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Emergence of measles virus genotype D8 amidst endemic B3 circulation in Uganda, 2023-2025
Prossy Namuwulya1, Irene Turyahabwe1, Rena Nakyeyune1
1Uganda Virus Research Institute (UVRI), Entebbe, Uganda.
Objectives:
Measles remains a significant global health threat, with recurrent outbreaks, even in regions such as America, where the disease had been eliminated. Despite the availability of an effective and freely accessible vaccine, measles remains a global burden especially in children. The World Health Organization (WHO) estimated 107,500 measles-related deaths in 2023, with over 95% occurring in low- and middle-income countries reflecting fragile health systems. Uganda has similarly experienced persistent outbreaks since 2023. This study aimed at investigating the emergence of measles genotype D8 in Uganda for the first time, alongside the endemic measles genotype B3.
Methods:
To track measles circulating strains, molecular genotyping targeting the measles virus N450 region was performed on 137 specimens. Phylogenetic analysis of the sequences was carried out along with WHO reference sequences and GenBank selected sequences.
Results:
Alongside the endemic B3 genotype, genotype D8 was detected for the first time in Uganda, revealing co-circulation of both lineages.
Conclusions:
The detection of measles D8 alongside the endemic B3 indicated possible gaps in the existing surveillance system and vaccination coverage. These findings highlight the critical importance of molecular surveillance and the urgent need to enhance measles vaccination coverage.
Insights
Measles genotype D8 has emerged in Uganda, co-circulating with the endemic B3 genotype. This finding highlights potential gaps in measles surveillance and vaccination coverage, underscoring the need for enhanced public health interventions.
Area of Science:
- Virology
- Epidemiology
- Public Health
Background:
- Measles remains a significant global health threat, causing substantial mortality, particularly in children in low- and middle-income countries.
- Despite effective vaccines, recurrent outbreaks persist, even in previously eliminated regions, indicating challenges in control strategies.
- Uganda has faced persistent measles outbreaks, necessitating an understanding of the circulating viral strains.
Purpose of the Study:
- To investigate the emergence of measles virus genotype D8 in Uganda for the first time.
- To identify and characterize measles genotypes co-circulating with the endemic genotype B3 in Uganda.
Main Methods:
- Molecular genotyping of the measles virus N450 region was performed on 137 collected specimens.
- Phylogenetic analysis was conducted using generated sequences, WHO reference sequences, and selected GenBank sequences.
Main Results:
- The study detected measles genotype D8 in Uganda, marking its first appearance in the region.
- Co-circulation of the newly emerged genotype D8 alongside the endemic genotype B3 was confirmed.
Conclusions:
- The co-circulation of measles genotypes D8 and B3 suggests potential weaknesses in the current measles surveillance system and vaccination coverage in Uganda.
- These findings emphasize the critical role of molecular surveillance in tracking viral evolution and the urgent necessity to improve measles vaccination rates.
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