Antecedent causes of a measles resurgence in the Democratic Republic of the Congo.
Pan Afr Med J
; 21: 30, 2015.
Article
em En
| MEDLINE
| ID: mdl-26401224
ABSTRACT
INTRODUCTION:
Despite accelerated measles control efforts, a massive measles resurgence occurred in the Democratic Republic of the Congo (DRC) starting in mid-2010, prompting an investigation into likely causes.METHODS:
We conducted a descriptive epidemiological analysis using measles immunization and surveillance data to understand the causes of the measles resurgence and to develop recommendations for elimination efforts in DRC.RESULTS:
During 2004-2012, performance indicator targets for case-based surveillance and routine measles vaccination were not met. Estimated coverage with the routine first dose of measles-containing vaccine (MCV1) increased from 57% to 73%. Phased supplementary immunization activities (SIAs) were conducted starting in 2002, in some cases with sub-optimal coverage (≤95%). In 2010, SIAs in five of 11 provinces were not implemented as planned, resulting in a prolonged interval between SIAs, and a missed birth cohort in one province. During July 1, 2010-December 30, 2012, high measles attack rates (>100 cases per 100,000 population) occurred in provinces that had estimated MCV1 coverage lower than the national estimate and did not implement planned 2010 SIAs. The majority of confirmed case-patients were aged <10 years (87%) and unvaccinated or with unknown vaccination status (75%). Surveillance detected two genotype B3 and one genotype B2 measles virus strains that were previously identified in the region.CONCLUSION:
The resurgence was likely caused by an accumulation of unvaccinated, measles-susceptible children due to low MCV1 coverage and suboptimal SIA implementation. To achieve the regional goal of measles elimination by 2020, efforts are needed in DRC to improve case-based surveillance and increase two-dose measles vaccination coverage through routine services and SIAs.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Vacina contra Sarampo
/
Surtos de Doenças
/
Sarampo
/
Vírus do Sarampo
Tipo de estudo:
Etiology_studies
/
Screening_studies
Limite:
Adolescent
/
Child
/
Child, preschool
/
Humans
/
Infant
País/Região como assunto:
Africa
Idioma:
En
Revista:
Pan Afr Med J
Ano de publicação:
2015
Tipo de documento:
Article