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Alemu TG, Tamir TT, Workneh BS, Mekonen EG, Ali MS, Zegeye AF, Wassie M, Kassie AT, Tekeba B, Gonete AT. Coverage and determinants of second-dose measles vaccination among under-five children in East Africa countries: a systematic review and meta-analysis. Front Public Health 2024; 12:1359572. [PMID: 38751581 PMCID: PMC11094336 DOI: 10.3389/fpubh.2024.1359572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/11/2024] [Indexed: 05/18/2024] Open
Abstract
Background One of the biggest breakthroughs of contemporary medicine is measles vaccination. It is essential for the total elimination of measles. Understanding the magnitude and determinants of effective second-dose measles vaccination coverage is a critical task. Accordingly, we set out to check the best available evidence of the pooled second-dose measles vaccination coverage among under-five children in East Africa. Method We searched electronic databases such as PubMed, Google Scholar, Cochrane, and others. Two reviewers separately carried out the search of the Joanna Briggs Institute, selection of studies, critical appraisal, and data extraction. A third party was involved in resolving the disagreement among the reviewers. Seven studies included in this study, four from Ethiopia, two from Kenya, and one from Tanzania were cross-sectional and published in English language, with publication dates before 29 November 2023. Articles lacking full-text, the intended outcome, and that are not qualitative studies were excluded from the analysis. The Microsoft Excel checklist was used to extract the data and then exported to STATA 11. In addition, I2, Funnel plots, and Egger's test were employed to measure heterogeneity and detect publication bias, respectively. A random effect model was used. Result The meta-analysis includes a total sample size of 4,962 children from seven articles. The pooled prevalence of second-dose measles vaccination among under-five children in East Africa was found to be 32.22% [95% CI; (18.82, 45.63)], and the significant factors were as follows: birth order (1.72; OR = 95% CI: 1.32, 2.23), information about measles-containing second-dose vaccine (MCV 2) (7.39; OR = 95% CI: 5.21, 10.50), mother's marital status (1.47; OR = 95% CI: 1.05, 2.07), complete immunization for other vaccines (2.17; OR = 95% CI: 1.49, 3.17), and distance of vaccination site (3.31; OR = 95% CI: 2.42, 4.53). Conclusion The current study found that pooled prevalence of second-dose measles vaccination coverage among under-five children was still very low. It was also observed that birth order, distance of the vaccination site, complete immunization for other vaccines, mother's marital status, and information about MCV were factors associated with second-dose measles vaccination. These factors imply that there is a need for countries and their partners to act urgently to secure political commitment, expand primary health service and health education, and increase vaccination coverage.
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Affiliation(s)
- Tewodros Getaneh Alemu
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Tarik Tamir
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Belayneh Shetie Workneh
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Enyew Getaneh Mekonen
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohammed Seid Ali
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alebachew Ferede Zegeye
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulugeta Wassie
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemneh Tadesse Kassie
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Berhan Tekeba
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Almaz Tefera Gonete
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Goshu Muluneh A, Woldemariam Merid M, Tigabu B, Getie Ferede M, Molla Kassa G, Animut Y. Less than one-fifth of Ethiopian children were vaccinated for measles second dose; evidence from the Ethiopian mini demographic and health survey 2019. Vaccine X 2022; 12:100217. [PMID: 36148266 PMCID: PMC9486014 DOI: 10.1016/j.jvacx.2022.100217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 11/27/2022] Open
Abstract
Ethiopia introduced the measles second dose vaccine from the routine expanded immunization program in 2018. Shreds of evidence are scarce on the measles second dose vaccination coverage and its associated factors in Ethiopia. We aimed to assess the measles second dose vaccination coverage and associated factors in Ethiopia using the recent Ethiopian Mini Demographic and Health Survey (EMDHS) 2019 data. An in-depth secondary data analysis was conducted based on the Ethiopian mini demographic and health survey 2019 data; which was a cross-sectional survey targeted on key indicators of maternal and child health. A weighted sample of 965 children was included in the analysis. A multi-level mixed effect logistics regression model was fitted. Adjusted Odds Ratio (AOR) with 95 %CI was reported for statistically significant variables. The measles second dose coverage was 12.36 % (95 %CI = 10.89, 15.44). Not vaccinated for the third dose of pentavalent vaccine (Penta 3) (AOR = 0.60, 95 %CI: 0.37, 0.95), age of the child [13 to 23 months (AOR = 2.14, 95 %CI: 1.05, 4.36), 24 to 36 months (AOR = 2.58, 95 %CI: 1.32, 5.05)], household head educational status [no education (AOR = 0.51,95 %CI: 0.26, 0.99), primary (AOR = 0.44, 95 %CI: 0.23, 0.85)], and living in south nation, nationalities and peoples region (SNNPR) (AOR = 2.83,95 %CI: 1.12, 7.11) were significantly associated with measles second dose vaccination coverage. Measles second dose vaccination coverage was low in Ethiopia. Age of the child, being vaccinated for the Penta 3, educational status of the household head, and region of residence were significant determinants of measles second dose vaccination coverage.
