การเฝ้าระวังเหตุการณ์การระบาดของโรคหัดในเรือนจำ ประเทศไทย ปี พ.ศ. 2559–2563

Abstract

Introduction: Thailand has been implementing a Measles Elimination program in accordance with international commitments since 2010, with the goal of eliminating measles by 2020. Therefore, Thailand has expanded the project to within 2023 due to the increasing measles epidemic situation in 2017–2019. The large clusters of outbreaks occurred in areas where many people live together, especially in prisons. Moreover, lower immunity levels or being unvaccinated among adults raises the risk of rapid outbreaks. This study conducted to describe the situation of measles in prisons, identify the area at risk of disease and the group at risk of disease, related risk and factors leading to the formulation of appropriate policies.
Methods: This is a descriptive epidemiological study using two data bases: Event–based surveillance (EBS) and Measles Eliminate Database (ME) from January 2016 to December 2020.
Results: From 2016–2020, measles outbreak incidents surveillance in prisons from the ME and EBS databases identified 25 measles outbreak confirmed events. The median number of cases for among these events 11 cases (2–246 cases), 68% of events were tested for measles strains confirmed. Most cases were the D8 strain (94.12%), 68% of all outbreak control events were vaccinated. A total of 904 cases were found, 350 laboratory examinations, and 201 confirmed cases (57.43%). Most of them were men (95.25%); median age was 27 years old. Most had unknown or unvaccinated history with 88.17%. The most common epidemic risk factor is close contact with the patient, i.e., sleeping in the same room as the patient and activities in the same room as the patient.
Recommendations: Department of Disease Control (DDC) should have the system for coordinating information of measles’s incident between those responsible for the ME database and the Situation Awareness Team, for detecting outbreaks with the ME database. Also, DDC should explore the measles vaccine history in prison staff and inmates and consider vaccination in groups that have never been vaccinated or not fully vaccinated in order to prevent measles outbreak and operate the prevention and control of communicable diseases in prisons under the “GOOD HEALTH GOOD HEART” project to achieve as specified in the objective.