Vaccines and Immunity Theme, MRC Unit the Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia.
Vaccines and Immunity Theme, MRC Unit the Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia.
Lancet Glob Health. 2021 Mar;9(3):e280-e290. doi: 10.1016/S2214-109X(20)30481-2.
The WHO Regional Office for the Africa Regional Immunization Technical Advisory Group, in 2011, adopted the measles control and elimination goals for all countries of the African region to achieve in 2015 and 2020 respectively. Our aim was to track the current status of progress towards measles control and elimination milestones across 15 west African countries between 2001 and 2019.
We did a retrospective multicountry series analysis of national immunisation coverage and case surveillance data from Jan 1, 2001, to Dec 31, 2019. Our analysis focused on the 15 west African countries that constitute the Economic Community of West African States. We tracked progress in the coverage of measles-containing vaccines (MCVs), measles supplementary immunisation activities, and measles incidence rates. We developed a country-level measles summary scorecard using eight indicators to track progress towards measles elimination as of the end of 2019. The summary indicators were tracked against measles control and elimination milestones.
The weighted average regional first-dose MCV coverage in 2019 was 66% compared with 45% in 2001. 73% (11 of 15) of the west African countries had introduced second-dose MCV as of December, 2019. An estimated 4 588 040 children (aged 12-23 months) did not receive first-dose MCV in 2019, the majority (71%) of whom lived in Nigeria. Based on the scorecard, 12 (80%) countries are off-track to achieving measles elimination milestones; however, Cape Verde, The Gambia, and Ghana have made substantial progress.
Measles will continue to be endemic in west Africa after 2020. The regional measles incidence rate in 2019 was 33 times the 2020 elimination target of less than 1 case per million population. However, some hope exists as countries can look at the efforts made by Cape Verde, The Gambia, and Ghana and learn from them.
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世界卫生组织非洲区域免疫技术咨询小组于 2011 年通过了非洲区域所有国家分别在 2015 年和 2020 年实现麻疹控制和消除目标。我们的目的是跟踪 2001 年至 2019 年期间，15 个西非国家在实现麻疹控制和消除里程碑方面的当前进展情况。
我们对 2001 年 1 月 1 日至 2019 年 12 月 31 日期间的国家免疫覆盖和病例监测数据进行了回顾性多国系列分析。我们的分析重点是构成西非国家经济共同体的 15 个西非国家。我们跟踪了含麻疹疫苗（MCV）的接种覆盖率、麻疹补充免疫活动和麻疹发病率的进展情况。我们使用八项指标制定了国家一级麻疹综合记分卡，以跟踪截至 2019 年底消除麻疹的进展情况。这些综合指标是根据麻疹控制和消除的里程碑来跟踪的。
2019 年，该区域首剂 MCV 的加权平均覆盖率为 66%，而 2001 年为 45%。截至 2019 年 12 月，73%（15 个国家中的 11 个）的西非国家已经引入了第二剂 MCV。估计有 458.804 万名（12-23 个月）儿童在 2019 年未接种第一剂 MCV，其中大多数（71%）生活在尼日利亚。根据记分卡，12 个（80%）国家无法实现消除麻疹的里程碑目标；然而，佛得角、冈比亚和加纳已取得实质性进展。
2020 年后，麻疹将继续在西非流行。2019 年该区域麻疹发病率是 2020 年消除目标（每百万人少于 1 例）的 33 倍。然而，一些国家仍有希望，因为它们可以借鉴佛得角、冈比亚和加纳所做的努力。
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