Wolfson Lara J, Strebel Peter M, Gacic-Dobo Marta, Hoekstra Edward J, McFarland Jeffrey W, Hersh Bradley S
Initiative for Vaccine Research, WHO, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland.
Lancet. 2007 Jan 20;369(9557):191-200. doi: 10.1016/S0140-6736(07)60107-X.
In 2002, the UN General Assembly Special Session on Children adopted a goal to reduce deaths owing to measles by half by the end of 2005, compared with 1999 estimates. We describe efforts and progress made towards this goal.
We assessed trends in immunisation against measles on the basis of national implementation of the WHO/UNICEF comprehensive strategy for measles mortality reduction, and the provision of a second opportunity for measles immunisation. We used a natural history model to evaluate trends in mortality due to measles.
Between 1999 and 2005, according to our model mortality owing to measles was reduced by 60%, from an estimated 873,000 deaths (uncertainty bounds 634,000-1,140,000) in 1999 to 345,000 deaths (247,000-458,000) in 2005. The largest percentage reduction in estimated measles mortality during this period was in the western Pacific region (81%), followed by Africa (75%) and the eastern Mediterranean region (62%). Africa achieved the largest total reduction, contributing 72% of the global reduction in measles mortality. Nearly 7.5 million deaths from measles were prevented through immunisation between 1999 and 2005, with supplemental immunisation activities and improved routine immunisation accounting for 2.3 million of these prevented deaths.
The achievement of the 2005 global measles mortality reduction goal is evidence of what can be accomplished for child survival in countries with high childhood mortality when safe, cost-effective, and affordable interventions are backed by country-level political commitment and an effective international partnership.
2002年，联合国儿童问题特别会议通过了一项目标，即到2005年底，将麻疹死亡人数较1999年的估计数减少一半。我们阐述了为实现这一目标所做的努力和取得的进展。
我们根据各国实施世界卫生组织/联合国儿童基金会降低麻疹死亡率综合战略的情况以及提供第二次麻疹免疫接种机会的情况，评估了麻疹免疫接种趋势。我们使用自然史模型来评估麻疹所致死亡率的趋势。
根据我们的模型，1999年至2005年期间，麻疹所致死亡率降低了60%，从1999年估计的87.3万例死亡（不确定区间为63.4万 - 114万例）降至2005年的34.5万例死亡（24.7万 - 45.8万例）。在此期间，估计麻疹死亡率下降百分比最大的是西太平洋区域（81%），其次是非洲（75%）和东地中海区域（62%）。非洲实现的死亡人数减少总量最大，占全球麻疹死亡率降低量的72%。1999年至2005年期间，通过免疫接种预防了近750万例麻疹死亡，其中补充免疫活动和改善常规免疫接种预防的死亡人数为230万例。
2005年全球麻疹死亡率降低目标的实现证明，在儿童死亡率高的国家，当安全、具有成本效益且可负担得起的干预措施得到国家层面的政治承诺和有效的国际伙伴关系支持时，在儿童生存方面能够取得成就。
