Suchergebnisse

This Strategic Plan 2012–2020 explains how countries, working together with the MR Initiative and its partners, will achieve a world without measles, rubella and congenital rubella syndrome (CRS). The Plan builds on the experience and successes of a decade of accelerated measles control efforts that resulted in a 74% reduction in measles deaths globally between 2000 and 2010 (1). It integrates the newest 2011 World Health Organization (WHO) policy on rubella vaccination which recommends combining measles and rubella control strategies and planning efforts, given the shared surveillance and widespread use of combined measles-rubella vaccine formulations, i.e. measles-rubella (MR) and measles-mumps-rubella (MMR). The Plan presents clear strategies that country immunization managers, working with domestic and international partners, can use as a blueprint to achieve the 2015 and 2020 measles and rubella control and elimination goals. The strategy focuses on the implementation of five core components. 1. Achieve and maintain high levels of population immunity by providing high vaccination coverage with two doses of measles- and rubella-containing vaccines. 2. Monitor disease using effective surveillance, and evaluate programmatic efforts to ensure progress. 3. Develop and maintain outbreak preparedness, respond rapidly to outbreaks and manage cases. 4. Communicate and engage to build public confidence and demand for immunization. 5. Perform the research and development needed to support cost-effective operations and improve vaccination and diagnostic tools. The Plan provides the global context and an assessment of the current state of the world with respect to national, regional and global management of measles and rubella. It outlines guiding principles that provide a foundation for all measles and rubella control efforts, including country ownership, strengthening routine immunization and health systems, ensuring linkages with other health interventions and providing equity in immunization by reaching every child. Given the progress made to date, the plan includes a list of priority countries that require additional support to meet regional and global goals. It also examines key challenges to measles and rubella control and elimination, including: financial risks; high population density and highly mobile populations; weak immunization systems and inaccurate reporting of vaccination coverage; managing perceptions and misperceptions; and conflict and emergency settings. The Plan offers solutions to these challenges, discusses the roles and responsibilities of stakeholders, and provides indicators to monitor and evaluate national, regional and global progress towards the vision and goals. Countries bear the largest responsibility for measles and rubella control and elimination, and they must support sustainable national planning, funding and advocacy to protect their citizens from devastating preventable diseases. The MR Initiative and its five spearheading partners — the American Red Cross, United States Centers for Disease Control and Prevention, United Nations Children's Fund, United Nations Foundation and World Health Organization — endorse this Strategic Plan and will work with countries and international donors on its implementation. As countries work towards attaining national, regional and global measles, rubella and CRS control and elimination goals, they can rely on technical and financial support from the MR Initiative and its partners, including the GAVI Alliance (formerly the Global Alliance for Vaccines and Immunization). To support this Plan, the MR Initiative developed and maintains a Financial Resource Requirements document that it reviews and updates regularly. The MR Initiative recommends that all stakeholders use this Plan and the referenced technical guidance to secure the commitments and actions required for a world free of measles, rubella and CRS. ; Abbreviations and acronyms -- Foreword -- Executive summary -- Introduction -- Vision, goals and milestones -- Global context -- Measles vaccination -- Rubella vaccination -- Laboratory network -- Current WHO global and regional targets -- Potential future WHO global targets -- Recent setbacks and risk of resurgence -- Economic analyses of measles, rubella and CRS control and elimination -- Strategy to eliminate measles, rubella and CRS -- 1. Achieve and maintain high levels of population immunity by providing high vaccination coverage with two doses of measles- and rubella-containing vaccines -- 2. Monitor disease using effective surveillance and evaluate programmatic efforts to ensure progress -- 3. Develop and maintain outbreak preparedness and respond rapidly to outbreaks and manage cases -- 4. Communicate and engage to build public confidence and demand for immunization -- 5. Perform the research and development needed to support cost-effective operations and improve vaccination and diagnostic tools -- Guiding principles to eliminate measles, rubella and CRS -- 1. Country ownership and sustainability -- 2. Routine immunization and health systems strengthening -- 3. Equity -- 4. Linkages -- Challenges to implementing the Strategic Plan -- 1. Financial risks -- 2. High population density and highly mobile populations -- 3. Weak immunization systems and inaccurate reporting of vaccination coverage -- 4. Managing perceptions and misperceptions -- 5. Confiict and emergency settings -- Roles and responsibilities -- 1. National governments -- 2. Global and regional partners -- The Measles and Rubella Initiative -- The GAVI Alliance -- Tracking progress -- Conclusion -- References -- Annex 1. List of measles and rubella priority countries.

Measles is one of the most communicable diseases of childhood. Children less than five years of age have higher risk being exposed to measles in Uttar Pradesh as found in the surveys conducted by the government and other studies.Objectives: (1) To study trend and pattern of vaccination coverage in India in general and Uttar Pradesh in particular. (2) To assess the impact of socio-economic factors on vaccination coverage against measles in Uttar Pradesh. Material & methods: The data of different years of national family health surveys, collected by Ministry of health and Family Welfare, Government of India have been collectively used for analysis. Findings have been investigated with the help of binary logistic regression using.Results and discussion: Socio-economic factors like type of place of residence, mother's education, social group and wealth index of the family do have an impact on measles vaccination coverage in Uttar Pradesh. This study presents the need to achieve and maintain high immunization coverage in UP with special focus on people's background characteristics.

