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Lancet. 2018 May 12; 391(10133):1886.Add to my documents.
MMWR. Morbidity and Mortality Weekly Report. 2018 May 4; 67(17):491-495.In 2005, the Regional Committee for the World Health Organization (WHO) Western Pacific Region (WPR)* established a goal for measles elimination(dagger) by 2012 (1). To achieve this goal, the 37 WPR countries and areas implemented the recommended strategies in the WPR Plan of Action for Measles Elimination (2) and the Field Guidelines for Measles Elimination (3). The strategies include 1) achieving and maintaining >/=95% coverage with 2 doses of measles-containing vaccine (MCV) through routine immunization services and supplementary immunization activities (SIAs), when required; 2) conducting high-quality case-based measles surveillance, including timely and accurate testing of specimens to confirm or discard suspected cases and detect measles virus for genotyping and molecular analysis; and 3) establishing and maintaining measles outbreak preparedness to ensure rapid response and appropriate case management. This report updates the previous report (4) and describes progress toward measles elimination in WPR during 2013-2017. During 2013-2016, estimated regional coverage with the first MCV dose (MCV1) decreased from 97% to 96%, and coverage with the routine second MCV dose (MCV2) increased from 91% to 93%. Eighteen (50%) countries achieved >/=95% MCV1 coverage in 2016. Seven (39%) of 18 nationwide SIAs during 2013-2017 reported achieving >/=95% administrative coverage. After a record low of 5.9 cases per million population in 2012, measles incidence increased during 2013-2016 to a high of 68.9 in 2014, because of outbreaks in the Philippines and Vietnam, as well as increased incidence in China, and then declined to 5.2 in 2017. To achieve measles elimination in WPR, additional measures are needed to strengthen immunization programs to achieve high population immunity, maintain high-quality surveillance for rapid case detection and confirmation, and ensure outbreak preparedness and prompt response to contain outbreaks.
Progress towards measles elimination - African Region, 2013-2016. Progres realises en vue d'eliminer la rougeole - Region africaine, 2013-2016.
Releve Epidemiologique Hebdomadaire. 2017 May 05; 92(18):229-39.Add to my documents.
MMWR. Morbidity and Mortality Weekly Report. 2017 May 05; 66(17):436-443.In 2011, the 46 World Health Organization (WHO) African Region (AFR) member states established a goal of measles elimination* by 2020, by achieving 1) >/=95% coverage of their target populations with the first dose of measles-containing vaccine (MCV1) at national and district levels; 2) >/=95% coverage with measles-containing vaccine (MCV) per district during supplemental immunization activities (SIAs); and 3) confirmed measles incidence of <1 case per 1 million population in all countries (1). Two key surveillance performance indicator targets include 1) investigating >/=2 cases of nonmeasles febrile rash illness per 100,000 population annually, and 2) obtaining a blood specimen from >/=1 suspected measles case in >/=80% of districts annually (2). This report updates the previous report (3) and describes progress toward measles elimination in AFR during 2013-2016. Estimated regional MCV1 coveragedagger increased from 71% in 2013 to 74% in 2015. section sign Seven (15%) countries achieved >/=95% MCV1 coverage in 2015. paragraph sign The number of countries providing a routine second MCV dose (MCV2) increased from 11 (24%) in 2013 to 23 (49%) in 2015. Forty-one (79%) of 52 SIAs** during 2013-2016 reported >/=95% coverage. Both surveillance targets were met in 19 (40%) countries in 2016. Confirmed measles incidence in AFR decreased from 76.3 per 1 million population to 27.9 during 2013-2016. To eliminate measles by 2020, AFR countries and partners need to 1) achieve >/=95% 2-dose MCV coverage through improved immunization services, including second dose (MCV2) introduction; 2) improve SIA quality by preparing 12-15 months in advance, and using readiness, intra-SIA, and post-SIA assessment tools; 3) fully implement elimination-standard surveillancedaggerdagger; 4) conduct annual district-level risk assessments; and 5) establish national committees and a regional commission for the verification of measles elimination.
Routine vaccination coverage in low- and middle-income countries: further arguments for accelerating support to child vaccination services.
