Global eradication of measles: A highly contagious and vaccine preventable disease-what went wrong in Africa?

Abstract

This review study reports on global eradication of measles: a highly contagious and vaccine preventable disease-what went wrong in its eradication in Africa. Measles is one of the most contagious human diseases which have continued to cause large outbreaks all over the world even in countries that have achieved high vaccination coverage with a single dose strategy. The disease can also lead to lifelong disabilities including brain damage, blindness, and deafness. These serious complications are rare in developed countries where measles vaccine is widely available, the highest mortality is however found in poor nations. The disease has remained the fifth leading cause of deaths among children less than five years of age, worldwide. It accounts for 44% of total deaths due to vaccine preventable diseases (VPD), among children less than 15 years, the highest mortality occurring in poor communities with malnutrition, overcrowding and low vaccination coverage. Indeed, measles transmission has been interrupted in several countries, reinforcing the view that measles eradication is technically feasible using existing vaccines and intervention strategies. However, measles still accounts for 10% of global mortality from all causes among children aged <5 years (i.e., approximately 1 million deaths annually). Progress toward measles control varies substantially among countries and regions. In Nigeria where there is perennial, low routine vaccination coverage and where the quality of the mass immunization campaign is not high enough, large and persistent measles outbreaks continue to occur with high morbidity and mortality. Today, despite the availability of a safe, effective and relatively inexpensive vaccine for more than 40 years, measles still kills more than any other vaccines preventable disease among children. There is therefore, the urgent need to revisit the measles immunization and vaccination programme in Africa and in our country Nigeria with the sole aim of introducing a two-dose schedule to halt the endemic transmission. This is believed to bring about the successful eradication of measles in Africa. Intensified efforts will be necessary to implement appropriate control and elimination strategies, including supplementary vaccination campaigns, expansion of routine vaccination services, and surveillance. These strategies and estimates of the resources will also be required to implement them will require adjustment based on accumulating experience. Programmatic and financial obstacles must be overcome if the final goal of measles eradication is to be achieved. Key words: Epidemiology; highly contagious disease, immunization, immunosuppression public health; vaccination, vaccine preventable disease, measles, measles virus, measles vaccine