Progress Toward Measles Elimination - Bangladesh, 2000-2016

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.