title: Measles immunity among pregnant women aged 15-44 years in Namibia, 2008 and 2010.
abstract: BACKGROUND
  Namibia experienced a large measles outbreak starting in 2009, with 38% of reported cases in adults, including women of reproductive age. Population immunity was assessed among pregnant women to determine whether immunization activities were needed in adults to achieve measles elimination in Namibia.
  
  
  METHODS
  A total of 1708 and 2040 specimens sampled from Namibian pregnant women aged 15-44 years who were included in the 2008 and 2010 National HIV Sentinel Survey, respectively, were tested for measles immunoglobulin G antibody. The proportion of women seropositive overall and by 5-year age strata was determined, and factors associated with seropositivity were analyzed by logistic regression, including age, facility type, gravidity, HIV status, and urban/rural setting. Seropositivity in 2008 versus 2010 was compared.
  
  
  RESULTS
  In both analysis years, measles seropositivity was lower in 15-19-year-olds (77%) and 20-24-year-olds (85-87%) and higher in 25-44-year-olds (90-94%) (2008, p<0.001; 2010, p<0.001). Overall measles seropositivity did not differ between 2008 (87%) and 2010 (87%) (p=0.7). HIV status did not affect seropositivity.
  
  
  CONCLUSIONS
  Late in a large measles outbreak, 13% of pregnant women in Namibia, and almost one in four 15-19-year-old pregnant women, remained susceptible to measles. In Namibia, immunization campaigns with measles-containing vaccine should be considered for adults.
authors.affiliation: Centers for Disease Control and Prevention, Global Immunization Division, 1600 Clifton Road, NE, Atlanta, GA 30333, USA. Electronic address: iyk8@cdc.gov.
authors.forename: Cristina V
authors.initials: CV
authors.lastname: Cardemil
authors.affiliation: Ministry of Health and Social Services, Directorate of Special Programmes, Primary Health Directorate, and Family Health Division (Expanded Programme on Immunizations), Windhoek, Namibia.
authors.forename: Anna
authors.initials: A
authors.lastname: Jonas
authors.affiliation: Centers for Disease Control and Prevention, Windhoek, Namibia.
authors.forename: Anita
authors.initials: A
authors.lastname: Beukes
authors.affiliation: Centers for Disease Control and Prevention, Division of Viral Diseases, Atlanta, GA, USA.
authors.forename: Raydel
authors.initials: R
authors.lastname: Anderson
authors.affiliation: Centers for Disease Control and Prevention, Division of Viral Diseases, Atlanta, GA, USA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Rota
authors.affiliation: Centers for Disease Control and Prevention, Division of Viral Diseases, Atlanta, GA, USA.
authors.forename: Bettina
authors.initials: B
authors.lastname: Bankamp
authors.affiliation: Ministry of Health and Social Services, Directorate of Special Programmes, Primary Health Directorate, and Family Health Division (Expanded Programme on Immunizations), Windhoek, Namibia.
authors.forename: Howard E
authors.initials: HE
authors.lastname: Gary
authors.affiliation: Centers for Disease Control and Prevention, Windhoek, Namibia.
authors.forename: Souleymane
authors.initials: S
authors.lastname: Sawadogo
authors.affiliation: Centers for Disease Control and Prevention, Windhoek, Namibia.
authors.forename: Sadhna V
authors.initials: SV
authors.lastname: Patel
authors.affiliation: Ministry of Health and Social Services, Directorate of Special Programmes, Primary Health Directorate, and Family Health Division (Expanded Programme on Immunizations), Windhoek, Namibia.
authors.forename: Sikota
authors.initials: S
authors.lastname: Zeko
authors.affiliation: Ministry of Health and Social Services, Directorate of Special Programmes, Primary Health Directorate, and Family Health Division (Expanded Programme on Immunizations), Windhoek, Namibia.
authors.forename: Clementine
authors.initials: C
authors.lastname: Muroua
authors.affiliation: Namibia Institute of Pathology, Windhoek, Namibia.
authors.forename: Esegiel
authors.initials: E
authors.lastname: Gaeb
authors.affiliation: Centers for Disease Control and Prevention, Global Immunization Division, 1600 Clifton Road, NE, Atlanta, GA 30333, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Wannemuehler
authors.affiliation: Centers for Disease Control and Prevention, Windhoek, Namibia.
authors.forename: Sue
authors.initials: S
authors.lastname: Gerber
authors.affiliation: Centers for Disease Control and Prevention, Global Immunization Division, 1600 Clifton Road, NE, Atlanta, GA 30333, USA.
authors.forename: James L
authors.initials: JL
authors.lastname: Goodson
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D005260:Female; D006801:Humans; D007114:Immunization; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008457:Measles / Q000276:immunology* / Q000517:prevention & control; D008458:Measles Vaccine / Q000276:immunology; D009276:Namibia; D011247:Pregnancy / Q000276:immunology*; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D008458:Measles Vaccine
keywords: Measles; Namibia; Population immunity; Pregnant women; Seroprevalence