Global Health Action. 2013; 6:20343.BACKGROUND AND OBJECTIVE: The Expanded Programme on Immunization was introduced by the World Health Organization (WHO) in all countries during the 1970s. Currently, this effective public health intervention is still not accessible to all. This study evaluates the change in routine vaccination coverage over time based on survey data and compares it to estimations by the WHO and United Nations Children's Fund (UNICEF). DESIGN: Data of vaccination coverage of children less than 5 years of age was extracted from Demographic and Health Surveys (DHS) conducted in 71 low- and middle-income countries during 1986-2009. Overall trends for vaccination coverage of tuberculosis, diphtheria, tetanus, pertussis, polio and measles were analysed and compared to WHO and UNICEF estimates. RESULTS: From 1986 to 2009, the annual average increase in vaccination coverage of the studied diseases ranged between 1.53 and 1.96% units according to DHS data. Vaccination coverage of diphtheria, tetanus, pertussis, polio and measles was all under 80% in 2009. Non-significant differences in coverage were found between DHS data and WHO and UNICEF estimates. CONCLUSIONS: The coverage of routine vaccinations in low- and middle-income countries may be lower than that previously reported. Hence, it is important to maintain and increase current vaccination levels.
Meeting of the Strategic Advisory Group of Experts on immunization, April 2013 - conclusions and recommendations.
Releve Epidemiologique Hebdomadaire. 2013 May 17; 88(20):201-6.Add to my documents.
Vaccine. 2010 Sep 24; 28(41):6723-9.In line with WHO objectives, the Lao Government is committed to eliminate measles by 2012. Yet from 1992 to 2007, the annual incidence of measles remained high while the vaccination coverage showed a wide diversity across provinces. A descriptive study was performed to determine factors affecting compliance with vaccination against measles, which included qualitative and quantitative components. The qualitative study used a convenience sample of 13 persons in charge of the vaccination program, consisting of officials from different levels of the health care structure and members of vaccination teams. The quantitative study performed on the target population consisted of a matched, case-control survey conducted on a stratified random sample of parents of children aged 9-23 months. Overall, 584 individuals (292 cases and 292 controls) were interviewed in the three provinces selected because of low vaccination coverage. On the provision of services side (supply), the main problems identified were a lack of vaccine supply and diluent, a difficulty in maintaining the cold chain, a lack of availability and competence among health workers, a lack of coordination and a limited capacity to assess needs and make coherent decisions. In the side of the consumer (demand), major obstacles identified were poor knowledge about measles immunization and difficulties in accessing vaccination centers because of distance and cost. In multivariate analysis, a low education level of the father was a factor of non-immunization while the factors of good compliance were high incomes, spacing of pregnancies, a feeling that children must be vaccinated, knowledge about immunization age, presenting oneself to the hospital rather than expecting the mobile vaccination teams and last, immunization of other family members or friends' children. The main factors affecting the compliance with vaccination against measles in Laos involve both the supply side and the demand side. Obtaining an effective coverage requires upgrading and training the Expanded Programme on Immunization (EPI) staff and a reinforcement of health education for target populations in all provinces. Copyright (c) 2010 Elsevier Ltd. All rights reserved.
Measles outbreaks and progress towards meeting measles pre-elimination goals: WHO African Region, 2009-2010. Flambees de rougeole et progres accomplis en vue d'atteindre les objectifs de preelimination de la rougeole: Region africaine de l'OMS, 2009-2010.
Releve Epidemiologique Hebdomadaire. 2011 Apr 1; 86(14):129-36.This report summarizes the progress made during 2009-2010 towards meeting the pre-elimination goals after a historically low incidence of measles cases was reported in 2008. In addition, it provides information on measles outbreaks occurring during the same period which highlights the urgent need for renewed political will from governments and their partners to ensure that national multiyear vaccination plans, budgetary line-items and financial commitments exist for routine immunization services and measles-control activities. To assist countries in resonding to measles outbreaks, WHO guidelines were published in 2009.