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Measles-Rubella Positivity Rate and Associated Factors in Pre-Mass and Post-Mass Vaccination Periods: Analysis of Uganda Routine Surveillance Laboratory Data. ADVANCES IN PUBLIC HEALTH 2022. [DOI: 10.1155/2022/5080631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Toward 2019, Uganda experienced an extensive outbreak of measles and rubella. The Uganda National Expanded Programme on Immunization implemented a mass measles-rubella vaccination campaign aimed at halting the ongoing transmission. This study determined the changes in the disease burden thereafter. We conducted a retrospective cross-sectional study on measles-rubella positivity and its associated factors in Uganda using 1697 case-based surveillance data for 2019 and 2020 stratified into two dispensations: prevaccination and postvaccination campaigns. Statistical tests employed in STATA 15 included chi-square, Fisher’s exact, and binomial tests. Measles positivity rates in the period before and after the mass immunization campaign were 41.88% (95% CI: 39.30–44.51) and 37.96% (95% CI: 32.81–43.40), respectively. For rubella, the positivity rate in the precampaign season was 21.73% (95% CI: 19.61–23.99) and in the postvaccination season was 6.65% (95% CI: 4.36–10.00). Binomial tests indicated that postcampaign positivity rates were significantly lower than the precampaign rate for measles (
) and rubella (
). Generally, age (χ2 = 58.94,
/χ2 = 51.91,
) and vaccination status (χ2 = 60.48,
/χ2 = 16.90,
) were associated with the measles positivity rate in both pre/postcampaign periods. Rubella positivity rate was associated with vaccination status (χ2 = 32.97,
/
) in both periods and age in the precampaign season (
). The measles-rubella mass campaign lessened rubella burden remarkably, but barely adequate change was observed in the extent of spread of measles. Children aged less than 9 months are at higher chances of testing positive amidst low vaccination levels among the eligible. The immunization programme must attain and maintain routine immunization coverage at 95% or more and roll out a second-dose measles-rubella vaccination to sustain the reduced disease burden.
