title: Using the World Health Organization Measles Programmatic Risk Assessment Tool for Monitoring of Supplemental Immunization Activities in the Philippines.
abstract: In 2012, the World Health Organization Regional Committee for the Western Pacific Region (WPR) reaffirmed its commitment to eliminate measles and urged WPR member states to interrupt endemic measles virus transmission as rapidly as possible. In 2013, a large measles outbreak occurred in the Philippines despite implementation of measles elimination strategies including a nationwide supplemental immunization activity (SIA) in 2011 using measles- and rubella-containing vaccine and targeting children aged nine months to seven years. To prevent future measles outbreaks a new tool was developed to assess district-level risk for measles outbreaks, based on the WPR polio risk assessment tool previously applied in the Philippines. Risk was assessed as a function of combined indicator scores from four data input categories: population immunity, surveillance quality, program performance, and threat assessment. On the basis of the overall score, the tool assigned each district a risk category of low, medium, high, or very high. Of the 122 districts and highly urbanized cities in the Philippines, 58 (48%) were classified as high risk or very high risk, including the district of the Metro Manila area and Region 4A where the outbreak began in 2013. Risk assessment results were used to guide the monitoring and supervision during the nationwide SIA conducted in 2014. The initial tool drafted in the Philippines served as a template for development of the global risk assessment tool. Regular annual measles programmatic risk assessments can be used to help plan risk mitigation activities and measure progress toward measles elimination.
authors.affiliation: National Center for Disease Prevention and Control, Department of Health, Manila, Philippines.
authors.forename: Maria Joyce U
authors.initials: MJU
authors.lastname: Ducusin
authors.affiliation: World Health Organization (WHO), Office of the WHO Representative in the Philippines, Manila, Philippines.
authors.forename: Maricel
authors.initials: M
authors.lastname: de Quiroz-Castro
authors.affiliation: World Health Organization (WHO), Office of the WHO Representative in the Philippines, Manila, Philippines.
authors.forename: Sigrun
authors.initials: S
authors.lastname: Roesel
authors.affiliation: National Center for Disease Prevention and Control, Department of Health, Manila, Philippines.
authors.forename: Luzviminda C
authors.initials: LC
authors.lastname: Garcia
authors.affiliation: National Epidemiology Center, Department of Health, Manila, Philippines.
authors.forename: Dulce
authors.initials: D
authors.lastname: Cecilio-Elfa
authors.affiliation: World Health Organization, Western Pacific Regional Office, Manila, Philippines.
authors.forename: W William
authors.initials: WW
authors.lastname: Schluter
authors.affiliation: Centers for Disease Control and Prevention (CDC), Center for Global Health, Global Immunization Division, Atlanta, GA, USA.
authors.forename: James L
authors.initials: JL
authors.lastname: Goodson
authors.affiliation: World Health Organization, Western Pacific Regional Office, Manila, Philippines.|Centers for Disease Control and Prevention (CDC), Center for Global Health, Global Immunization Division, Atlanta, GA, USA.
authors.forename: Eugene
authors.initials: E
authors.lastname: Lam
mesh_terms: D002648:Child; D002675:Child, Preschool; D060740:Disease Eradication; D004196:Disease Outbreaks / Q000517:prevention & control*; D005843:Geography; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D015994:Incidence; D007223:Infant; D008457:Measles / Q000453:epidemiology / Q000517:prevention & control*; D008458:Measles Vaccine / Q000627:therapeutic use*; D010679:Philippines; D011159:Population Surveillance; D018570:Risk Assessment; D014611:Vaccination; D014944:World Health Organization
chemical_list: D008458:Measles Vaccine
keywords: Elimination; measles; risk assessment