MMWR Morb Mortal Wkly Rep. 2009 Dec 4;58(47):1321-6.
The United Nations (UN) Millennium Development Goals include a goal (MDG 4) to achieve a two thirds overall reduction of child deaths by 2015 compared with the 1990 level. Because many unvaccinated children die from measles, routine measles vaccination coverage is used as an indicator of progress toward this goal. In 2008, all UN member states reaffirmed their commitment to achieving a 90% reduction in measles mortality by 2010 compared with 2000, from an estimated 733,000 deaths in 2000 worldwide to <73,300 by 2010. The World Health Organization (WHO) and UNICEF have identified 47 priority countries with the highest burden of measles for an accelerated strategy for measles mortality reduction. The strategy includes 1) achieving and maintaining high coverage (>or=90% nationally and >or=80% in each district) with 2 doses of measles-containing vaccine (MCV) delivered through routine services or supplemental immunization activities (SIAs) , 2) implementing effective laboratory-supported disease surveillance, and 3) providing appropriate clinical management for measles cases. This report updates a previously published report, provides details on activities implemented during 2008, assesses progress toward the 2010 goal, and evaluates the potential effects of decreased financial support. During 2000--2008, global measles mortality declined by 78%, from an estimated 733,000 deaths in 2000 to 164,000 in 2008, but the reduction in measles mortality has been leveling off since 2007. To reach the 2010 goal, India should fully implement the recommended strategies, and financial support for sustaining measles control in the other 46 priority countries should be secured.
联合国千年发展目标包括一个目标(千年发展目标4),即到2015年使儿童死亡总数比1990年水平总体降低三分之二。由于许多未接种疫苗的儿童死于麻疹,常规麻疹疫苗接种覆盖率被用作实现该目标进展情况的一项指标。2008年,所有联合国会员国重申致力于到2010年使麻疹死亡率比2000年降低90%,从2000年全球估计73.3万例死亡降至2010年的<7.33万例。世界卫生组织(世卫组织)和联合国儿童基金会已确定47个麻疹负担最重的重点国家,以实施加速降低麻疹死亡率战略。该战略包括:1)通过常规服务或补充免疫活动(SIAs)实现并维持含麻疹疫苗(MCV)2剂次的高接种覆盖率(全国≥90%且每个地区≥80%);2)实施有效的实验室支持的疾病监测;3)为麻疹病例提供适当的临床管理。本报告更新了此前发布的一份报告,详细介绍了2008年开展的活动,评估了朝着2010年目标取得的进展,并评估了资金支持减少可能产生的影响。在2000 - 2008年期间,全球麻疹死亡率下降了78%,从2000年估计的73.3万例死亡降至2008年的16.4万例,但自2007年以来,麻疹死亡率的降幅趋于平稳。为实现2010年目标,印度应全面实施推荐的战略,同时应确保为在其他46个重点国家维持麻疹控制提供资金支持。