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Sowe A, Njie M, Sowe D, Fofana S, Ceesay L, Camara Y, Tesfaye B, Bah S, Bah AK, Baldeh AK, Dampha BD, Baldeh SN, Touray A. Epidemiology of measles cases, vaccine effectiveness, and performance towards measles elimination in The Gambia. PLoS One 2021; 16:e0258961. [PMID: 34673828 PMCID: PMC8530347 DOI: 10.1371/journal.pone.0258961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 10/10/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction In 2011, member states of the World Health Organization (WHO) Africa Regional Office (AFRO) resolved to eliminate Measles by 2020. Our study aims to assess The Gambia’s progress towards the set AFRO measles elimination target and highlight surveillance and immunisation gaps to better inform future measles prevention strategies. Material and methods A retrospective review of measles surveillance data for the period 2011–2019, was extracted from The Gambia case-based measles surveillance database. WHO—UNICEF national coverage estimates were used for estimating national level MCV coverage. Measles post campaign coverage survey coverage estimates were used to estimate national measles campaign coverage. Results One hundred and twenty-five of the 863 reported suspected cases were laboratory confirmed as measles cases. More than half (53.6%) of the confirmed cases have unknown vaccination status, 24% of cases were vaccinated, 52.8% of cases occurred among males, and 72.8% cases were among urban residents. The incidence of measles cases per million population was lowest (0) in 2011–2012 and highest in 2015 and 2016 (31 and 23 respectively). The indicator for surveillance sensitivity was met in all years except in 2016 and 2019. Children aged 5–9 years (Incidence Rate Ratio—IRR = 0.6) and residents of Central River region (IRR = 0.21) had lower measles risk whilst unvaccinated (Adjusted IRR = 5.95) and those with unknown vaccination status (IRR 2.21) had higher measles risk. Vaccine effectiveness was 89.5%. Conclusion The Gambia’s quest to attain measles elimination status by 2020 has registered significant success but it is unlikely that all target indicators will be met. Vaccination has been very effective in preventing cases. There is variation in measles risk by health region, and it will be important to take it into account when designing prevention and control strategies. The quality of case investigations should be improved to enhance the quality of surveillance for decision making.
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Affiliation(s)
- Alieu Sowe
- WHO Country Office, Nairobi, Kenya
- * E-mail:
| | - Mbye Njie
- Expanded Program on Immunisation, Ministry of Health, Banjul, The Gambia
| | - Dawda Sowe
- Expanded Program on Immunisation, Ministry of Health, Banjul, The Gambia
| | - Sidat Fofana
- Expanded Program on Immunisation, Ministry of Health, Banjul, The Gambia
| | - Lamin Ceesay
- Expanded Program on Immunisation, Ministry of Health, Banjul, The Gambia
| | | | | | - Samba Bah
- Expanded Program on Immunisation, Ministry of Health, Banjul, The Gambia
| | - Alieu K. Bah
- World Bank Country Office, Cape Point, Bakau, The Gambia
| | - Abdoulie K. Baldeh
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Bakary D. Dampha
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Samba N. Baldeh
- Expanded Program on Immunisation, Ministry of Health, Banjul, The Gambia
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Yang X, Tang T, Yang Z, Liu L, Yuan S, Zhang T. Evaluation of measles vaccination coverage in Lincang City, Yunnan Province, China. Hum Vaccin Immunother 2021; 17:3145-3152. [PMID: 33847247 DOI: 10.1080/21645515.2021.1911215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Background: Lincang City in Yunnan Province on the China-Myanmar border, has reached the World Health Organization recommended coverage (95%) for measles-containing vaccine (MCV), but measles outbreaks still occur. We conducted a survey in Lincang City to determine the measles vaccination status of children on the China-Myanmar border.Methods: We used multistage sampling among children aged 8-83 months. Information on measles vaccination status was obtained from the child's vaccination certificate, and serum samples were tested using commercially available ELISA kits.Results: A total of 938 children were surveyed. The vaccination coverage rate was 98.9% (95% CI: 98.2-99.6%) for measles-containing vaccine dose 1 (MCV1), and 95.8% (95% CI:94.9-96.7%) for measles-containing vaccine dose 2 (MCV2). The timely vaccination coverage rate was 52.0% (95% CI:48.8-55.2%) for MCV1, and 74.1% (95% CI: 82.9-89.0%) for MCV2. The timely-and-complete vaccination coverage rate was 41.0% (95% CI: 36.7-45.3%). The median delay period was 33 (95% CI: 27-39) days for MCV1, and 196 (95% CI: 146-246) days for MCV2. The seropositivity rate in children aged less than 7 years was 94.0% (95% CI: 92.5-95.5%) with a geometric mean titer of 1210.1 mIU/mL.Conclusions: The MCV coverage was high, but timely and timely-and-complete vaccination coverage were low and insufficient to prevent measles outbreaks. It is necessary to add the timely and timely-and-complete vaccination coverage as indicators of vaccination to provide a more complete picture of measles immunization status.
