MMWR Morb Mortal Wkly Rep. 2016 Mar 4;65(8):206-10. doi: 10.15585/mmwr.mm6508a3.
In 2013, the 66th session of the Regional Committee of the World Health Organization (WHO) South-East Asia Region (SEAR) established a goal to eliminate measles and to control rubella and congenital rubella syndrome (CRS) in SEAR by 2020. Current recommended measles elimination strategies in the region include 1) achieving and maintaining ≥95% coverage with 2 doses of measles-containing vaccine (MCV) in every district, delivered through the routine immunization program or through supplementary immunization activities (SIAs); 2) developing and sustaining a sensitive and timely measles case-based surveillance system that meets minimum recommended performance indicators; 3) developing and maintaining an accredited measles laboratory network; and 4) achieving timely identification, investigation, and response to measles outbreaks. In 2013, Nepal, one of the 11 SEAR member states, adopted a goal for national measles elimination by 2019. This report updates a previous report and summarizes progress toward measles elimination in Nepal during 2007-2014. During 2007-2014, estimated coverage with the first MCV dose (MCV1) increased from 81% to 88%. Approximately 3.9 and 9.7 million children were vaccinated in SIAs conducted in 2008 and 2014, respectively. Reported suspected measles incidence declined by 13% during 2007-2014, from 54 to 47 cases per 1 million population. However, in 2014, 81% of districts did not meet the measles case-based surveillance performance indicator target of ≥2 discarded non-measles cases per 100,000 population per year. To achieve and maintain measles elimination, additional measures are needed to strengthen routine immunization services to increase coverage with MCV1 and a recently introduced second dose of MCV (MCV2) to ≥95% in all districts, and to enhance sensitivity of measles case-based surveillance by adopting a more sensitive case definition, expanding case-based surveillance sites nationwide, and ensuring timely transport of specimens to the accredited national laboratory.
2013 年，世界卫生组织（世卫组织）东南亚区域委员会（区域委员会）第 66 届会议制定了一个目标，即在 2020 年之前消除东南亚区域的麻疹，并控制风疹和先天性风疹综合征（CRS）。该区域目前建议采用的麻疹消除策略包括：1）在每个地区实现和维持麻疹疫苗（MCV）两剂次接种覆盖率达到 95%以上，通过常规免疫规划或补充免疫活动（SIAs）提供；2）建立和维持一个敏感和及时的麻疹基于病例的监测系统，达到最低建议的绩效指标；3）建立和维持一个经认证的麻疹实验室网络；4）及时发现、调查和应对麻疹疫情。2013 年，东南亚区域 11 个成员国之一的尼泊尔通过了到 2019 年消除本国麻疹的目标。本报告更新了之前的报告，总结了尼泊尔在 2007-2014 年期间消除麻疹的进展情况。2007-2014 年，第一剂麻疹疫苗（MCV1）的估计覆盖率从 81%增加到 88%。分别于 2008 年和 2014 年开展的两次补充免疫活动中，约有 390 万和 970 万名儿童接种了疫苗。2007-2014 年，报告的疑似麻疹发病率下降了 13%，从每 100 万人 54 例降至 47 例。然而，2014 年，81%的地区未达到麻疹基于病例的监测绩效指标目标，即每年每 10 万人中至少有 2 例非麻疹病例被丢弃。为了实现和维持麻疹消除，需要采取更多措施，加强常规免疫服务，将第一剂和最近引入的第二剂麻疹疫苗（MCV2）的覆盖率提高到所有地区的 95%以上，并通过采用更敏感的病例定义、在全国范围内扩大基于病例的监测点以及确保及时将标本运送到经认证的国家实验室，提高麻疹基于病例的监测的敏感性。