JAMA. 2008 Jan 30; 299(4):400-402.The World Health Organization (WHO) and United Nations Children's Fund (UNICEF) comprehensive strategy for measles mortality reduction is focused on 47 priority countries. Components include (1) achieving and maintaining high coverage (greater than 90%) with the first dose of measles vaccine by age 12 months in every district of each priority country through routine immunization services; (2) ensuring that all children receive a second opportunity for measles vaccination; (3) maintaining effective case-based surveillance and monitoring of vaccination coverage; and (4) providing appropriate clinical management, including vitamin A supplementation. In 2005, the World Health Assembly set a goal for global measles control as part of the Global Immunization Vision and Strategy (GIVS): a 90% reduction in measles mortality by 2010, compared with 2000 levels. In January 2007, WHO/UNICEF reported that implementation of measles mortality reduction strategies had reduced measles mortality by 60%, from an estimated 873,000 deaths in 1999 to 345,000 deaths in 2005. This reduction exceeded the goal of 50% measles mortality reduction by 2005 (compared with 1999 levels) that had been set in 2002. This report updates previous reports by detailing (1) measles mortality reduction activities implemented during 2006 and (2) the impact of activities since 2000 on the global burden of measles and progress toward the GIVS mortality reduction goal for 2010. (author's)
Lancet Infectious Diseases. 2008 Jan; 8(1):13.According to new data, the global number of measles deaths fell by 68% from 757 000 to 242 000 between 2000 and 2006. This decrease was a result of a spectacular 91% reduction in Africa, where countries rallied behind concerted immunisation campaigns to achieve a rare success story for a continent blighted by public-health failures. In Africa, deaths were cut from 396 000 to 36 000 by implementing the measles reduction strategy, which includes vaccinating all children before their first birthday and providing a second opportunity for measles vaccination through mass vaccination campaigns. "The clear message from this achievement is that the strategy works", said Julie Gerberding, director of the US Centers for Disease Control and Prevention, which was one of the founding partners of the Measles Initiative, together with WHO, UNICEF, the American Red Cross, and the United Nations Foundation. She said the focus would now move to India, where an estimated 10.5 million children are not immunised. Some178 000 people died of measles in south Asia last year - mostly in India and Pakistan - only 26% down from 2000. (excerpt)
Weekly Epidemiological Record. 2007 Oct; 82(40):345-356.In 2002, the United Nations Special Session on Children set the goal of reducing the number of deaths caused by measles by half between 1999 and 2005. Nepal adopted the WHO/UNICEF comprehensive strategy for sustainable measles mortality reduction in 2003; this strategy has the goal of reducing by 50% the number measles deaths in the country by 2005 compared with the number in 2003. This report summarizes efforts made to strengthen routine childhood immunization, the implementation of measles supplementary immunization activities (SIAs) and reviews measles surveillance data from 2000 to 2006, which demonstrate a significant decrease in the reported incidence of measles in Nepal. (excerpt)
Bulletin of the World Health Organization. 2007 Jun; 85(6):449-457.The objective was to assess the progress made towards meeting the goals of the African Regional Strategic Plan of the Expanded Programme on Immunization between 2001 and 2005. We reviewed data from national infant immunization programmes in the 46 countries of WHO's African Region, reviewed the literature and analysed existing data sources. We carried out face-to-face and telephone interviews with relevant staff members at regional and subregional levels. The African Region fell short of the target for 80% of countries to achieve at least 80% immunization coverage by 2005. However, diphtheria-tetanus-pertussis-3 coverage increased by 15%, from 54% in 2000 to 69% in 2004. As a result, we estimate that the number of nonimmunized children declined from 1.4 million in 2002 to 900 000 in 2004. In 2004, four of seven countries with endemic or re-established wild polio virus had coverage of 50% or less, and some neighbouring countries at high risk of importation did not meet the 80% vaccination target. Reported measles cases dropped from 520 000 in 2000 to 316 000 in 2005, and mortality was reduced by approximately 60% when compared to 1999 baseline levels. A network of measles and yellow fever laboratories had been established in 29 countries by July 2005. Rates of immunization coverage are improving dramatically in the WHO African Region. The huge increases in spending on immunization and the related improvements in programme performance are linked predominantly to increases in donor funding. (author's)
Lancet. 2007 Jan 20; 369(9557):191-200.In 2002, the UN General Assembly Special Session on Children adopted a goal to reduce deaths owing to measles by half by the end of 2005, compared with 1999 estimates. We describe efforts and progress made towards this goal. We assessed trends in immunisation against measles on the basis of national implementation of the WHO/ UNICEF comprehensive strategy for measles mortality reduction, and the provision of a second opportunity for measles immunisation. We used a natural history model to evaluate trends in mortality due to measles. Between 1999 and 2005, according to our model mortality owing to measles was reduced by 60%, from an estimated 873 000 deaths (uncertainty bounds 634 000-1 140 000) in 1999 to 345 000 deaths (247 000-458 000) in 2005. The largest percentage reduction in estimated measles mortality during this period was in the western Pacific region (81%), followed by Africa (75%) and the eastern Mediterranean region (62%). Africa achieved the largest total reduction, contributing 72% of the global reduction in measles mortality. Nearly 7.5 million deaths from measles were prevented through immunisation between 1999 and 2005, with supplemental immunisation activities and improved routine immunisation accounting for 2.3 million of these prevented deaths. The achievement of the 2005 global measles mortality reduction goal is evidence of what can be accomplished for child survival in countries with high childhood mortality when safe, cost-effective, and affordable interventions are backed by country-level political commitment and an effective international partnership. (author's)
