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dc.contributor.authorCoulborn, RM
dc.contributor.authorNackers, F
dc.contributor.authorBachy, C
dc.contributor.authorPorten, K
dc.contributor.authorVochten, H
dc.contributor.authorNdele, E
dc.contributor.authorVan Herp, M
dc.contributor.authorBibala-Faray, E
dc.contributor.authorCohuet, S
dc.contributor.authorPanunzi, I
dc.date.accessioned2020-03-20T18:16:56Z
dc.date.available2020-03-20T18:16:56Z
dc.date.issued2020-02-25
dc.date.submitted2020-03-06
dc.identifier.pmid32111528
dc.identifier.doi10.1016/j.vaccine.2020.02.029
dc.identifier.urihttp://hdl.handle.net/10144/619613
dc.description.abstractBACKGROUND: During a measles epidemic, the Ministry of Public Health (MOH) of the Democratic Republic of the Congo conducted supplementary immunization activities (2016-SIA) from August 28-September 3, 2016 throughout Maniema Province. From October 29-November 4, 2016, Médecins Sans Frontières and the MOH conducted a reactive measles vaccination campaign (2016-RVC) targeting children six months to 14 years old in seven health areas with heavy ongoing transmission despite inclusion in the 2016-SIA, and a post-vaccination survey. We report the measles vaccine coverage (VC) and effectiveness (VE) of the 2016-SIA and VC of the 2016-RVC. METHODS: A cross-sectional VC cluster survey stratified by semi-urban/rural health area and age was conducted. A retrospective cohort analysis of measles reported by the parent/guardian allowed calculation of the cumulative measles incidence according to vaccination status after the 2016-SIA for an estimation of crude and adjusted VE. RESULTS: In November 2016, 1145 children (6-59 months old) in the semi-urban and 1158 in the rural areas were surveyed. Post-2016-SIA VC (documentation/declaration) was 81.6% (95%CI: 76.5-85.7) in the semi-urban and 91.0% (95%CI: 84.9-94.7) in the rural areas. The reported measles incidence in October among children less than 5 years old was 5.0% for 2016-SIA-vaccinated and 11.2% for 2016-SIA-non-vaccinated in the semi-urban area, and 0.7% for 2016-SIA-vaccinated and 4.0% for 2016-SIA-non-vaccinated in the rural area. Post-2016-SIA VE (adjusted for age, sex) was 53.9% (95%CI: 2.9-78.8) in the semi-urban and 78.7% (95%CI: 0-97.1) in the rural areas. Post 2016-RVC VC (documentation/declaration) was 99.1% (95%CI: 98.2-99.6) in the semi-urban and 98.8% (95%CI: 96.5-99.6) in the rural areas. CONCLUSIONS: Although our VE estimates could be underestimated due to misclassification of measles status, the VC and VE point estimates of the 2016-SIA in the semi-urban area appear suboptimal, and in combination, could not limit the epidemic. Further research is needed on vaccination strategies adapted to urban contexts.en_US
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.rightsWith thanks to Elsevier.en_US
dc.subjectDemocratic Republic of the Congo
dc.subjectMass vaccination
dc.subjectMeasles vaccination
dc.subjectVaccination coverage
dc.subjectVaccine effectiveness
dc.titleField challenges to measles elimination in the Democratic Republic of the Congoen_US
dc.typeArticle
dc.identifier.eissn1873-2518
dc.identifier.journalVaccineen_US
dc.source.journaltitleVaccine
refterms.dateFOA2020-03-20T18:16:56Z
dc.source.countryNetherlands


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