George Marlyn Susan, Khan Hamza Rafique, Khadka Sheetal, Dey Rohit Chandra, Khadka Sworup, Sánchez-Velazco Diana F, Manandhar Sarbagya, Kumar Harendra, Ahmed Shahzaib
Yerevan State Medical University, Yerevan, Armenia.
University of Health Sciences.
Ann Med Surg (Lond). 2024 Aug 6;86(9):5394-5400. doi: 10.1097/MS9.0000000000002413. eCollection 2024 Sep.
Measles is an acute febrile illness associated with rashes, fever and life-threatening complications. It is a vaccine-preventable disease with the Measles Mumps Rubella(MMR) vaccine but a recent global trend unveils a resurgence of measles in various parts of the world including Armenia. Measles was declared eliminated from Armenia in 2021 before reports of local outbreaks surfaced in 2023. The WHO identified discrepancies in the vaccination coverage during COVID-19. Measles also poses a great financial burden as a public health issue worldwide. Sociocultural factors impacting measles transmission are maternal education, healthcare access, migration, vaccine hesitancy, and socioeconomic status (Table 3). Efforts to control and eradicate measles from Armenia are run by a collaborative approach of national and international health bodies such as United Nations Children's Fund (UNICEF), WHO, Global Vaccine Alliance (GAVI), and the Ministry of Health. Thus, the resurgence of measles can be managed through widespread patient education, innovative approaches, strengthening the healthcare system and addressing vaccine hesitancy, sociocultural barriers, and humanitarian emergencies. This review investigates the complicated dynamics of measles inside Armenia's health system in depth. A thorough examination of measles incidence and immunization patterns highlights the shift from few cases and high vaccination rates to a comeback caused by imported viruses. The causes of its recurrence have been thoroughly investigated, including reduced immunization programs and vaccine hesitancy. The research delves further into the 'One Health' idea, assessing the possibility of interspecies transmission among nonhuman primates and examining the environmental factors that influence measles transmission. Among the challenges are weaknesses within Armenia's health system as well as the possibility of interruptions from the COVID-19 outbreak. In measles vaccination status, the combination of maternal education, postnatal care, and socioeconomic variables exposes the larger drivers at work. The study concludes with a comprehensive set of public health policy recommendations covering vaccination promotion, surveillance, healthcare provider education, public awareness, international collaboration, data analysis, law enforcement, emergency preparedness, research, and coordination. The research sheds light on the tangled web of measles dynamics, health system resilience, and contextual subtleties via this multifaceted approach, inviting readers to investigate the multiple strategies required for eliminating measles in Armenia.
麻疹是一种伴有皮疹、发热和危及生命并发症的急性发热性疾病。它是一种可用麻疹腮腺炎风疹（MMR）疫苗预防的疾病，但最近的全球趋势显示，包括亚美尼亚在内的世界各地区麻疹疫情有所回升。2021年亚美尼亚宣布消除麻疹，然而在2023年出现了局部疫情报告。世卫组织发现了新冠疫情期间疫苗接种覆盖率存在差异。麻疹作为一个全球公共卫生问题，也带来了巨大的经济负担。影响麻疹传播的社会文化因素包括母亲教育程度、医疗保健可及性、移民、疫苗犹豫以及社会经济地位（表3）。亚美尼亚为控制和消除麻疹所做的努力是由联合国儿童基金会（UNICEF）、世卫组织、全球疫苗免疫联盟（GAVI）以及卫生部等国家和国际卫生机构合作开展的。因此，可通过广泛的患者教育、创新方法、加强医疗保健系统以及解决疫苗犹豫、社会文化障碍和人道主义紧急情况来应对麻疹疫情的回升。本综述深入研究了亚美尼亚卫生系统内麻疹的复杂动态。对麻疹发病率和免疫模式的全面检查突出了从少数病例和高疫苗接种率到由输入病毒导致疫情反弹的转变。对其复发原因进行了深入调查，包括免疫规划减少和疫苗犹豫。该研究进一步深入探讨了“同一健康”理念，评估了非人类灵长类动物之间跨物种传播的可能性，并研究了影响麻疹传播的环境因素。其中的挑战包括亚美尼亚卫生系统的薄弱环节以及新冠疫情爆发可能造成的干扰。在麻疹疫苗接种状况方面，母亲教育程度、产后护理和社会经济变量的综合作用揭示了背后更大的驱动因素。该研究最后提出了一套全面的公共卫生政策建议，涵盖疫苗接种推广、监测、医护人员教育、公众意识、国际合作、数据分析、执法、应急准备、研究和协调。通过这种多方面的方法，该研究揭示了麻疹动态、卫生系统复原力和背景细节的复杂网络，促使读者探究在亚美尼亚消除麻疹所需的多种策略。
