A scorecard of progress towards measles elimination in 15 west African countries, 2001-19: a retrospective, multicountry analysis of national immunisation coverage and surveillance data.


Journal

The Lancet. Global health
ISSN: 2214-109X
Titre abrégé: Lancet Glob Health
Pays: England
ID NLM: 101613665

Informations de publication

Date de publication:
03 2021
Historique:
received: 27 04 2020
revised: 16 10 2020
accepted: 28 10 2020
pubmed: 20 2 2021
medline: 10 3 2021
entrez: 19 2 2021
Statut: ppublish

Résumé

The WHO Regional Office for the Africa Regional Immunization Technical Advisory Group, in 2011, adopted the measles control and elimination goals for all countries of the African region to achieve in 2015 and 2020 respectively. Our aim was to track the current status of progress towards measles control and elimination milestones across 15 west African countries between 2001 and 2019. We did a retrospective multicountry series analysis of national immunisation coverage and case surveillance data from Jan 1, 2001, to Dec 31, 2019. Our analysis focused on the 15 west African countries that constitute the Economic Community of West African States. We tracked progress in the coverage of measles-containing vaccines (MCVs), measles supplementary immunisation activities, and measles incidence rates. We developed a country-level measles summary scorecard using eight indicators to track progress towards measles elimination as of the end of 2019. The summary indicators were tracked against measles control and elimination milestones. The weighted average regional first-dose MCV coverage in 2019 was 66% compared with 45% in 2001. 73% (11 of 15) of the west African countries had introduced second-dose MCV as of December, 2019. An estimated 4 588 040 children (aged 12-23 months) did not receive first-dose MCV in 2019, the majority (71%) of whom lived in Nigeria. Based on the scorecard, 12 (80%) countries are off-track to achieving measles elimination milestones; however, Cape Verde, The Gambia, and Ghana have made substantial progress. Measles will continue to be endemic in west Africa after 2020. The regional measles incidence rate in 2019 was 33 times the 2020 elimination target of less than 1 case per million population. However, some hope exists as countries can look at the efforts made by Cape Verde, The Gambia, and Ghana and learn from them. None.

Sections du résumé

BACKGROUND
The WHO Regional Office for the Africa Regional Immunization Technical Advisory Group, in 2011, adopted the measles control and elimination goals for all countries of the African region to achieve in 2015 and 2020 respectively. Our aim was to track the current status of progress towards measles control and elimination milestones across 15 west African countries between 2001 and 2019.
METHODS
We did a retrospective multicountry series analysis of national immunisation coverage and case surveillance data from Jan 1, 2001, to Dec 31, 2019. Our analysis focused on the 15 west African countries that constitute the Economic Community of West African States. We tracked progress in the coverage of measles-containing vaccines (MCVs), measles supplementary immunisation activities, and measles incidence rates. We developed a country-level measles summary scorecard using eight indicators to track progress towards measles elimination as of the end of 2019. The summary indicators were tracked against measles control and elimination milestones.
FINDINGS
The weighted average regional first-dose MCV coverage in 2019 was 66% compared with 45% in 2001. 73% (11 of 15) of the west African countries had introduced second-dose MCV as of December, 2019. An estimated 4 588 040 children (aged 12-23 months) did not receive first-dose MCV in 2019, the majority (71%) of whom lived in Nigeria. Based on the scorecard, 12 (80%) countries are off-track to achieving measles elimination milestones; however, Cape Verde, The Gambia, and Ghana have made substantial progress.
INTERPRETATION
Measles will continue to be endemic in west Africa after 2020. The regional measles incidence rate in 2019 was 33 times the 2020 elimination target of less than 1 case per million population. However, some hope exists as countries can look at the efforts made by Cape Verde, The Gambia, and Ghana and learn from them.
FUNDING
None.

Identifiants

pubmed: 33607028
pii: S2214-109X(20)30481-2
doi: 10.1016/S2214-109X(20)30481-2
pmc: PMC7900524
pii:
doi:

Substances chimiques

Measles Vaccine 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e280-e290

Subventions

Organisme : World Health Organization
ID : 001
Pays : International
Organisme : Medical Research Council
ID : MC_UP_A900/115
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UP_A900/1122
Pays : United Kingdom

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

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Auteurs

Oghenebrume Wariri (O)

Vaccines and Immunity Theme, MRC Unit the Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia. Electronic address: oghenebrume.wariri@lshtm.ac.uk.

Esin Nkereuwem (E)

Vaccines and Immunity Theme, MRC Unit the Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia.

Ngozi A Erondu (NA)

Centre for Universal Health, Chatham House, London, UK.

Bassey Edem (B)

Vaccines and Immunity Theme, MRC Unit the Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia.

Oluwatosin O Nkereuwem (OO)

Vaccines and Immunity Theme, MRC Unit the Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia.

Olubukola T Idoko (OT)

Sanofi Pasteur, Lyon, France; The Vaccine Centre, London School of Hygiene and Tropical Medicine, London, UK.

Emmanuel Agogo (E)

Nigeria Centre for Disease Control, Abuja, Nigeria.

Joseph E Enegela (JE)

Africa Diseases Prevention and Research Development Initiative, Abuja, Nigeria.

Tom Sesay (T)

Expanded Programme on Immunization, Freetown, Sierra Leone.

Iya Saidou Conde (IS)

Expanded Programme on Immunization, Conakry, Guinea.

Landry Kaucley (L)

Expanded Programme on Immunization, Cotonou, Benin.

Anthony Afum-Adjei Awuah (AA)

Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana.

Sule Abdullahi (S)

WHO Country Office, Monrovia, Liberia.

Richard Ray Luce (RR)

WHO, West African Regional Support Team, Ouagadougou, Burkina Faso.

Richard Banda (R)

WHO Country Office, Abuja, Nigeria.

Terna Nomhwange (T)

WHO Country Office, Abuja, Nigeria.

Beate Kampmann (B)

Vaccines and Immunity Theme, MRC Unit the Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia; The Vaccine Centre, London School of Hygiene and Tropical Medicine, London, UK.

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