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Antecedent causes of a measles resurgence in the Democratic Republic of the Congo

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...

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Autores principales: Scobie, Heather Melissa, Ilunga, Benoît Kebela, Mulumba, Audry, Shidi, Calixte, Coulibaly, Tiekoura, Obama, Ricardo, Tamfum, Jean-Jacques Muyembe, Simbu, Elisabeth Pukuta, Smit, Sheilagh Brigitte, Masresha, Balcha, Perry, Robert Tyrrell, Alleman, Mary Margaret, Kretsinger, Katrina, Goodson, James
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The African Field Epidemiology Network 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561157/
https://www.ncbi.nlm.nih.gov/pubmed/26401224
http://dx.doi.org/10.11604/pamj.2015.21.30.6335
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author Scobie, Heather Melissa
Ilunga, Benoît Kebela
Mulumba, Audry
Shidi, Calixte
Coulibaly, Tiekoura
Obama, Ricardo
Tamfum, Jean-Jacques Muyembe
Simbu, Elisabeth Pukuta
Smit, Sheilagh Brigitte
Masresha, Balcha
Perry, Robert Tyrrell
Alleman, Mary Margaret
Kretsinger, Katrina
Goodson, James
author_facet Scobie, Heather Melissa
Ilunga, Benoît Kebela
Mulumba, Audry
Shidi, Calixte
Coulibaly, Tiekoura
Obama, Ricardo
Tamfum, Jean-Jacques Muyembe
Simbu, Elisabeth Pukuta
Smit, Sheilagh Brigitte
Masresha, Balcha
Perry, Robert Tyrrell
Alleman, Mary Margaret
Kretsinger, Katrina
Goodson, James
author_sort Scobie, Heather Melissa
collection PubMed
description 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.
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spelling pubmed-45611572015-09-23 Antecedent causes of a measles resurgence in the Democratic Republic of the Congo Scobie, Heather Melissa Ilunga, Benoît Kebela Mulumba, Audry Shidi, Calixte Coulibaly, Tiekoura Obama, Ricardo Tamfum, Jean-Jacques Muyembe Simbu, Elisabeth Pukuta Smit, Sheilagh Brigitte Masresha, Balcha Perry, Robert Tyrrell Alleman, Mary Margaret Kretsinger, Katrina Goodson, James Pan Afr Med J Research 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. The African Field Epidemiology Network 2015-05-15 /pmc/articles/PMC4561157/ /pubmed/26401224 http://dx.doi.org/10.11604/pamj.2015.21.30.6335 Text en © Heather Melissa Scobie et al. http://creativecommons.org/licenses/by/2.0/ The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Scobie, Heather Melissa
Ilunga, Benoît Kebela
Mulumba, Audry
Shidi, Calixte
Coulibaly, Tiekoura
Obama, Ricardo
Tamfum, Jean-Jacques Muyembe
Simbu, Elisabeth Pukuta
Smit, Sheilagh Brigitte
Masresha, Balcha
Perry, Robert Tyrrell
Alleman, Mary Margaret
Kretsinger, Katrina
Goodson, James
Antecedent causes of a measles resurgence in the Democratic Republic of the Congo
title Antecedent causes of a measles resurgence in the Democratic Republic of the Congo
title_full Antecedent causes of a measles resurgence in the Democratic Republic of the Congo
title_fullStr Antecedent causes of a measles resurgence in the Democratic Republic of the Congo
title_full_unstemmed Antecedent causes of a measles resurgence in the Democratic Republic of the Congo
title_short Antecedent causes of a measles resurgence in the Democratic Republic of the Congo
title_sort antecedent causes of a measles resurgence in the democratic republic of the congo
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561157/
https://www.ncbi.nlm.nih.gov/pubmed/26401224
http://dx.doi.org/10.11604/pamj.2015.21.30.6335
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