Desta Teklay K, Lemango Ephrem T, Wayess Jimma D, Masresha Balcha G
Maternal and Child Health Directorate, FMOH Ethiopia, P.O. Box 1234, Addis Ababa, Ethiopia.
Ethiopian Public Health Institute, FMOH. P.O. Box 1242, Addis Ababa, Ethiopia.
J Immunol Sci. 2018 Sep 1;2(SI1):122-129. doi: 10.29245/2578-3009/2018/si.1118.
Ethiopia endorsed the African Regional measles elimination goal and has been implementing the recommended strategies. Measles immunization coverage has been increasing but is still below the target, and measles incidence has remained high.
To describe the measles epidemiology in Ethiopia, identify predictors of high measles incidence in Ethiopia and recommend strategies to achieve the elimination goal.
Measles surveillance 2006-2016 data, routine immunization and post measles campaign coverage data was analyzed. We analysed the epidemiology and incidence of measles cases by age, vaccination status, year of occurrence, and geographic area.
There were 66,719 confirmed cases, out of the 94,104 suspected measles cases reported between January 2006 and December 2016. Measles incidence increased from 20 cases per million total population in 2006 to 194 cases per million in 2015 and declined to 49 per million in 2016. On multiple logistic regression analysis, the median age of measles cases, the 2013 measles Supplemental Immunisation Activity (SIAs) coverage, the 2012 routine immunization coverage, and the proportion of reported under-five measles cases were predictors of very high measles incidence (>240 cases per million in the under-five years age population) in the three-year period following the 2013 measles SIAs implementation (p<0.01).
Ethiopia is not on track to achieve the measles elimination goal of less than 1 case per million population by 2020 with the current pace of elimination efforts. Accumulation of susceptible children due to suboptimal routine measles immunization combined with suboptimal and narrow age-group (9-59 months) measles SIAs resulted in continued measles outbreaks.
Ethiopia should scale up the quality and implementation of all the measles elimination strategies, including the introduction of measles second dose and conducting high quality measles SIAs targeting the appropriate age groups as per the measles epidemiology in various parts of the country to accelerate and achieve the 2020 measles elimination goal.
埃塞俄比亚认可非洲区域消除麻疹目标，并一直在实施推荐的策略。麻疹免疫接种覆盖率一直在上升，但仍低于目标，麻疹发病率一直居高不下。
描述埃塞俄比亚的麻疹流行病学情况，确定埃塞俄比亚麻疹高发病率的预测因素，并推荐实现消除目标的策略。
分析了2006 - 2016年麻疹监测数据、常规免疫和麻疹强化免疫活动覆盖率数据。我们按年龄、疫苗接种状况、发病年份和地理区域分析了麻疹病例的流行病学和发病率。
在2006年1月至2016年12月报告的94,104例疑似麻疹病例中，有66,719例确诊病例。麻疹发病率从2006年每百万总人口20例增至2015年的每百万194例，并在2016年降至每百万49例。在多因素logistic回归分析中，麻疹病例的中位年龄、2013年麻疹强化免疫活动覆盖率、2012年常规免疫覆盖率以及报告的五岁以下麻疹病例比例是2013年麻疹强化免疫活动实施后三年期间麻疹高发病率（五岁以下年龄组每百万>240例）的预测因素（p<0.01）。
按照目前的消除工作速度，埃塞俄比亚无法在2020年实现每百万人口麻疹病例少于1例的消除目标。常规麻疹免疫接种效果欠佳，加上麻疹强化免疫活动效果欠佳且年龄组范围狭窄（9 - 59个月），导致易感儿童积累，进而持续出现麻疹疫情。
埃塞俄比亚应扩大所有麻疹消除策略的质量和实施范围，包括引入麻疹第二剂疫苗，并根据该国不同地区的麻疹流行病学情况，针对适当年龄组开展高质量的麻疹强化免疫活动，以加速并实现2020年麻疹消除目标。