Measles is one of the most communicable diseases of childhood. Children less than five years of age have higher risk being exposed to measles in Uttar Pradesh as found in the surveys conducted by the government and other studies.Objectives: (1) To study trend and pattern of vaccination coverage in India in general and Uttar Pradesh in particular. (2) To assess the impact of socio-economic factors on vaccination coverage against measles in Uttar Pradesh. Material & methods: The data of different years of national family health surveys, collected by Ministry of health and Family Welfare, Government of India have been collectively used for analysis. Findings have been investigated with the help of binary logistic regression using.Results and discussion: Socio-economic factors like type of place of residence, mother's education, social group and wealth index of the family do have an impact on measles vaccination coverage in Uttar Pradesh. This study presents the need to achieve and maintain high immunization coverage in UP with special focus on people's background characteristics.

Measles is one of the most severe infectious diseases of childhood, and one of the major causes of mortali-ty, especially in developing countries. Despite rare measles outbreaks in recent years, Kyrgyzstan seeks to show its commitment towards the global anti-measles campaign. The aim of this article is to summarize the scattered information on the recent status of measles, valid surveillance system, and measles elimination strategies in Kyrgyzstan, based on sources that include non-confidential but usually inaccessible governmental data. Infor-mation was extracted from the reports to the Ministry of Health and documents on the national surveillance system, in addition to outbreak cases extracted from the Republican Infectious Diseases Hospital's archive. To tackle the worsening measles situation in Kyrgyzstan, the Ministry of Health established the Republican Center for Immunoprophylaxis in 1994. Measles related death, which was rampant up until 1992, has not been registered since 2000 due to improved routine vaccination coverage, increasing from 88% in 1994 to 97% and over in 1997. The national surveillance system was modernized thanks to the World Health Organization, helping to detect measles cases and prevent major outbreaks. The system identified 222 cases in the outbreak of 2011, and the case cards in the hospital provided the findings of 69 admitted cases (42 infants, 22 children aged 1 to 14 years, and 5 aged 15 years or over), including 32 severe cases. This article provides a whole view on measles in Kyrgyzstan, which would be useful to control measles worldwide.

Abstract Background Measles remains a major public health concern in Thailand despite the introduction of vaccination since 1984. Similar to other countries, Thailand has experienced numerous measles outbreaks including adult communities such as university student dormitories, prisons, refugee camps, and military recruit camps. These outbreaks raise questions on the seroprotective antibody level in Thai adults. Methods To better understand measles susceptibility in young Thai adults, a retrospective measles seroprevalence study on repository serum specimens obtained with informed consent from young Thai men entering the Royal Thai Army (RTA) during 2007–2008 was conducted. A total of 7760 stratified randomized samples were chosen by residence province. Measles IgG titer was measured using a commercial IgG quantitative ELISA kit following the manufacturer's instructions. An antibody level ≥ 250 International Units per Liter (IU/L) was interpreted as seropositive. Results The overall measles seroprevalence was 78.5 % (95 % Confidence Interval: 77.6–79.4 %) with geometric mean titer of 738 IU/L (95 % Confidence Interval: 716–760 IU/L). The measles seroprevalence by province ranged from 59.6 % to 93.1 %. A trend of decreasing seroprevalence in the younger cohorts despite increasing immunization coverage was found. Lower seroprevalence than vaccination coverage was observed in the youngest age group. Conclusions To achieve long term measles control and elimination, an integrated two doses vaccination strategy has been implemented in children in Thailand. This nationwide measles seroprevalence study in young adult RTA recruits found a measles seroprevalence lower than WHO's recommendation for measles outbreak prevention and elimination. These results raise concerns for measles control in Thailand. Supplementary immunization in young adults is essential especially in high-risk and densely populated communities to establish herd immunity for outbreak prevention and elimination.

Over the last 5 years, a number of outbreaks of measles have occurred in several European Union (EU) countries. Many of these outbreaks continue and/or continued for more than 1 year after the notification of the first case. Curiously in many of measles outbreaks about 10% of the patients were less than 12 months of age. All these patients according to the current EU countries vaccination calendars were not yet vaccinated against measles. Based on the results of measles outbreaks, especially age of affected patients, we should consider changing measles vaccination schedules in all EU countries. Most of mothers between 30 and 40 years of age are not vaccinated against measles, and many of them are not naturally immune against measles. These mothers do not pose antibodies against measles and in turn do not provide vertical protection for their infants. In conclusion, administrating the first dose of measles vaccine in the EU countries should be considered before 12 months of age, most probably at 9 months of age.

Measles is considered to be an important cause of morbidity and mortality in children in developing nations. After poliomyelitis, measles is the next candidate disease for eradication. The feasibility of measles eradication has been studied and approved by an expert panel convened by WHO. Pan American Health Organisation evolved the strategy for measles eradication which includes initial "catch up campaign" followed by "keep up" and "follow up" campaigns. Region of The Americas has achieved elimination of measles by adopting this strategy. To reduce measles mortality in South East Asia region, The Strategic Advisory Group of Experts (SAGE) has drafted recommendations stating all children should receive two doses of measles vaccine. In spite of biological and technical feasibility, challenges are many for measles eradication. Competing priorities like ongoing polio eradication, introduction of new vaccines under Universal Immunisation Program and other ongoing health initiatives pose major challenges. Limited resources and injectable vaccine requiring trained workforce to administer are other considerations. Wars, political and social unrest as well as population displacement and migration create hindrance in achieving and maintaining a good vaccine coverage which is essential for eradication. Hence, measles eradication seems to be very challenging. Each and every part of the world should comply with the efforts for eradication; only then global transmission of disease can be terminated.