospitals, there were sporadic outbreaks with up to 34 weekly cases.

Conclusion: In Ghana, children aged nine months to 14 years could be appropriately targeted for supplementary, measles immunization campaigns. The best period for the campaigns is during the low transmission months of August to October. Retrospective surveillance can expediently inform decisions about the timing and target age groups for such campaigns.