Reduction of vaccine-preventable communicable diseases in a Bedouin population: summary of a community-based intervention programme.
BACKGROUND
The Bedouin Arab population of southern Israel is in transition from a semi-nomadic lifestyle to permanent settlement, with many characteristics of a third-world population. A major outbreak of measles in the winter of 1990-91, with an incidence of 415.6 per 100,000 and a case fatality rate of 2.2 % among the Bedouin, led to the establishment of a national committee, which recommended an intervention programme. We report on the effect of the programme implementation on the reduction of vaccine-preventable communicable diseases in a Bedouin Arab population.


METHODS
We compared immunisation coverage and incidence of reportable vaccine-preventable communicable diseases before and after implementation of the intervention programme.


RESULTS
Implementation of the intervention programme was associated with a marked increase in immunisation coverage, from 53% for first measles immunisation among those born in 1988, and reaching 2 years of age in 1990 at the start of the outbreak, to 90% at age 2 years among those born in 2001. We noted a decrease in all vaccine-preventable communicable diseases, except for pertussis, during this period.


CONCLUSIONS
The implementation of a targeted programme to improve immunisation coverage, and other concomitant changes in health-care delivery, was temporally associated with reduction of vaccine-preventable communicable diseases in a population of Bedouin Arabs in Israel who are living in semi-nomadic conditions. The success of the programme could be applicable to semi-nomadic populations living in other areas of the middle east.
Belmaker
I
I
Ministry of Health, Regional Health Office, Southern Region, Post office box 10050, Beer-Sheva, Israel. ilna.belmaker@lbr.health.gov.il
Dukhan
L
L
Elgrici
M
M
Yosef
Y
Y
Shahar-Rotberg
L
L
D000293:Adolescent; D000328:Adult; D018912:Arabs; D002648:Child; D002675:Child, Preschool; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage; D004196:Disease Outbreaks / Q000517:prevention & control*; D005260:Female; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration* / Q000706:statistics & numerical data; D015994:Incidence; D007223:Infant; D007557:Israel / Q000453:epidemiology; D008297:Male; D008457:Measles / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage; D011314:Preventive Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D012042:Registries
D015721:Diphtheria-Tetanus-Pertussis Vaccine; D022542:Measles-Mumps-Rubella Vaccine