Conference Abstract | Volume 8, Abstract NACNDC/19JASH0024 (Poster) | Published: 08 Dec 2025
Kyomugisha Aman1,&, Sharon Namasambi1, Deborah Aujo1, Charles Opolot2, Ivan Nalungu2, Suzan Okwakol2, Emmanuel Ongala2, Paul Okello3, Benon Kwesiga3, Richard Migisha3, Daniel Kadobera4, Alex Riolexus Ario3
1Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda, 2Kumi District Health Office, Uganda, 3Ugandan National Institute of Public Health, Ministry of Health, Kampala, Uganda, 4Division of Global Health and Protection, U.S. Centres for Disease Control and Prevention, Kampala, Uganda.
&Corresponding author: Kyomugisha Aman, Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda, Email: akyomugisha@uniph.go.ug ORCID: https://orcid.org/0009-0009-3559-5693
Received: 11 Sep 2025, Accepted: 20 Oct 2025, Published: 08 Dec 2025
Domain: Infectious Disease Epidemiology, Outbreak Investigation
Keywords: Measles outbreak, Health-facility exposure, Transmission risk factors, Vaccination coverage, Vaccine effectiveness, Uganda
©Kyomugisha Aman et al. Journal of Interventional Epidemiology and Public Health (ISSN: 2664-2824). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Kyomugisha Aman et al., A measles outbreak linked to low vaccination coverage and propagated by health facility exposure in Kumi District, Uganda, May–July 2025. Journal of Interventional Epidemiology and Public Health. 2025;8(ConfProc6):00024. https://doi.org/10.37432/JIEPH-CONFPRO6-00024
A suspected case was acute onset of fever, maculopapular rash with ≥1 of cough, coryza, or conjunctivitis in a Kumi resident from 1 May–31 July 2025. A confirmed case was IgM-positive. We line-listed cases through health facility records review and community active case searches supported by local leaders. We conducted descriptive epidemiology, environmental assessment and a matched case-control study (1:2). Risk factors were assessed using conditional logistic regression. Vaccine coverage and effectiveness were estimated for the first measles vaccine dose (MR1).
We identified 177 cases, including 6(3%) confirmed and 2(1%) dead. 57(32%) were aged 18-59 months, 89(51%) were male and 104(61%) were vaccinated with ≥1 dose. Initial transmission occurred during religious gatherings attended by symptomatic individuals. A second cluster followed arrival of symptomatic guests from affected districts. The final cluster reflected community propagation, driven by hospital ward exposure and visits of healthy children to hospitalized symptomatic children. Visiting health facilities (aOR=20, 95% CI: 5.7–71), playing around neighbouring homes (aOR=6, 95% CI: 1.4–24), and attending religious gatherings (aOR=1.9, 95% CI: 1.03–3.5) increased odds of infection. Vaccination with ≥1 dose was protective (aOR=0.36, 95% CI: 0.16–0.79). Poor isolation and triage practices were observed in high-volume health facilities. Vaccine coverage among controls was 73% for MR1 and 13% for MR2. Vaccine effectiveness for MR1 was 65% (95% CI: 23–84).
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