Munyoro M N, Kufa E, Biellik R, Pazvakavambwa I E, Cairns K L
Expanded Program on Immunization, Disease Surveillance, Office of the World Health Organization Representative to Zimbabwe, Harare, Zimbabwe.
J Infect Dis. 2003 May 15;187 Suppl 1:S91-6. doi: 10.1086/368116.
Zimbabwe (population 11,365,000) introduced nationwide one-dose measles vaccination in 1981. This strategy reached 70%-80% of infants <1 year of age over the next two decades; in 1998, a nationwide supplemental immunization activity (SIA) targeting all children aged 9 months to 14 years achieved 93% coverage. Surveillance data were examined to determine the impact of these strategies. During 1985-1997, there were 8529-49,812 measles cases annually. After the SIA, laboratory confirmation of the first 5 outbreak cases and all sporadic cases was required. In 1999 and 2000, 1343 (88%) of 1534 suspected cases had adequate specimens submitted and 28 (2%) were measles IgM positive. In 2001, of 529 suspected cases, 513 (97%) had adequate specimens and only 7 (1%) were measles IgM positive. These data suggest that indigenous measles transmission in Zimbabwe has been interrupted and that high prevalence of human immunodeficiency virus seropositivity does not hinder vaccination-induced measles control. High vaccination coverage obtained through the routine health care system supplemented by periodic follow-up SIAs will be required to maintain low transmission levels.
津巴布韦(人口1136.5万)于1981年在全国范围内推行单剂次麻疹疫苗接种。在接下来的二十年里,这一策略覆盖了70%-80%的1岁以下婴儿;1998年,针对所有9个月至14岁儿童开展的全国性补充免疫活动(SIA)的覆盖率达到了93%。对监测数据进行了分析,以确定这些策略的影响。在1985年至1997年期间,每年有8529-49812例麻疹病例。补充免疫活动之后,要求对最初5例疫情病例和所有散发病例进行实验室确诊。1999年和2000年,1534例疑似病例中有1343例(88%)提交了足够的样本,其中28例(2%)麻疹IgM呈阳性。2001年,529例疑似病例中有513例(97%)提交了足够的样本,只有7例(1%)麻疹IgM呈阳性。这些数据表明,津巴布韦本土的麻疹传播已被阻断,而且人类免疫缺陷病毒血清阳性率高并不妨碍疫苗接种引发的麻疹控制。需要通过常规卫生保健系统辅以定期的后续补充免疫活动来获得高疫苗接种覆盖率,以维持低传播水平。