Measles in Mashonaland Central Province: Zimbabwe.

A review of measles notifications in Mashonaland Central Province, Zimbabwe from 1st September 1987 to 31st October 1989 was done. Data reviewed were from monthly maternal and child health summary forms and from hospital in-patients disease statistics. There was an increase in the incidence of measles first towards the end of 1987 and secondly after August 1988. The overall case fatality rate (CFR) for in-patients was 2.0%, with 2 peaks in CFR. The second peak of CFR coincided with the peak of the epidemic in December 1988. CFR was highest in infancy, intermediate in the 1 to 4 year age group and least for older children (above 5 years). The highest age specific attack rate was observed in infancy. The efficacy of the measles vaccine (Schwartz freeze dried measles vaccine given as a single dose at 9 months) was estimated to be 84.9% A large pool of susceptibles who possibly maintained the epidemic include an accumulation of unimmunised children and adults. Despite a measles immunisation coverage rate of 67.6% for Mashonaland Central Province in 1988, a sustained effort to maintain and increase immunisation coverage is vital to contain measles together with other EPI target diseases.