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    Nepal made progress in measles elimination efforts by increasing vaccine coverage and reducing incidence between 2007 and 2014. However, challenges remain in achieving high vaccination rates and robust surveillance for measles elimination.

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    Area of Science:

    • Public Health
    • Epidemiology
    • Vaccinology

    Background:

    • The World Health Organization's South-East Asia Region (SEAR) aimed for measles and rubella elimination by 2020.
    • Nepal set a national goal for measles elimination by 2019, aligning with regional objectives.
    • Key strategies include high vaccination coverage, sensitive surveillance, laboratory capacity, and outbreak response.

    Purpose of the Study:

    • To update on progress towards measles elimination in Nepal from 2007 to 2014.
    • To assess the effectiveness of implemented measles control strategies in Nepal.

    Main Methods:

    • Analysis of routine immunization coverage data for measles-containing vaccine (MCV).
    • Review of data from supplementary immunization activities (SIAs).
    • Assessment of reported suspected measles incidence and case-based surveillance performance indicators.

    Main Results:

    • Estimated MCV1 coverage increased from 81% to 88% between 2007 and 2014.
    • Millions of children were vaccinated during SIAs in 2008 and 2014.
    • Suspected measles incidence decreased by 13%, but 81% of districts failed to meet surveillance targets in 2014.

    Conclusions:

    • Nepal has shown progress in increasing vaccination coverage and reducing measles incidence.
    • Significant improvements are needed in routine immunization coverage (MCV1 and MCV2) to reach the 95% target in all districts.
    • Enhancing measles case-based surveillance sensitivity is crucial for achieving and sustaining elimination.