IJE Advance Access originally published online on January 19, 2005
International Journal of Epidemiology 2005 34(3):556-564; doi:10.1093/ije/dyi001
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Published by Oxford University Press 2005
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Migration as a risk factor for measles after a mass vaccination campaign, Burkina Faso, 2002
1 Health Information System, Directorate of Studies and Planning, Ministry of Health, Ouagadougou, Burkina Faso
2 Global Immunization Division, National Immunization Program, Centres for Disease Control and Prevention, 1600 Clifton Road, NE MS-E05, Atlanta, GA 30333, USA
3 Service for Vaccine Prevention, Directorate of Preventive Medicine, Ministry of Health, Ouagadougou, Burkina Faso
4 Office of the World Health Organization Representative, Ouagadougou, Burkina Faso
5 World Health Organization Office for Africa, Vaccine Preventable Diseases, Harare, Zimbabwe
6 Expanded Programme on Immunization, World Health Organization, Geneva, Switzerland
* Corresponding author. Dr Robert Perry, Centres for Disease Control and Prevention, 1600 Clifton Rd, NE MS-E05, Atlanta, GA 30333, USA. E-mail: RPerry{at}cdc.gov
Background Shortly after a measles supplementary immunization activity (SIA) targeting children from 9 months to 14 years of age that achieved high coverage, Burkina Faso had a large, serologically confirmed measles outbreak. To investigate the causes of this first reported failure of a widely successful measles control strategy we conducted a case–control study.
Methods Serologically confirmed measles cases aged 
9 months at the time of the SIA in 6 heavily affected districts were frequency matched on age to 3 controls recruited from people frequenting health centres in the same districts.
Results Between January and July 2002, 1287 measles cases were reported throughout Burkina Faso. Of the 707 cases that were serologically confirmed, 358 (51%) were from 9 months to 14 years of age and 265 (37%) were 15 years of age. Among cases and controls from 9 months to 14 years of age significant risk factors for measles were lack of measles vaccination and, in the unvaccinated, recent travel to Côte d'Ivoire. Of the recent measles cases in Côte d'Ivoire 54% were there when exposed to measles. Among adults, risk factors included non-vaccination and the lack of school attendance during childhood. Vaccine effectiveness was estimated to be 98%.
Conclusions Migration of children between Côte d'Ivoire and Burkina Faso played a major role in the failure of the SIA to interrupt measles transmission. Synchronization of measles control activities should be a high priority in countries with regions where much migration occurs.
Keywords Measles, migration, Burkina Faso, Côte d'Ivoire, outbreak investigation, retrospective study, surveillance, risk factors
Accepted 22 November 2004
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  C. S. Wiysonge, J. N.-N. Mawo, J. M. Ticha, E. Nomo, and M. S. Shey Migration and measles Int. J. Epidemiol., December 1, 2005; 34(6): 1443 - 1444. [Full Text] [PDF]
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