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Progress Toward Measles Elimination - Pakistan, 2000-2018.
MMWR. Morbidity and Mortality Weekly Report
|June 7, 2019
Summary
Pakistan made progress in measles vaccination coverage, but challenges remain. Increased efforts are needed to achieve measles elimination, focusing on higher vaccination rates and improved surveillance.
Area of Science:
- Public Health
- Epidemiology
- Vaccinology
Background:
- The World Health Organization (WHO) Eastern Mediterranean Region (EMR) committed to measles elimination in 1997, with this goal reiterated in the 2015 Eastern Mediterranean Vaccine Action Plan.
- Pakistan, a populous EMR country, plays a significant role in regional measles elimination efforts.
- A four-pronged strategy by the WHO Regional Office for the Eastern Mediterranean includes high vaccination coverage (MCV1 and MCV2), robust surveillance, and optimal case management.
Purpose of the Study:
- To assess progress and identify challenges in achieving measles elimination in Pakistan from 2000 to 2018.
- To evaluate vaccination coverage trends and measles incidence during the study period.
Main Methods:
- Analysis of estimated measles-containing vaccine (MCV) first dose (MCV1) and second dose (MCV2) coverage.
- Review of data from supplementary immunization activities (SIAs).
- Examination of reported confirmed measles incidence and suspected case investigation rates.
Main Results:
- MCV1 coverage increased from 57% in 2000 to 76% in 2017; MCV2 coverage rose from 30% in 2009 to 45% in 2017.
- Over 232 million children received MCV doses during SIAs between 2000 and 2018.
- Reported confirmed measles incidence significantly increased from 24.6 per million (2000-2009) to 80.4 per million (2010-2018), with notable peaks.
- Low rates of non-measles cases suggest underreporting of measles cases.
Conclusions:
- Despite progress in vaccination coverage, Pakistan faces substantial challenges in achieving measles elimination.
- Increased MCV1 and MCV2 coverage, targeted strategies for underserved communities, and enhanced surveillance sensitivity are crucial.
- Urgent, intensified efforts are required to meet regional measles elimination goals.
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