title: Progress Toward Measles Elimination - Nepal, 2007-2014.
abstract: In 2013, the 66th session of the Regional Committee of the World Health Organization (WHO) South-East Asia Region (SEAR) established a goal to eliminate measles and to control rubella and congenital rubella syndrome (CRS) in SEAR by 2020. Current recommended measles elimination strategies in the region include 1) achieving and maintaining ≥95% coverage with 2 doses of measles-containing vaccine (MCV) in every district, delivered through the routine immunization program or through supplementary immunization activities (SIAs); 2) developing and sustaining a sensitive and timely measles case-based surveillance system that meets minimum recommended performance indicators; 3) developing and maintaining an accredited measles laboratory network; and 4) achieving timely identification, investigation, and response to measles outbreaks. In 2013, Nepal, one of the 11 SEAR member states, adopted a goal for national measles elimination by 2019. This report updates a previous report and summarizes progress toward measles elimination in Nepal during 2007-2014. During 2007-2014, estimated coverage with the first MCV dose (MCV1) increased from 81% to 88%. Approximately 3.9 and 9.7 million children were vaccinated in SIAs conducted in 2008 and 2014, respectively. Reported suspected measles incidence declined by 13% during 2007-2014, from 54 to 47 cases per 1 million population. However, in 2014, 81% of districts did not meet the measles case-based surveillance performance indicator target of ≥2 discarded non-measles cases per 100,000 population per year. To achieve and maintain measles elimination, additional measures are needed to strengthen routine immunization services to increase coverage with MCV1 and a recently introduced second dose of MCV (MCV2) to ≥95% in all districts, and to enhance sensitivity of measles case-based surveillance by adopting a more sensitive case definition, expanding case-based surveillance sites nationwide, and ensuring timely transport of specimens to the accredited national laboratory.
authors.forename: Sudhir
authors.initials: S
authors.lastname: Khanal
authors.forename: Tika Ram
authors.initials: TR
authors.lastname: Sedai
authors.forename: Ganga Ram
authors.initials: GR
authors.lastname: Choudary
authors.forename: Jagat Narain
authors.initials: JN
authors.lastname: Giri
authors.forename: Rajendra
authors.initials: R
authors.lastname: Bohara
authors.forename: Rajendra
authors.initials: R
authors.lastname: Pant
authors.forename: Mukunda
authors.initials: M
authors.lastname: Gautam
authors.forename: Umid M
authors.initials: UM
authors.lastname: Sharapov
authors.forename: James L
authors.initials: JL
authors.lastname: Goodson
authors.forename: James
authors.initials: J
authors.lastname: Alexander
authors.forename: Alya
authors.initials: A
authors.lastname: Dabbagh
authors.forename: Peter
authors.initials: P
authors.lastname: Strebel
authors.forename: Robert T
authors.initials: RT
authors.lastname: Perry
authors.forename: Sunil
authors.initials: S
authors.lastname: Bah
authors.forename: Nihal
authors.initials: N
authors.lastname: Abeysinghe
authors.forename: Arun
authors.initials: A
authors.lastname: Thapa
mesh_terms: D060740:Disease Eradication; D006801:Humans; D017589:Immunization Programs; D007115:Immunization Schedule; D015994:Incidence; D007223:Infant; D008457:Measles / Q000453:epidemiology* / Q000517:prevention & control*; D008458:Measles Vaccine / Q000008:administration & dosage; D008459:Measles virus / Q000302:isolation & purification; D009390:Nepal / Q000453:epidemiology; D011159:Population Surveillance; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: D008458:Measles Vaccine