Abstract
IntroductionBased on the World Health Organization (WHO) reports the EMRO countries did not reached to eradication of measles at 2010. This study aimed to estimate the risk of measles outbreak in different districts of Iran to identify high-risk areas based on WHO measles programmatic risk assessment tool. Materials and methodsThe WHO measles programmatic risk assessment tool was used to estimate the overall risk of measles in 31 providences and 322 districts of Iran at 2017. The measles risk was calculated by a function of four indicator scores including population immunity, surveillance quality, program performance, and threat assessment and the overall risk of measles for each districts calculated. Then, the tool assigned each district a risk category of low, medium, high, or very high according to the overall risk score. ResultsOf the 322 districts in Iran, all districts were categorized as low risk and there was no very high risk, high risk and medium risk district in Iran. Twenty-six districts (7.4%) received to risk point higher than 20. Based on population immunity and program delivery performance indicators, all districts in Iarn were categorized as low risk and 92.86% of districts were in low risk category by surveillance quality indicator. ConclusionThe overall risk of measles profile was categorized as low risk and Iranian practices for measles elimination is very good in comparing other studies in this area. However, more attempts should be conducted to sustaining the surveillance quality indicators in all districts.
Highlights
Based on the World Health Organization (WHO) reports the EMRO countries did not reached to eradication of measles at 2010
A cross sectional study conducted on data of measles during 2014e2016 between March to May 2017, the WHO measles programmatic risk assessment tool was used to estimate the overall risk of measles in different districts of Iran in order to guide and strengthen measles elimination program activities and reduce the risk of outbreaks
Each District in a country is assigned to a programmatic risk category of low, medium, high, or very high risk based on the overall risk score
Summary
Based on the World Health Organization (WHO) reports the EMRO countries did not reached to eradication of measles at 2010. This study aimed to estimate the risk of measles outbreak in different districts of Iran to identify high-risk areas based on WHO measles programmatic risk assessment tool. Materials and methods: The WHO measles programmatic risk assessment tool was used to estimate the overall risk of measles in 31 providences and 322 districts of Iran at 2017. To prioritize efforts to strengthen implementation of elimination strategies, the Centers for Disease Control and Prevention and WHO developed a measles programmatic risk assessment tool to identify high-risk districts and guide and strengthen program activities at the subnational level [3, 4, 5, 6]. Based on regression models, delay in MMR vaccination in children is associated with city of living (faring from capital) and nationality [7, 14]
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