Successful measles vaccination feasible in low-income countries

Results of a study in this weeks issue of THE LANCET highlight the success of a WHO-recommended measles elimination strategy in southern Africa. Authors of the study emphasise how such strategies can substantially reduce illness and death from measles, the most contagious disease known to man.

Globally, although national immunisation programmes are estimated to prevent 80 million cases and 4. 5million deaths due to measles yearly, it is estimated that more than 30 million cases and 0.9 million deaths still occur every year; around half of these deaths occur in Africa.

In southern Africa from 1996, seven countries with a total population of around 70 million (Botswana, Lesotho, Malawi, Namibia, South Africa, Swaziland, and Zimbabwe) implemented measles elimination strategies. In addition to routine measles immunisation at nine months of age, these included nationwide catch-up campaigns among children aged 9 months to 14 years, then follow-up campaigns every 3-4 years among children aged nine months to five years.

Nearly 24 million children aged nine months to 14 years were vaccinated, with overall vaccination coverage of 91%. Illness and deaths were substantially reduced between 1996 and 2000; reported clinical measles cases declined from 60,000 in 1996 to 117 cases in 2000. Reported measles deaths declined from 166 in 1996 to zero in 2000.

Robin Biellik (leading WHO investigator) comments: A reduction in measles mortality and morbidity can be achieved in very low-income countries, in countries that split their vaccination campaigns by geographical area or by age-group of the target population, and where initial routine measles vaccination coverage among infants was less than 90%, even when prevalance of HIV/AIDS was extremely high. Continued high-level national commitment will be crucial to implementation and maintenance of proven strategies in southern Africa.


Contact: Richard Lane

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