Abstract:

Most global estimates indicate that more than 1 million children a year die from acute measles. The actual number of deaths may, however, be considerably higher than this. In addition, the impact of delayed mortality as a result of measles infection is only now being realized. Many months after they contract measles, children continue to experience higher levels of mortality and morbidity than those who do not. Immunization of children against measles therefore prevents mortality and morbidity not only during the acute phase but also during subsequent months. The impact of measles immunization programmes may therefore have generally been underestimated. The effects of measles infection on children during the early months of life are more damaging than those experienced by older children. Children should therefore be immunized against measles as early in life as possible, given the limitations of existing vaccines.

As per DHIS, measles coverage amongst children below one year achieved in the first 10 months of 2018 is 56%. This is slightly lower of what was reported in previous years (going back to 2015, when CUAMM started working in Rumbek East) In a context as South Sudan, where several households live far from the nearest Health Facilities and are used to nomadic habits, it is common for children to access EPI services later than the regular immunization schedule, which stipulates getting vaccinated against measles after the first birthday. However, even merging U1 and U2 vaccinated children, the coverage of U5 population remains extremely low, not surpassing 30%.

Keywords: Expanded programme on Immunization, Vaccinated, Children Under five, measles coverage, Rumbek East, Western Lake state.

References:

[1].Aaby P, Bukh J, Lisse IM, Smits AJ, Gomes J, Fernandes MA, Indi F, Soares M. Determinants of measles mortality in a rural area of Guinea-Bissau: crowding, age, and malnutrition. J Trop Pediatr. 1984 Jun; 30(3):164–168. [PubMed].

[2].Aaby P, Bukh J, Lisse IM, Smits AJ. Overcrowding and intensive exposure as determinants of measles mortality. Am J Epidemiol. 1984 Jul;120(1):49–63. [PubMed].

[3].Aaby P, Bukh J, Lisse IM, da Silva MC. Further community studies on the role of overcrowding and intensive exposure on measles mortality. Rev Infect Dis. 1988 Mar-Apr;10(2):474–477. [PubMed].

[4].GORDON JE, JANSEN AA, ASCOLI W. MEASLES IN RURAL GUATEMALA. J Pediatr. 1965 Apr; 66: 779–786. [PubMed].

[5].Aaby P, Bukh J, Hoff G, Leerhøy J, Lisse IM, Mordhorst CH, Pedersen IR. High measles mortality in infancy related to intensity of exposure. J Pediatr. 1986 Jul;109(1):40–44. [PubMed].

[6].Aaby P. Malnutrition and overcrowding/intensive exposure in severe measles infection: review of community studies. Rev Infect Dis. 1988 Mar-Apr;10(2):478–491. [PubMed].

[7].Aaby P, Jensen TG, Hansen HL, Kristiansen H, Thårup J, Poulsen A, Sodemann M, Jakobsen M, Knudsen K, Clotilde da Silva M, et al. Trial of high-dose Edmonston-Zagreb measles vaccine in Guinea-Bissau: protective efficacy. Lancet. 1988 Oct 8;2(8615):809–811. [PubMed].

[8].Bhaskaram P, Reddy V, Raj S, Bhatnagar RC. Effect of measles on the nutritional status of preschool children. J Trop Med Hyg. 1984 Feb;87(1):21–25. [PubMed].

[9].Bhaskaram P, Madhusudhan J, Radhakrishna KV, Reddy V. Immune response in malnourished children with measles. J Trop Pediatr. 1986 Jun;32(3):123–126. [PubMed].

[10]. Chen LC, Chowdhury A, Huffman SL. Anthropometric assessment of energy-protein malnutrition and subsequent risk of mortality among preschool aged children. Am J Clin Nutr. 1980 Aug;33(8):1836–1845. [PubMed].

[11]. Chen LC, Rahman M, Sarder AM. Epidemiology and causes of death among children in a rural area of Bangladesh. Int J Epidemiol. 1980 Mar;9(1):25–33. [PubMed].

[12]. Hull HF, Williams PJ, Oldfield F. Measles mortality and vaccine efficacy in rural West Africa. Lancet. 1983 Apr 30;1(8331):972–975. [PubMed].

[13]. Koster FT, Curlin GC, Aziz KM, Haque A. Synergistic impact of measles and diarrhoea on nutrition and mortality in Bangladesh. Bull World Health Organ. 1981;59(6):901–908. [PMC free article][PubMed].

[14]. Muller AS, Voorhoeve AM, Mannetje W, Schulpen TW. The impact of measles in a rural area of Kenya. East Afr Med J. 1977 Jul;54(7):364–372. [PubMed].

[15]. Mina, M. J., Metcalf, C. J., de Swart, R. L., Osterhaus, A. D. & Grenfell, B. T. Long-term measles-induced immunomodulation increases overall childhood infectious disease mortality. Science 348, 694–699 (2015).

[16]. Natu M, Chavan H, Pratinidhi A. Measles vaccination. Prevention strategy for malnutrition. Indian Pediatr. 1985 Aug;22(8):597–600. [PubMed].

[17]. Reddy V, Bhaskaram P, Raghuramulu N, Milton RC, Rao V, Madhusudan J, Krishna KV. Relationship between measles, malnutrition, and blindness: a prospective study in Indian children. Am J Clin Nutr. 1986 Dec;44(6):924–930. [PubMed].

[18]. Walsh JA, Warren KS. Selective primary health care: an interim strategy for disease control in developing countries. N Engl J Med. 1979 Nov 1;301(18):967–974. [PubMed].

[19]. Whittle HC, Rowland MG, Mann GF, Lamb WH, Lewis RA. Immunisation of 4-6-month-old Gambian infants with Edmonston-Zagreb measles vaccine. Lancet. 1984 Oct 13;2(8407):834–837.[PubMed].

[20]. Whittle H, Hanlon P, O'Neill K, Hanlon L, Marsh V, Jupp E, Aaby P. Trial of high-dose Edmonston-Zagreb measles vaccine in the Gambia: antibody response and side-effects. Lancet. 1988 Oct 8;2(8615):811–814. [PubMed].