Measles vaccination coverage survey in Moba Katanga Democratic Republic of Congo 2013: need to adapt routine and mass vaccination campaigns to reach the unreached.

Thursday, 5th of May 2016

PLoS Curr. 2015 Feb 2;7. pii: ecurrents.outbreaks.8a1b00760dfd81481eb42234bd18ced3. doi: 10.1371/currents.outbreaks.8a1b00760dfd81481eb42234bd18ced3.

Measles vaccination coverage survey in Moba Katanga Democratic Republic of Congo 2013: need to adapt routine and mass vaccination campaigns to reach the unreached.

Gil Cuesta J¹ Mukembe N² Valentiner-Branth P Stefanoff P³ Lenglet A⁴.

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Abstract

The Democratic Republic of Congo (DRC) has committed to eliminate measles by 2020. In 2013 in response to a large outbreak Médecins Sans Frontières conducted a mass vaccination campaign (MVC) in Moba Katanga DRC. We estimated the measles vaccination coverage for the MVC the Expanded Programme on Immunization routine measles vaccination (EPI) and assessed reasons for non-vaccination. We conducted a household-based survey among caretakers of children aged 6 months-15 years in Moba from November to December 2013. We used a two-stage-cluster-sampling where clusters were allocated proportionally to village size and households were randomly selected from each cluster. The questionnaire included demographic variables vaccination status (card or oral history) during MVC and EPI and reasons for non-vaccination. We estimated the coverage by gender age and the reasons for non-vaccination and calculated 95% confidence intervals (95% CI). We recruited 4768 children living in 1684 households. The MVC coverage by vaccination card and oral history was 87% (95% CI 84-90) and 66% (95% CI 61-70) if documented by card. The EPI coverage was 76% (95% CI 72-81) and 3% (95% CI 1-4) respectively. The MVC coverage was significantly higher among children previously vaccinated during EPI 91% (95% CI 88-93) compared to 74% (95% CI 66-80) among those not previously vaccinated. Six percent (n=317) of children were never vaccinated. The main reason for non-vaccination was family absence 68% (95% CI 58-78). The MVC and EPI measles coverage was insufficient to prevent the recurrence of outbreaks in Moba. Lack of EPI vaccination and lack of accessibility by road were associated with lower MVC coverage. We recommend intensified social mobilization and extended EPI and MVCs to increase the coverage of absent residents and unreached children. Routine and MVCs need to be adapted accordingly to improve coverage in hard-to-reach populations in DRC.