title: Priorities in global measles control: report of an outbreak in N'Djamena, Chad.
abstract: In N'Djamena, capital of Chad, measles vaccination coverage of 12-23-month-old children fell from 61% in 1990 to 15% in 1993. A community survey of measles after an outbreak in 1993 showed that among children < 5 years of age, the mean monthly attack rate was 37 per 1,000 (95% CI, 32-43) and the mean case fatality rate was 7.4%. Measles incidence was highest (77/1,000/month) in children aged 9-11 months and fell among children > 3 years of age. Incidence rates were high (56/1,000/month) among 6-8-month-old children, but only 3 deaths occurred in this age group. Measles vaccine efficacy, estimated by comparing attack rates in unvaccinated and vaccinated children, was 71% (95% CI, 59-80%). Extrapolation of the results to the city population indicated that an estimated 19,000 cases and > 1,000 measles-associated deaths occurred in 1993. This preventable morbidity and mortality, in a city where coverage was formerly among the highest in Africa, shows the need for sustained global commitment to preventive health care.
authors.affiliation: World Health Organization, Chad, UK.
authors.forename: A
authors.initials: A
authors.lastname: Ndikuyeze
authors.forename: A
authors.initials: A
authors.lastname: Cook
authors.forename: F T
authors.initials: FT
authors.lastname: Cutts
authors.forename: S
authors.initials: S
authors.lastname: Bennett
mesh_terms: D017677:Age Distribution; D002596:Chad / Q000453:epidemiology; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008457:Measles / Q000453:epidemiology* / Q000517:prevention & control*; D008458:Measles Vaccine; D011159:Population Surveillance; D012307:Risk Factors; D012621:Seasons; D014504:Urban Health; D014611:Vaccination / Q000706:statistics & numerical data / Q000639:trends
chemical_list: D008458:Measles Vaccine