title: Secular trend and epidemiology of measles in the Kingdom of Saudi Arabia: 2009-2012.
abstract: OBJECTIVE
  To determine incidence of measles and progress towards its elimination in Saudi Arabia.
  
  
  METHODS
  A retrospective analysis of routinely collected active and passive surveillance data on measles at the Ministry of Health, Saudi Arabia. All laboratory confirmed measles from (2009-2012) were analyzed to determine measles annual incidences and distribution by age, gender, nationality, seasonality, vaccination status and spatial distribution by region.
  
  
  RESULTS
  Measles incidence per 1,000,000 populations increased from 3.2 in 2009 to a peak of 12.8in 2011 and a slight fall to 9.9 in 2012. About 50% of cases were in children under-five years, 12% were infants and 33% were 15 years and above. Of the total, 39%were unvaccinated and16% had unknown vaccination status. Fifty-five percent of infants were not due for vaccination. Of children <5 years, 42% received vaccination. Spatial distribution is not countrywide in each of the four years but seemed to concentrate in the central and South West regions with40% in Jizan and Jeddah.
  
  
  CONCLUSIONS
  High incidence of confirmed measles among unvaccinated infants requires strengthening of the immunization services. Improvement in measles case surveillance for completeness of vaccination status, vaccination of unvaccinated youths and comprehensive immunization are needed for measles elimination.
authors.affiliation: Public Health Directorate, Ministry of Health, Riyadh, Saudi Arabia; College of Medicine, Al-Faisal University, Riyadh, Saudi Arabia. Electronic address: zmemish@yahoo.com.
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Memish
authors.affiliation: Public Health Directorate, Ministry of Health, Riyadh, Saudi Arabia; Department of Medical Statistics and Epidemiology, University of Ibadan, Nigeria.
authors.forename: Elijah A
authors.initials: EA
authors.lastname: Bamgboye
authors.affiliation: Public Health Directorate, Ministry of Health, Riyadh, Saudi Arabia.
authors.forename: Mutaz
authors.initials: M
authors.lastname: Mohammed
authors.affiliation: Public Health Directorate, Ministry of Health, Riyadh, Saudi Arabia.
authors.forename: Rafat
authors.initials: R
authors.lastname: AlHakeem
authors.affiliation: Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Jaffar A
authors.initials: JA
authors.lastname: Al-Tawfiq
authors.affiliation: Public Health Directorate, Ministry of Health, Riyadh, Saudi Arabia.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Assiri
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D060740:Disease Eradication; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D005838:Genotype; D006801:Humans; D017589:Immunization Programs; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008457:Measles / Q000453:epidemiology*; D008458:Measles Vaccine; D008875:Middle Aged; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D017678:Sex Distribution; D014611:Vaccination / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D008458:Measles Vaccine
keywords: Elimination; Incidence; Measles; Saudi Arabia; Vaccination