Abstract
BackgroundThe health needs of children and adolescents in humanitarian emergencies are critical to the success of relief efforts and reduction in mortality. Measles has been one of the major causes of child deaths in humanitarian emergencies and further contributes to mortality by exacerbating malnutrition and vitamin A deficiency. Here, we review measles vaccination activities in humanitarian emergencies as documented in published literature. Our main interest was to review the available evidence focusing on the target age range for mass vaccination campaigns either in response to a humanitarian emergency or in response to an outbreak of measles in a humanitarian context to determine whether the current guidance required revision based on recent experience.MethodsWe searched the published literature for articles published from January 1, 1998 to January 1, 2010 reporting on measles in emergencies. As definitions and concepts of emergencies vary and have changed over time, we chose to consider any context where an application for either a Consolidated Appeals Process or a Flash Appeal to the UN Central Emergency Revolving Fund (CERF) occurred during the period examined. We included publications from countries irrespective of their progress in measles control as humanitarian emergencies may occur in any of these contexts and as such, guidance applies irrespective of measles control goals.ResultsOf the few well-documented epidemic descriptions in humanitarian emergencies, the age range of cases is not limited to under 5 year olds. Combining all data, both from preventive and outbreak response interventions, about 59% of cases in reports with sufficient data reviewed here remain in children under 5, 18% in 5-15 and 2% above 15 years. In instances where interventions targeted a reduced age range, several reports concluded that the age range should have been extended to 15 years, given that a significant proportion of cases occurred beyond 5 years of age.ConclusionsMeasles outbreaks continue to occur in humanitarian emergencies due to low levels of pre-existing population immunity. According to available published information, cases continue to occur in children over age 5. Preventing cases in older age groups may prevent younger children from becoming infected and reduce mortality in both younger and older age groups.
Highlights
The health needs of children and adolescents in humanitarian emergencies are critical to the success of relief efforts and reduction in mortality
Outbreaks of measles are far less likely in many regions, interruption of measles virus transmission requires a high level of population immunity (> 90%) and measles outbreaks continue to occur in populations where such high levels of immunity cannot be maintained
Our main interest was to review the available evidence focusing on the target age range for mass vaccination campaigns either in response to a humanitarian emergency or in response to an outbreak of measles in a humanitarian context to determine whether the current guidance required revision based on recent experience
Summary
The health needs of children and adolescents in humanitarian emergencies are critical to the success of relief efforts and reduction in mortality. Measles has been one of the major causes of child deaths in humanitarian emergencies and further contributes to mortality by exacerbating malnutrition and vitamin A deficiency. We review measles vaccination activities in humanitarian emergencies as documented in published literature. Humanitarian emergencies occur in situations of conflict, war or civil disturbance, natural disasters, food insecurity or other crises resulting in disruptions that overwhelm national capacities and require international assistance [1]. Measles has been one of the major causes of child deaths in humanitarian emergencies and further contributes to mortality. Humanitarian emergencies often occur in populations with low levels of immunity, given long-term disruption of routine vaccination programs, poor infrastructure and access to health services, and an increased risk of measles epidemics with consequent mortality
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have