Trends in measles incidence and measles vaccination coverage in Nigeria, 2008–2018
Jean Baptiste, Anne Eudes; Masresha, Balcha; Wagai, John; Luce, Richard; Oteri, Joseph; Dieng, Boubacar; Bawa, Samuel; Ikeonu, Obianuju Caroline; Chukwuji, Martin; Braka, Fiona; Sanders, E. A.M.; Hahné, Susan; Hak, Eelko
(2021) Vaccine, volume 39, pp. C89 - C95
(Article)
Abstract
Introduction: All WHO regions have set measles elimination objective for 2020. To address the specific needs of achieving measles elimination, Nigeria is using a strategy focusing on improving vaccination coverage with the first routine dose of (monovalent) measles (MCV1) at 9 months, providing measles vaccine through supplemental immunization activities (children
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9–59 months), and intensified measles case-based surveillance system. Methods: We reviewed measles immunization coverage from population-based surveys conducted in 2010, 2013 and 2017–18. Additionally, we analyzed measles case-based surveillance reports from 2008–2018 to determine annual, regional and age-specific incidence rates. Findings: Survey results indicated low MCV1 coverage (54.0% in 2018); with lower coverage in the North (mean 45.5%). Of the 153,097 confirmed cases reported over the studied period, 85.5% (130,871) were from the North. Moreover, 70.8% (108,310) of the confirmed cases were unvaccinated. Annual measles incidence varied from a high of 320.39 per 1,000,000 population in 2013 to a low of 9.80 per 1,000,000 in 2009. The incidence rate is higher among the 9–11 months (524.0 per million) and 12–59 months (376.0 per million). Between 2008 and 2018, the incidence rate had showed geographical variation, with higher incidence in the North (70.6 per million) compare to the South (17.8 per million). Conclusion: The aim of this study was to provide a descriptive analysis of measles vaccine coverage and incidence in Nigeria from 2008 to 2018 to assess country progress towards measles elimination. Although the total numbers of confirmed measles cases had decreased over the time period, measles routine coverage remains sub-optimal, and the incidence rates are critically high. The high burden of measles in the North highlight the need for region-specific interventions. The measles program relies heavily on polio resources. As the polio program winds down, strong commitments will be required to achieve elimination goals.
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Keywords: Coverage, Epidemiology, Measles, Nigeria, Molecular Medicine, General Immunology and Microbiology, General Veterinary, Public Health, Environmental and Occupational Health, Infectious Diseases
ISSN: 0264-410X
Publisher: Elsevier BV
Note: Funding Information: Special gratitude goes to the National Primary Health Care Development Agency (NPHCDA), State and LGA Health Teams across the country, World Health Organization Nigeria country office and field staff. We gratefully acknowledge the Disease Surveillance Notification Officers for their contributions upon which this report is based. Some of the data sets used in this paper are publicly available via the sources referenced in the manuscript (e.g. Nigeria Demographic and Health Survey 2013 and 2018, the National Immunization Coverage Surveys (NICS) 2010 and NICS 2017/2018). Others are confidential and the authors do not have the permission to share these data. This work was supported by the World Health Organization, Nigeria Country Office. This supplement was sponsored by the World Health Organization Country Office in Nigeria. The opinions expressed in this publication are those of the authors and are not attributable to the sponsors. This is an Open Access article published under the CC BY 3.0 IGO license which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Please also check the additional requirements on the Elsevier.com WHO page. Funding Information: This work was supported by the World Health Organization, Nigeria Country Office. Publisher Copyright: © 2021 World Health Organization
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