Thar Aye Mya Chan, Wai Khin Thet, Harries Anthony D, Show Kyaw Lwin, Mon Lei Lei, Lin Htar Htar
1The Expanded Programme on Immunization, Department of Public Health, Ministry of Health and Sports, Naypyitaw, Myanmar.
2Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar.
Trop Med Health. 2020 Feb 7;48:4. doi: 10.1186/s41182-020-0191-4. eCollection 2020.
There is a global resurgence of measles, consequent upon worldwide stagnating measles vaccination coverage. The study aim was to document trends and characteristics of reported cases of measles, measles-related deaths, and measles vaccination coverage (MCV1-first dose of measles-containing vaccine and MCV2-second dose of measles-containing vaccine) at national and sub-national level in Myanmar over a five year period between 2014 and 2018.
This was a descriptive study using routine data collected and submitted to the Expanded Programme on Immunization.
Between 2014 and 2018, there were 2673 measles cases of which 2272 (85%) occurred in 2017 and 2018. Five adjacent regions in lower Myanmar were the most affected: in 2017 and 2018, these regions reported 1647 (73%) of the 2272 measles cases in the country. Overall, 73% of measles cases were laboratory confirmed, 21% were epidemiologically linked, and 6% were clinically compatible (clinical diagnosis only), with more laboratory confirmed cases in recent years. Annual measles-related deaths were either zero or one except in 2016 when there were 21 deaths, all occurring in one remote village. In the recent years, the most commonly affected age groups were 0-8 months, 9 months to 4 years, and ≥ 15 years. Among 1907 measles cases with known vaccination status, only 22% had been vaccinated and 70% of those had only received one dose of vaccine. Annual MCV1 coverage nationally varied from 83 to 93% while annual MCV2 coverage nationally varied from 78 to 87%, with no clear trends over the years. Between 2014 and 2018, a high proportion of the 330 townships had MCV coverage < 95%. Over 80% of measles cases were reported from townships that had MCV coverage < 95%.
There have been a large number of measles cases in recent years associated with sub-optimal measles vaccine coverage. Myanmar has already conducted supplemental immunization activities in October and November, 2019. Myanmar also needs to improve routine immunization services and targeted responses to measles outbreaks.
由于全球麻疹疫苗接种覆盖率停滞不前，麻疹正在全球范围内再度流行。本研究旨在记录2014年至2018年五年间缅甸全国及次国家级层面上报的麻疹病例、麻疹相关死亡病例以及麻疹疫苗接种覆盖率（MCV1 - 首剂含麻疹成分疫苗和MCV2 - 第二剂含麻疹成分疫苗）的趋势和特征。
这是一项描述性研究，使用收集并提交至扩大免疫规划的常规数据。
2014年至2018年期间，共报告2673例麻疹病例，其中2272例（85%）发生在2017年和2018年。缅甸下缅甸的五个相邻地区受影响最为严重：2017年和2018年，这些地区报告了该国2272例麻疹病例中的1647例（73%）。总体而言，73%的麻疹病例经实验室确诊，21%有流行病学关联，6%为临床符合病例（仅临床诊断），近年来实验室确诊病例增多。除2016年有21例死亡（均发生在一个偏远村庄）外，每年麻疹相关死亡病例为零或一例。近年来，受影响最常见的年龄组为0 - 8个月、9个月至4岁以及≥15岁。在1907例已知疫苗接种状况的麻疹病例中，只有22%接种过疫苗，其中70%仅接种过一剂疫苗。全国年度MCV1覆盖率在83%至93%之间，全国年度MCV2覆盖率在78%至87%之间，多年来无明显趋势。2014年至2018年期间，330个镇区中很大一部分的MCV覆盖率<95%。超过80%的麻疹病例报告自MCV覆盖率<95%的镇区。
近年来，麻疹病例数量众多，与麻疹疫苗覆盖率未达最佳水平有关。缅甸已于2019年10月和11月开展了补充免疫活动。缅甸还需要改善常规免疫服务以及针对麻疹疫情的针对性应对措施。
