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Progress Toward Measles Elimination - Bangladesh, 2000-2016.

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    Bangladesh has made significant progress in measles elimination, increasing vaccination coverage to 94% for the first dose and 93% for the second. However, challenges remain in surveillance systems to achieve the 2018 elimination goal.

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    Area of Science:

    • Public Health
    • Epidemiology
    • Vaccinology

    Background:

    • The World Health Organization (WHO) South-East Asia Region (SEAR) set a goal to eliminate measles and control rubella by 2020.
    • Bangladesh adopted a national measles elimination goal for 2018, aligning with regional objectives.
    • Key strategies include high vaccination coverage, robust surveillance, and a functional laboratory network.

    Purpose of the Study:

    • To assess progress and identify challenges in measles elimination efforts in Bangladesh from 2000 to 2016.
    • To evaluate the impact of vaccination campaigns and surveillance systems on measles incidence.

    Main Methods:

    • Analysis of measles-containing vaccine (MCV) coverage data, including the first (MCV1) and second (MCV2) doses.
    • Review of data from nationwide supplementary immunization activities (SIAs) conducted between 2000 and 2016.
    • Assessment of measles case-based surveillance system performance against established indicators.

    Main Results:

    • MCV1 coverage increased from 74% in 2000 to 94% in 2016; MCV2 coverage rose from 35% in 2013 to 93% in 2016.
    • Over 108.9 million children received MCV during three nationwide SIAs.
    • Confirmed measles incidence decreased by 82% (from 34.2 to 6.1 per million population) during the study period.
    • In 2016, 56% of districts failed to meet the surveillance performance target for discarded non-measles/non-rubella cases.

    Conclusions:

    • Bangladesh has achieved substantial gains in measles vaccination coverage and incidence reduction.
    • Enhancing surveillance sensitivity and achieving universal ≥95% MCV coverage in all districts are critical for elimination.
    • Targeted strategies for hard-to-reach populations and improved specimen transport are necessary to meet elimination goals.