Progress Toward Measles Elimination - Nepal, 2007-2014.

Sunday, 6th of March 2016

MMWR Morb Mortal Wkly Rep. 2016 Mar 4;65(8):206-10. doi: 10.15585/mmwr.mm6508a3.

Progress Toward Measles Elimination - Nepal, 2007-2014.

Khanal S, Sedai TR, Choudary GR, Giri JN, Bohara R, Pant R, Gautam M, Sharapov UM, Goodson JL, Alexander J, Dabbagh A, Strebel P, Perry RT, Bah S,Abeysinghe N, Thapa A.

Abstract

In 2013, the 66th session of the Regional Committee of the World Health Organization (WHO) South-East Asia Region (SEAR) established a goal to eliminate measles and to control rubella and congenital rubella syndrome (CRS)* in SEAR by 2020 (1,2). Current recommended measles elimination strategies in the region include 1) achieving and maintaining ≥95% coverage with 2 doses of measles-containing vaccine (MCV) in every district, delivered through the routine immunization program or through supplementary immunization activities (SIAs)(†); 2) developing and sustaining a sensitive and timely measles case-based surveillance system that meets minimum recommended performance indicators(§); 3) developing and maintaining an accredited measles laboratory network; and 4) achieving timely identification, investigation, and response to measles outbreaks. In 2013, Nepal, one of the 11 SEAR member states, adopted a goal for national measles elimination by 2019 (3). This report updates a previous report (4) and summarizes progress toward measles elimination in Nepal during 2007-2014. During 2007-2014, estimated coverage with the first MCV dose (MCV1) increased from 81% to 88%. Approximately 3.9 and 9.7 million children were vaccinated in SIAs conducted in 2008 and 2014, respectively (1). Reported suspected measles incidence declined by 13% during 2007-2014, from 54 to 47 cases per 1 million population. However, in 2014, 81% of districts did not meet the measles case-based surveillance performance indicator target of ≥2 discarded non-measles cases per 100,000 population per year. To achieve and maintain measles elimination, additional measures are needed to strengthen routine immunization services to increase coverage with MCV1 and a recently introduced second dose of MCV (MCV2**) to ≥95% in all districts, and to enhance sensitivity of measles case-based surveillance by adopting a more sensitive case definition, expanding case-based surveillance sites nationwide, and ensuring timely transport of specimens to the accredited national laboratory.