Clinical Laboratory Investigations ofMeasles Virus Infection among SymptomaticPatients in South Central Somalia

Abstract

Background: The number of measles cases among fully vaccinated individuals is still higher than expected because
of vaccination. A retrospective cohort study was performed in this population using data collected over the course of
2 years – from January 2020 to December 2021 – to provide a detailed epidemiological and laboratory description
of measles infections in symptomatic patients presenting to health care facilities throughout Somalia. Methods: In
these patients, demographic information (e.g., age, sex, place of residence, available health care center type, socio-
economic status, past history of infections, etc.) and clinical characteristics were pulled from their respective medical
records for further analyses. Results: Of all patients tested for measles, 1180 were positive (61.1% males; 38.9%
females), with infants <1 year of age/children <15 years accounting for a majority (85%) of cases. Banadir had
the highest prevalence of reported cases (n = 808, 68%), while the lowest were seen in the Galgaduud and Middle
Shebelle provinces. Districts with the highest reporting rates were Daynile (n = 142, 12.0%), while the lowest were
Moqokori (0.01%). Overall, 71.5% of the total population had detectable immunoglobulin (Ig)G or IgM antibodies
present. Various indicators and characteristics (fever, skin rash, etc.) were analyzed for all individuals in this study,
and were 100% positive. The infant morbidity rate has been reported at 0.10%. Conclusion: This report finds
that measles is more prevalent among infants/domestic populations primarily due to decreased immune system
capability, inadequacy to current vaccination programs, poor hygiene conditions, nutritional deficiencies, lack of
medical access/facilities, and lack of knowledge about infectious diseases