Abstract
IntroductionMeasles is targeted for elimination in the World Health Organization African Region by the year 2020. In 2011, Kenya was off track in attaining the 2012 pre-elimination goal. We describe the epidemiology of measles in Kenya and assess progress made towards elimination.MethodsWe reviewed national case-based measles surveillance and immunization data from January 2003 to December 2016. A case was confirmed if serum was positive for anti-measles IgM antibody, was epidemiologically linked to a laboratory-confirmed case or clinically compatible. Data on case-patient demographics, vaccination status, and clinical outcome and measles containing vaccine (MCV) coverage were analyzed. We calculated measles surveillance indicators and incidence, using population estimates for the respective years.ResultsThe coverage of first dose MCV (MCV1) increased from 65% to 86% from 2003-2012, then declined to 75% in 2016. Coverage of second dose MCV (MCV2) remained < 50% since introduction in 2013. During 2003-2016, there were 26,188 suspected measles cases were reported, with 9043(35%) confirmed cases, and 165 deaths (case fatality rate, 1.8%). The non-measles febrile rash illness rate was consistently > 2/100,000 population, and “80% of the sub-national level investigated a case in 11 of the 14 years. National incidence ranged from 4 to 62/million in 2003-2006 and decreased to 3/million in 2016. The age specific incidence ranged from 1 to 364/million population and was highest among children aged < 1 year.ConclusionKenya has made progress towards measles elimination. However, this progress remains at risk and the recent declines in MCV1 coverage and the low uptake in MCV2 could reverse these gains.
Highlights
Measles is targeted for elimination in the World Health Organization African Region by the year 2020
In 2011, the WHO African Region (AFR) adopted a measles elimination goal to be reached by the end of 2020 [5]
In Kenya, once a clinician suspects measles, he/she notifies the sub-county disease surveillance coordinator (SCDSC) who completes a case-based form in duplicate and collects a blood specimen for laboratory testing. Both specimen and completed form are sent to the Kenya Medical Research Institute (KEMRI) measles laboratory, the WHO-accredited national laboratory, and case details are entered into a central database
Summary
Measles is targeted for elimination in the World Health Organization African Region by the year 2020. In Kenya, the Expanded Program on Immunization (EPI) was started in 1980 with the first dose of measles-containing vaccine (MCV) or MCV1 given at 9 months of age. Accelerated control for measles was started in 2002 when the first catch-up SIA that targeted children aged 9 months to 14 years was conducted, followed by periodic SIAs and the establishment of a case-based surveillance for measles with laboratory confirmation. Kenya developed a national measles elimination strategic plan 2012-2020 as a road map for eliminating measles transmission This analysis aims to describe measles immunization performance, the surveillance performance against WHO standards, the epidemiology of measles cases in Kenya and to track the progress towards elimination of measles
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