Adding interventions to mass measles vaccinations in India.

Wednesday, 16th of November 2016

Bull World Health Organ. 2016 Oct 1;94(10):718-727. Epub 2016 Jul 5.

Adding interventions to mass measles vaccinations in India.

Johri M¹ Verguet S² Morris SK³ Sharma JK⁴ Ram U⁵ Gauvreau C⁵ Jones E⁶ Jha P⁵ Jit M⁶.

Author information

Abstract

OBJECTIVE:

To quantify the impact on mortality of offering a hypothetical set of technically feasible high-impact interventions for maternal and child survival during Indias 2010-2013 measles supplementary immunization activity.

METHODS:

We developed Lives Saved Tool models for 12 Indian states participating in the supplementary immunization based on state- and sex-specific data on mortality from Indias Million Deaths Study and on health services coverage from Indian household surveys. Potential add-on interventions were identified through a literature review and expert consultations. We quantified the number of lives saved for a campaign offering measles vaccine alone versus a campaign offering measles vaccine with six add-on interventions (nutritional screening and complementary feeding for children vitamin A and zinc supplementation for children multiple micronutrient and calcium supplementation in pregnancy and free distribution of insecticide-treated bed nets).

FINDINGS:

The measles vaccination campaign saved an estimated 19 016 lives of children younger than 5 years. A hypothetical campaign including measles vaccine with add-on interventions was projected to save around 73 900 lives (range: 70 200-79 300) preventing 73 700 child deaths (range: 70 000-79 000) and 300 maternal deaths (range: 200-400). The most effective interventions in the whole package were insecticide-treated bed nets measles vaccine and preventive zinc supplementation. Girls accounted for 66% of expected lives saved (12 712/19 346) for the measles vaccine campaign and 62% of lives saved (45 721/74 367) for the hypothetical campaign including add-on interventions.

CONCLUSION:

In India a measles vaccination campaign including feasible high-impact interventions could substantially increase the number of lives saved and mitigate gender-related inequities in child mortality.