DESCRIPTION OF A LARGE MEASLES EPIDEMIC IN DEMOCRATIC REPUBLIC OF CONGO, 2010–2013

Monday, 13th of October 2014

[source]Conflict and Health[|source]

A large measles epidemic began in DRC in October 2010. This outbreak affected six provinces. In all affected provinces, follow up SIAs campaigns were scheduled for 2010 but had not yet been conducted when the epidemic started. Financial and logistic reasons were the cause of this delay, which undoubtedly contributed to increasing the pool of susceptible individuals.

In this report, authors reviewed and present national measles surveillance data from 2010–2013, the period coinciding with this major measles epidemic. The report documents that measles vaccination coverage in the DRC has improved in recent years but remained below protective levels, leading to the large epidemic which affected mainly children under 5 years old. More details on the epidemiological description, discussion and conclusions,  are accessible at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4105555/

 

ABSTRACT

BACKGROUND: Although measles mortality has declined dramatically in Sub-Saharan Africa, measles remains a major public health problem in countries like the Democratic Republic of Congo (DRC). Here, we describe the large measles epidemic that occurred in the Democratic Republic of Congo between 2010 and 2013 using data from the national surveillance system as well as vaccine coverage surveys to provide a snapshot of the epidemiology of measles in DRC.

METHODS: Standardized national surveillance data were used to describe measles cases from 2010 to 2013. Attack rates and case fatality ratios were calculated and the temporal and spatial evolution of the epidemic described. Data on laboratory confirmation and vaccination coverage surveys as a part of routine program monitoring are also presented.

FINDINGS: Between week 1 of 2010 and week 45 of 2013, a total of 294,455 cases and 5,045 deaths were reported. The cumulative attack rate (AR) was 0.4%. The Case Fatality Ratio (CFR) was 1.7% among cases reported in health structures through national surveillance. A total of 186,178 cases (63%) were under 5 years old, representing an estimated AR of 1.4% in this age group. Following the first mass vaccination campaigns, weekly reported cases decreased by 21.5%. Results of post-vaccination campaign coverage surveys indicated sub-optimal (under 95%) vaccination coverage among children surveyed.

CONCLUSIONS: The data reported here highlight the need to seek additional means to reinforce routine immunization as well as ensure the timely implementation of Supplementary Immunization Activities to prevent large and repeated measles epidemics in DRC. Although reactive campaigns were conducted in response to the epidemic, strategies to ensure that children are vaccinated in the routine system remains the foundation of measles control.