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

Thursday, 28th of April 2016

Pan Afr Med J. 2015 May 15;21:30. doi: 10.11604/pamj.2015.21.30.6335. eCollection 2015.

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

Scobie HM¹ Ilunga BK² Mulumba A² Shidi C² Coulibaly T³ Obama R³ Tamfum JJ⁴ Simbu EP⁴ Smit SB⁵ Masresha B⁶ Perry RT⁷ Alleman MM⁸ Kretsinger K⁸ Goodson J⁸.

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Abstract

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 100000 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.

 More graphic presentations can be found on URL  https://www.ncbi.nlm.nih.gov/pubmed/2640122

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