Masresha Balcha G, Wiysonge Charles Shey, Katsande Reggis, O'Connor Patrick Michael, Lebo Emmaculate, Perry Robert T
WHO Regional Office for Africa, Brazzaville P.O. Box 06, Congo.
WHO Headquarters, 1211 Geneva, Switzerland.
Vaccines (Basel). 2024 Aug 22;12(8):949. doi: 10.3390/vaccines12080949.
Measles or rubella elimination is verified when endemic transmission of the corresponding virus has been absent for over 36 months in a defined area, in the presence of a well-performing surveillance system. This report updates the progress by 47 countries in the WHO African Region towards the goal of attaining verification of measles and rubella elimination in at least 80% of the countries of the region by 2030. We reviewed the WHO-UNICEF vaccination coverage estimates for the first and second doses of measles- and measles-rubella-containing vaccines, as well as the available coverage data for measles supplementary immunization activities, during 2022-2023. We also reviewed the measles-surveillance performance and analyzed the epidemiological trends of measles and rubella as reported in the case-based surveillance database. The WHO-UNICEF estimates of first measles vaccine dose (MCV1) and second measles vaccine dose (MCV2) coverage for the African Region for 2022 were 69% and 45%, respectively. Rubella-containing vaccines have been introduced in the routine immunization program in 32 of 47 (68%) countries as of the end of 2022, with no introductions during 2023. In 2022 and 2023, a total of 144,767,764 children were vaccinated in the region with measles or MR vaccines in 24 countries through 32 mass vaccination campaigns. The administrative coverage target of 95% was reached in only 15 (49%) of the 32 vaccination campaigns. In 2023, a total of 125,957 suspected cases of measles were reported through the case-based surveillance system, and 73,625 cases (58%) were confirmed to be measles, either by laboratory testing, by epidemiological linkage, or based on clinical compatibility. A total of 4805 confirmed rubella cases were reported, though this total represents substantial under-ascertainment. The regional incidence of measles was 60.3 cases per million population. Twenty-six countries (55%) met the targets for the two principal surveillance system performance-monitoring indicators. No country in the region has attained the verification of measles or rubella elimination as of the end of 2023. Addressing systemic problems with routine immunization and using tailored approaches to reach unvaccinated children can contribute to progress towards measles and rubella elimination. In addition, periodic and timely high-quality preventive SIAs remain a critical programmatic strategy to reach unvaccinated children.
当在一个特定区域，相应病毒的地方性传播在超过36个月的时间里不存在，且存在运行良好的监测系统时，麻疹或风疹消除得到确认。本报告更新了世卫组织非洲区域47个国家在实现到2030年至少80%的区域国家麻疹和风疹消除得到确认这一目标方面的进展情况。我们审查了2022 - 2023年期间世卫组织 - 联合国儿童基金会对含麻疹疫苗和含麻疹 - 风疹疫苗第一剂和第二剂的疫苗接种覆盖率估计，以及麻疹补充免疫活动的现有覆盖率数据。我们还审查了麻疹监测绩效，并分析了基于病例的监测数据库中报告的麻疹和风疹的流行病学趋势。2022年世卫组织 - 联合国儿童基金会对非洲区域第一剂麻疹疫苗（MCV1）和第二剂麻疹疫苗（MCV2）覆盖率的估计分别为69%和45%。截至2022年底，47个国家中有32个（68%）在常规免疫规划中引入了含风疹疫苗，2023年没有新的引入。2022年和2023年，该区域24个国家通过32次大规模疫苗接种活动，共有144,767,764名儿童接种了麻疹或含麻疹 - 风疹疫苗。在32次疫苗接种活动中，只有15次（49%）达到了95%的行政覆盖率目标。2023年，通过基于病例的监测系统共报告了125,957例疑似麻疹病例，其中73,625例（58%）通过实验室检测、流行病学关联或基于临床相容性被确认为麻疹。共报告了4805例确诊风疹病例，不过这一总数存在大量漏报情况。该区域麻疹发病率为每百万人口60.3例。26个国家（55%）达到了两个主要监测系统绩效监测指标的目标。截至2023年底，该区域没有一个国家实现麻疹或风疹消除的确认。解决常规免疫中的系统性问题，并采用针对性方法覆盖未接种疫苗的儿童，有助于在消除麻疹和风疹方面取得进展。此外，定期且及时开展高质量的预防性补充免疫活动仍然是覆盖未接种疫苗儿童的关键规划策略。
