Mortality from measles fell by 91% in Africa from 2000 to 2006

BMJ 2007; 335 doi: (Published 06 December 2007) Cite this as: BMJ 2007;335:1173
  1. John Zarocostas
  1. 1Geneva

    The number of deaths in Africa from measles fell from an estimated 396 000 in 2000 to 36 000 in 2006, a fall of 91%, says a progress report by the World Health Organization and Unicef. It attributes the decrease largely to better coverage in routine immunisation programmes and targeted campaigns to ensure that children had a second chance to be vaccinated.

    “This is a major public health success and a tribute to the commitment of countries in the African region,” said Margaret Chan, director general of WHO.

    “We need to sustain this success and intensify our efforts in other parts of the world, as there are still far too many lives lost to this disease,” she said.

    The executive director of Unicef, Ann Veneman, also lauded the results in Africa but went on to say: “Measles is still killing nearly 600 children under 5 every day, an unacceptable reality when we have a safe, effective, and inexpensive vaccine to prevent the disease.”

    Of the deaths from measles in 2006, 90% were among children aged under 5 years, says the report by the Measles Initiative, which is run by WHO and Unicef in conjunction with the American Red Cross and the US Centers for Disease Control and Prevention (CDC).

    WHO’s objective is to achieve a 90% worldwide reduction in the number of measles deaths by 2010, and officials are confident that this can be met.

    Mortality from measles worldwide fell by 68% from 2000 to 2006—from an estimated 757 000 deaths to 242 000. The fall in Africa accounted for 70% of this reduction.

    Big reductions were also registered in WHO’s Western Pacific region, down by 81% to 5000 deaths from 25 000, and in the Eastern Mediterranean region, by 76% from 96 000 to 23 000.

    However, in WHO’s South East Asia region, which includes the Indian subcontinent, the fall in measles mortality was substantially smaller—only 26%, from 240 000 to 178 000—because reduction strategies in some large countries with a high burden of the disease, such as India and Pakistan, were lagging behind those in other countries.

    Julie Gerberding, director of the CDC, said, “The next step is to fully implement the strategy in South Asia, where the measles disease burden is now the highest in the world.”

    Between 2000 and 2006, the report says, 478 million children aged between 9 months and 14 years received measles vaccine through supplementary campaigns in 46 of the 47 priority countries.

    In WHO’s African region alone, between 2001 and 2006 more than 304 million children in 40 countries were given a second vaccination through these campaigns, WHO says.

    In more than half of the priority countries measles vaccination was integrated with at least one other intervention to improve children’s survival, such as the distribution of bed nets treated with insecticide, administration of anthelmintics, or provision of vitamin A supplements.

    Overall in 2006 the worldwide campaign to improve vaccination coverage reached an estimated 80% of its target population for the first time, up from 72% in 2000. The biggest gains were recorded in the African region, where it reached 73%, up from 56% six years earlier.

    Moreover, the report notes that coverage reached 83% in the Eastern Mediterranean region (up from 73% in 2000), 93% in the Western Pacific (up from 86%), and 65% in South East Asia (up from 60%).

    But it also points out that 26.2 million children aged 1 year old did not receive a dose of measles vaccine through routine vaccination services in 2006. Of these children an estimated 16 million (61%) reside in five large countries: India (with 10.5 million of the children), Nigeria (two million), China and Indonesia (each with 1.2 million), and Ethiopia (1.1 million).


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