Measles elimination in Sudan : incidence trend and vaccine coverage -

Abstract

Introduction: Measles remains a leading cause of vaccine-preventable deaths among children worldwide, despite the availability of vaccines and global activities in mortality reduction. In 1997, The EMR adopted a resolution to eliminate measles by 2010 in all countries of the region. However, constrains and challenges forced the delay of the elimination date to year 2015. Sudan is one of the countries still affected by relatively higher measles morbidity and mortality rates. Control activities have been conducted under the Extended Immunization Programme (EPI) – Sudan to reach elimination by 2015, but that goal has not been reached yet. Aim: To highlight gaps and challenges facing the programme toward achieving the EMR goal of measles elimination by 2015.Methodology: A descriptive cross–sectional analysis of recorded surveillance and vaccination data was conducted covering all related records between the year 2006 and 2013.Results: Through-out the 8-year period, the programme reported 17,974 cases and 261 deaths (Case-Fatality Rate 1.5percent). Most cases (94.3percent) reported over that 8-year period occurred during an outbreak period, which started in 2011 (n=5616), peaked in 2012 (n=8523) and receded in 2013 (n=2813). Cases belonged mostly to the (1-5 years) and (15 years) age-groups (32.5percent and 27.9percent respectively). The majority were either epidemiologically–linked (73percent) or laboratory-confirmed (23percent). Vaccination history of cases showed that out of the total case-load, only 19percent had been previously vaccinated and almost all (97percent) had single dose of MCV vaccine. The vaccination distribution was highest among age-group (1-15 years) (82percent). Nevertheless, only 33percent among the vaccinated cases were laboratory confirmed with IgM, indicated a large rate of vaccine primary failure. The analysis of measles surveillance indicators found that all WHO targets for measles elimination had been met since 2007. MCV1 coverage and Supplementary Immunization Activities (SIAs) had reached (85percent) all over Sudan States. However