title: Measles mortality reduction and pre-elimination in the African region, 2001-2009.
abstract: BACKGROUND
  In 2001, countries in the African region adopted the measles-associated mortality reduction strategy recommended by the World Health Organization and the United Nations Children's Fund. With support from partners, these strategies were implemented during 2001-2009.
  
  
  METHODS
  To assess implementation, estimates of the first dose of measles vaccination through routine services (MCVI) and reported coverage for measles supplemental immunization activities (SIAs) were reviewed. Measles surveillance data were analyzed.
  
  
  RESULTS
  During 2001-2009, regional MCV1 coverage increased from 56% to 69%, and >425 million children received measles vaccination through 125 SIAs. Measles case-based surveillance was established in 40 of 46 countries; the remaining 6 have aggregated case reporting. From 2001 through 2008, reported measles cases decreased by 92%, from 492,116 to 37,010; however, in 2009, cases increased to 83,625.
  
  
  CONCLUSIONS
  The implementation of the recommended strategies led to a marked decrease in measles cases in the region; however, the outbreaks occurring since 2008 indicate suboptimal vaccination coverage. To achieve high MCV1 coverage, provide a second dose through either periodic SIAs or routine services, and to ensure further progress toward attaining the regional measles pre-elimination goal by 2012, a renewed commitment from implementing partners and donors is needed.
authors.affiliation: Immunisation and Vaccines Development Programme, Regional Office for Africa, World Health Organization, Brazzaville, The Republic of the Congo. masreshab@zw.afro.who.int
authors.forename: Balcha G
authors.initials: BG
authors.lastname: Masresha
authors.forename: Amadou
authors.initials: A
authors.lastname: Fall
authors.forename: Messeret
authors.initials: M
authors.lastname: Eshetu
authors.forename: Steve
authors.initials: S
authors.lastname: Sosler
authors.forename: Mary
authors.initials: M
authors.lastname: Alleman
authors.forename: James L
authors.initials: JL
authors.lastname: Goodson
authors.forename: Reggis
authors.initials: R
authors.lastname: Katsande
authors.forename: Deogratias
authors.initials: D
authors.lastname: Nshimirimana
mesh_terms: D000349:Africa / Q000453:epidemiology; D002675:Child, Preschool; D004196:Disease Outbreaks; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D008457:Measles / Q000453:epidemiology / Q000401:mortality* / Q000517:prevention & control*; D008458:Measles Vaccine / Q000008:administration & dosage; D011159:Population Surveillance; D013997:Time Factors
chemical_list: D008458:Measles Vaccine