Seminars in Pediatric Infectious Diseases. 2004 Jul; 15(3):130-136.Since Edward Jenner's discovery of the smallpox vaccine 200 years ago, vaccines have been one of the most lifesaving health interventions for humankind and, conversely, one of the most underused health interventions in developing countries. The implementation of childhood vaccines in the United States and other industrialized countries led to a rapid and large decrease in morbidity and mortality from common childhood diseases. The smallpox eradication program, led by the World Health Organization (WHO) from 1967 to 1977, ended deaths from smallpox, a disease that once killed millions of children and adults each year. Beginning in the early 1980s, the development of routine immunization programs by WHO and UNICEF for children in developing countries led to a sustained program of administration of lifesaving vaccinations as part of primary healthcare systems. Since the launch of these routine immunization programs in most countries, more than 20 million deaths have been prevented from vaccine-preventable diseases (Fig 1). Ongoing initiatives to eradicate polio, reduce measles mortality rates, eliminate measles from discrete regions of the world, and introduce additional vaccines have been remarkably successful. However, more than 1.4 million children died from vaccine-preventable diseases in 2002, 610,000 from measles alone, suggesting that great challenges still exist to fully utilize the potential of lifesaving vaccines (WHO, unpublished data). This article reviews the status of current immunization initiatives, summarizes lessons learned, and makes recommendations for a healthier world through the use of vaccines. (excerpt)
Geneva, Switzerland, WHO, Department of Immunization, Vaccines and Biologicals, 2004.  p. (WHO/EPI/TRAM/93.5 (updated 2004); WHO/PBL/93.31)This teaching aid is about measles, and its potentially harmful effects on the eyes of children.1 Understanding the risks of damage to the eye from measles is the first step before learning what action to take to save sight. Measles causes a great amount of unnecessary death and blindness in children, especially in Africa and parts of Asia. Death and loss of sight due to measles are health care disasters that simply should not occur. Measles is a highly infectious disease preventable by immunization. Reducing deaths due to measles is a global health priority. Immunized children rarely get measles and the cost of immunization is low. The road to good health is also the road to good vision. Since the eye problems due to measles are especially dangerous in children who eat less well, this teaching aid also presents good feeding habits and how to improve the diet for the malnourished child. Protein-energy malnutrition is the most widespread form of malnutrition. It is not easily preventable in poor communities or where there is serious shortage of food as in famine situations and civil strife. (excerpt)
Lancet. 2004 May 8; 363(9420):1531.Aconcerted immunisation drive, especially in Africa, has helped cut the number of measles deaths to 610 000, down 30% from the benchmark year of 1999, according to WHO and UNICEF. The UN agencies said that almost 260 000 lives had been saved annually since 1999 and the world was on target to achieve the goal of cutting deaths in half by the end of 2005. They attributed the progress to the adoption by high-burden countries of the comprehensive WHO/ UNICEF strategy for sustainable measles mortality reduction. This is aimed at achieving at least 80% routine measles vaccination coverage in every district, and ensuring that all children get a second opportunity for measles immunisation—either through routine services or periodic supplemental immunisation activities (SIAs) every 3–4 years. (excerpt)
Geneva, Switzerland, WHO, 1999 May. 56 p. (WHO/CDS/CSR/ISR/99.1)These technical guidelines are part of a series developed by the Communicable Diseases Cluster (CDS) at the World Health Organization. The purpose of this series is to update current knowledge on diseases with epidemic potential, to help health officials detect and control outbreaks, and to strengthen the capacity for emergency response to an epidemic situation. These guidelines have been prepared jointly with the Health Technology and Pharmaceuticals Cluster (HTP). The contribution of the Government of Ireland to the production of this document is gratefully acknowledged. (excerpt)
Geneva, Switzerland, WHO, 2004.  p. (WHO/V&B/04.03; UNICEF/PD/Measles/02)Immunization is an essential part of a child’s right to the highest attainable standard of health. This joint statement outlines optimal strategies to reduce measles mortality during and after emergencies. The goals are to reduce the number of measles deaths and interrupt transmission of the measles virus. Through encouraging and supporting national commitment and rapid action, and coordination with UNICEF and WHO, all vulnerable children can be protected against measles. (excerpt)
Lancet. 2003 Oct 25; 362(9393):1386.Delegates from 50 countries have vowed to intensify efforts to reduce deaths from measles, which claims the lives of 2000 children a day. More than 200 health officials launched the Cape Town Measles Declaration on Oct 17, pledging to save the lives of almost half a million children every year by 2005. This will be done by expanding proven immunisation strategies and focusing on 45 countries identified as the highest priority for mortality-reduction strategies. (excerpt)
Monday Developments. 2003 Sep 22; 21(17):8-9.At the end of June, the Zambian Red Cross in coordination with the Ministry of Health helped vaccinate five million children between the ages of six months to 15 years against measles. The integrated campaign delivered an unprecedented number of health interventions at the same time. To combat malaria, 75,000 insecticide treated bed nets were distributed to vulnerable families with children under five. Vitamin supplements and a de-worming medication called Mebendazole were also administered by some 1,800 Red Cross volunteers. (excerpt)
Perspectives in Health. 2003; 8(2):15-21.Andean ministers of health meeting last April proposed an Andean vaccination week. The idea was soon expanded to include South America and later Mexico, Central America and the Caribbean. Eventually 19 countries joined together for the first Vaccination Week in the Americas. The focus was on children who had never been vaccinated: those in hard-to-reach rural areas or marginal urban zones whom earlier campaigns had left behind. (excerpt)
Epidemiology of measles in the central region of Ghana: a five-year case review in three district hospitals.
