Performance of National Measles Case-Based Surveillance Systems in The WHO African Region. 2012 - 2016

Balcha Masresha,Richard Luce,Reggis Katsande,Amadou Fall,Messeret Shibeshi,Goitom Weldegebriel,Richard Mihigo

doi:10.29245/2578-3009/2018/si.1119

Abstract

Case based surveillance for measles is implemented in the African Region integrated with Acute Flaccid Paralysis (AFP) surveillance. In 2011, the Region adopted a measles elimination goal to be achieved by 2020, which included coverage, incidence and surveillance performance targets. We reviewed measles case-based surveillance data and surveillance performance from countries in the African Region for the years 2012 - 2016. During this period, a total of 359,019 cases of suspected measles were reported from the 44 of 47 (94%) countries using the case based surveillance system. Of these, 202,126 (56%) had specimens collected for laboratory testing. A total of 39,806 measles cases and 25,679 rubella cases were confirmed by IgM serology. Twelve countries met the two principal surveillance performance indicators for each year during the period and four countries met neither indicator over the period. At the Regional level, both surveillance targets were met in 3 of the 5 years in the period of study; however performance varies widely by country. Surveillance performance did not improve across the Region during the 5 years period. High quality surveillance performance is critical to support the achievement of the regional measles elimination goal. Better integrating implementation with AFP surveillance, securing predictable long-term funding sources, and conducting detailed evaluations at country level to identify and address the root cause of performance gaps is recommended.

Highlights

IntroductionThe 47 Member States of the African Region of the World Health Organization established a goal in 2011 to achieve measles elimination by 2020 using the following strategies: attaining high routine immunization coverage; conducting measles supplemental immunization activities (SIAs); conducting case based surveillance with laboratory confirmation of suspected cases and improving management of measles cases.The targets for measles eliminationa are 1) ≥95% coverage with the first dose of measles-containing vaccine (MCV1) at national level and in each district 2) ≥95% supplemental immunization activity (SIA) coverage in every district, 3) confirmed measles incidence of
Parameter Total suspected measles cases reported Number of cases with specimens collected % suspected measles cases investigated % lab results available Measles cases confirmed by lab Measles cases confirmed by lab, epidemiological linkage and clinically Rubella cases confirmed by lab Non-measles febrile rash illness rate (NMFRI) per 100,000 population# Number of countries meeting the 2 per 100,000 target for NMFRI rate Proportion of districts reporting at least 1 suspected case with blood specimen# Number of countries meeting the 80% target for proportion districts reporting Number of countries with at least 80% lab results available % specimens received at the lab within 3 days of collection % specimens received at the lab within 7 days of collection
In the 5 years between 2012 and 2016, a total of 359,019 cases of suspected measles were reported from the 44 countries in the network, out of which 202,126 (56%) specimens were collected for processing at the national laboratories

Summary

Introduction

The 47 Member States of the African Region of the World Health Organization established a goal in 2011 to achieve measles elimination by 2020 using the following strategies: attaining high routine immunization coverage; conducting measles supplemental immunization activities (SIAs); conducting case based surveillance with laboratory confirmation of suspected cases and improving management of measles cases.The targets for measles eliminationa are 1) ≥95% coverage with the first dose of measles-containing vaccine (MCV1) at national level and in each district 2) ≥95% supplemental immunization activity (SIA) coverage in every district, 3) confirmed measles incidence of

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