Local discrepancies in measles vaccination opportunities: results of population-based surveys in Sub-Saharan Africa

BMC Public Health

Rebecca F Grais²  Klaudia Porten²  Andrea Minetti²  Emmanuel Grellety²  Alexandra N’Goran²  Florence Fermon¹  Northan Hurtado¹  Aitana Juan Giner²  Nolwenn Conan²  Lise Grout² 

[1] Médecins Sans Frontières, 8, rue St Sabin, 75011 Paris, France;Epicentre, 8, rue St Sabin, 75011 Paris, France

关键词: Vaccine coverage;    Outbreak response immunization;    Immunization activity;    Supplemental;    Expanded program of immunization;    Immunization;    Measles;   

Others  :  1132480
DOI  :  10.1186/1471-2458-14-193

 received in 2013-10-15, accepted in 2014-01-31,  发布年份 2014

【 摘 要 】

Background

The World Health Organization recommends African children receive two doses of measles containing vaccine (MCV) through routine programs or supplemental immunization activities (SIA). Moreover, children have an additional opportunity to receive MCV through outbreak response immunization (ORI) mass campaigns in certain contexts. Here, we present the results of MCV coverage by dose estimated through surveys conducted after outbreak response in diverse settings in Sub-Saharan Africa.

Methods

We included 24 household-based surveys conducted in six countries after a non-selective mass vaccination campaign. In the majority (22/24), the survey sample was selected using probability proportional to size cluster-based sampling. Others used Lot Quality Assurance Sampling.

Results

In total, data were collected on 60,895 children from 2005 to 2011. Routine coverage varied between countries (>95% in Malawi and Kirundo province (Burundi) while <35% in N’Djamena (Chad) in 2005), within a country and over time. SIA coverage was <75% in most settings. ORI coverage ranged from >95% in Malawi to 71.4% [95% CI: 68.9-73.8] in N’Djamena (Chad) in 2005.

In five sites, >5% of children remained unvaccinated after several opportunities. Conversely, in Malawi and DRC, over half of the children eligible for the last SIA received a third dose of MCV.

Conclusions

Control pre-elimination targets were still not reached, contributing to the occurrence of repeated measles outbreak in the Sub-Saharan African countries reported here. Although children receiving a dose of MCV through outbreak response benefit from the intervention, ensuring that programs effectively target hard to reach children remains the cornerstone of measles control.

【 授权许可】

   
2014 Grout et al.; licensee BioMed Central Ltd.

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