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    Jan 26, 2021
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    Field challenges to measles elimination in the Democratic Republic of the Congo

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    Coulborn et al 2020 Field ...
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    Authors
    Coulborn, RM
    Nackers, F
    Bachy, C
    Porten, K
    Vochten, H
    Ndele, E
    Van Herp, M
    Bibala-Faray, E
    Cohuet, S
    Panunzi, I
    Issue Date
    2020-03-17
    Submitted date
    2020-04-17
    
    Metadata
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    Journal
    Vaccine
    Abstract
    BACKGROUND: 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.
    Publisher
    Elsevier
    URI
    http://hdl.handle.net/10144/619655
    DOI
    10.1016/j.vaccine.2020.02.029
    PubMed ID
    32111528
    Type
    Article
    Language
    en
    EISSN
    1873-2518
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.vaccine.2020.02.029
    Scopus Count
    Collections
    Vaccination

    entitlement

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