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Affiliation(s)
- Xiaotong Yang
- Epidemiology and Biostatistics Unit, Faculty of Public Health, Dali University, Dali, China
| | - Tingting Tang
- Department of Expanded Program on Immunization, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Zhikang Yang
- Epidemiology and Biostatistics Unit, Faculty of Public Health, Dali University, Dali, China
| | - Lu Liu
- Epidemiology and Biostatistics Unit, Faculty of Public Health, Dali University, Dali, China
| | - Shuyi Yuan
- Expanded Program on Immunization Department, Lincang Center for Disease Control and Prevention, Lincang City, China
| | - Tai Zhang
- Epidemiology and Biostatistics Unit, Faculty of Public Health, Dali University, Dali, China
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Wongsanuphat S, Thitichai P, Jaiyong R, Plernprom P, Thintip K, Jitpeera C, Suphanchaimat R. Investigation of Measles Outbreak among Thai and Migrant Workers in Two Factories in Nakhon Pathom, Thailand, 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134627. [PMID: 32605070 PMCID: PMC7369850 DOI: 10.3390/ijerph17134627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/12/2020] [Accepted: 06/22/2020] [Indexed: 11/24/2022]
Abstract
On 22 March 2019 the Thai Department of Disease Control (DDC) was notified that 16 workers, including Thai and Myanmar migrant workers, from two factories located in Nakhon Phathom Province, had presented with a fever with rash during the previous 2 weeks. Active case finding was conducted among workers in both factories using face-to-face interviews. Suspected cases were defined as a worker who developed fever with rash with one of the following symptoms: cough, coryza or conjunctivitis. Testing for measles IgM antibodies and viral identification through throat swabs by polymerase chain reaction (PCR) were performed to confirm diagnosis. Vaccination history among cases was reviewed. Nationality and age-specific attack rates (AR) were calculated. An environmental study and a social network analysis were conducted to better understand the transmission process. A total 56 cases (AR = 0.97%) were identified. Of 21 serum measles IgM collected, 8 (38.0%) were positive. Of 8 throat swabs collected, 5 (62.5%) were positive for measles genotype D8. The disease attack rate in migrant employees was twice as large as the rate in Thai counterparts (AR = 0.7 and 1.4%). The first case was identified as a Myanmar worker who arrived in Thailand two weeks prior to his illness. The Myanmar workers’ accommodation was more crowded than that for Thai workers. The hot spots of transmission were found at a drinking water tank which had shared glasses. Among the cases, 62.5% could not recall their vaccination history, and 25% had never had an injection containing a measles vaccination. The majority of migrant cases had never completed a two-dose measles vaccination. To halt the outbreak, measles vaccines were administered to the employees, particularly those working in the same sections with the cases and shared glasses were removed. For future policy action, a vaccination program should be incorporated into the work permit issuance process.
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Affiliation(s)
- Suphanat Wongsanuphat
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health and Thailand, Nonthaburi 11000, Thailand; (S.W.); (P.T.); (R.J.); (P.P.); (K.T.); (C.J.)
| | - Phanthanee Thitichai
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health and Thailand, Nonthaburi 11000, Thailand; (S.W.); (P.T.); (R.J.); (P.P.); (K.T.); (C.J.)
| | - Rungrot Jaiyong
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health and Thailand, Nonthaburi 11000, Thailand; (S.W.); (P.T.); (R.J.); (P.P.); (K.T.); (C.J.)
| | - Patchanee Plernprom
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health and Thailand, Nonthaburi 11000, Thailand; (S.W.); (P.T.); (R.J.); (P.P.); (K.T.); (C.J.)
| | - Kanthika Thintip
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health and Thailand, Nonthaburi 11000, Thailand; (S.W.); (P.T.); (R.J.); (P.P.); (K.T.); (C.J.)
| | - Charuttaporn Jitpeera
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health and Thailand, Nonthaburi 11000, Thailand; (S.W.); (P.T.); (R.J.); (P.P.); (K.T.); (C.J.)
| | - Rapeepong Suphanchaimat
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health and Thailand, Nonthaburi 11000, Thailand; (S.W.); (P.T.); (R.J.); (P.P.); (K.T.); (C.J.)
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand
- Correspondence:
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