East African Medical Journal. 2003 Jun; 80(6):312-317.Objective: As part of a national accelerated campaign to eliminate measles, we conducted a study, to define the epidemiology of measles in the Central Region. Design: A descriptive survey was carried out on retrospective cases of measles. Setting: Patients were drawn from the three district hospitals (Assin, Asikuma and Winneba Hospitals) with the highest number of reported cases in the region. Subjects: Records of outpatient and inpatient measles patients attending the selected health facilities between 1996 and 2000. Data on reported measles eases in all health facilities in the three study, districts were also analysed. Main outcome measures: The distribution of measles eases in person (age and sex), time (weekly, or monthly, trends) anti place (residence), the relative frequency, of eases, and the outcome of treatment. Results: There was an overall decline in reported eases of measles between 1996 and 2000 both in absolute terms and relative to other diseases. Females constituted 48%- 52% of the reported 1508 eases in the hospitals. The median age of patients was 36 months. Eleven percent of eases were aged under nine months; 66% under five years and 96% under 15 years. With some minor variations between districts, the highest and lowest transmission occurred in March and September respectively. Within hospitals, there were sporadic outbreaks with up to 34 weekly eases. Conclusion: In Ghana, children aged nine months to 14 years could be appropriately targeted for supplementary, measles immunization campaigns. The best period for the campaigns is during the low transmission months of August to October. Retrospective surveillance can expediently inform decisions about the timing and target age groups for such campaigns. (author's)
Western Sahrawi in Algeria. Report on the nutrition situation of refugees and displaced populations. [Sahara Occidental algérien : Rapport sur l'état de nutrition des réfugiés et des populations déplacées]
RNIS. Report on the Nutrition Situation of Refugees and Displaced Populations. 2003 Jan; (40):41-42.The nutrition situation of Sahrawi refugee Children seems average (category III) but could deteriorate if refugees were highly dependent on food aid and that food aid were to be disrupted by pipeline breaks. Analyses of food security and underlying causes of malnutrition need to be under- taken to better understand the overall nutrition situation of the refugees. (excerpt)
RNIS. Report on the Nutrition Situation of Refugees and Displaced Populations. 2003 Jan; (40):38-40.The nutrition situation seems to have greatly improved in some areas of Angola, probably because of the efforts to deliver massive humanitarian aid, but mortality rates remained high. People are still highly dependent on relief aid, which needs to continue to be delivered. Rehabilitation of infrastructure and de-mining are also crucial for the country re-construction. (excerpt)
Journal of Infectious Diseases. 2003 May 15; 187 Suppl 1:S15-S21.Worldwide during the 1980s remarkable progress was made in controlling measles through increasing routine measles vaccination to nearly 80%. In 2000, an estimated 777,000 measles deaths occurred, of which 452,000 were in the African Region of the World Health Organization (WHO). In 2001, WHO and the United Nations Children’s Fund published a 5-year strategic plan to reduce measles mortality by half by 2005. Strategies include providing a second opportunity for measles immunization to all children through nationwide supplementary immunization activities, increasing routine vaccination coverage, and improving surveillance with laboratory confirmation of suspected measles cases. In 2000, over 100 million children received a dose of measles vaccine through supplementary immunization activities, a number projected to increase during 2002–2005. Current systems for monitoring measles vaccination coverage and disease burden must be improved to accurately assess progress toward measles control goals. (author's)