Priorities in global measles control: report of an outbreak in N'Djamena, Chad

Ndikuyeze, Andre; Cook, A. J. C.; Cutts, Felicity; Bennett, Steve

doi:10.1017/s095026880005843x

Cited by 15 publications

(9 citation statements)

References 7 publications

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“…The 2.8%–7.0% CFRs found in our study are as high as those reported in the early 1990s [3,16–20] from these same countries that were included in our surveys. Similar retrospective community studies conducted in Boukoki, Niamey, Niger after measles epidemics estimated an overall CFR of 6.6% in 1991 [16] and a CFR of 2.4% in children aged under 5 y in 1995 [17].…”

Section: Discussionsupporting

confidence: 68%

See 1 more Smart Citation

Unacceptably High Mortality Related to Measles Epidemics in Niger, Nigeria, and Chad

Grais¹,

Dubray²,

Gerstl³

et al. 2007

PLoS Med

121

101

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BackgroundDespite the comprehensive World Health Organization (WHO)/United Nations Children's Fund (UNICEF) measles mortality–reduction strategy and the Measles Initiative, a partnership of international organizations supporting measles mortality reduction in Africa, certain high-burden countries continue to face recurrent epidemics. To our knowledge, few recent studies have documented measles mortality in sub-Saharan Africa. The objective of our study was to investigate measles mortality in three recent epidemics in Niamey (Niger), N'Djamena (Chad), and Adamawa State (Nigeria).Methods and FindingsWe conducted three exhaustive household retrospective mortality surveys in one neighbourhood of each of the three affected areas: Boukoki, Niamey, Niger (April 2004, n = 26,795); Moursal, N'Djamena, Chad (June 2005, n = 21,812); and Dong District, Adamawa State, Nigeria (April 2005, n = 16,249), where n is the total surveyed population in each of the respective areas. Study populations included all persons resident for at least 2 wk prior to the study, a duration encompassing the measles incubation period. Heads of households provided information on measles cases, clinical outcomes up to 30 d after rash onset, and health-seeking behaviour during the epidemic. Measles cases and deaths were ascertained using standard WHO surveillance-case definitions. Our main outcome measures were measles attack rates (ARs) and case fatality ratios (CFRs) by age group, and descriptions of measles complications and health-seeking behaviour. Measles ARs were the highest in children under 5 y old (under 5 y): 17.1% in Boukoki, 17.2% in Moursal, and 24.3% in Dong District. CFRs in under 5-y-olds were 4.6%, 4.0%, and 10.8% in Boukoki, Moursal, and Dong District, respectively. In all sites, more than half of measles cases in children aged under 5 y experienced acute respiratory infection and/or diarrhoea in the 30 d following rash onset. Of measles cases, it was reported that 85.7% (979/1,142) of patients visited a health-care facility within 30 d after rash onset in Boukoki, 73.5% (519/706) in Moursal, and 52.8% (603/1,142) in Dong District.ConclusionsChildren in these countries still face unacceptably high mortality from a completely preventable disease. While the successes of measles mortality–reduction strategies and progress observed in measles control in other countries of the region are laudable and evident, they should not overshadow the need for intensive efforts in countries that have just begun implementation of the WHO/UNICEF comprehensive strategy.

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Section: Discussionsupporting

confidence: 68%

“…A recent study in Mirriah district in Niger found a CFR of 9.7% [3]. In N'Djamena, a community survey after a measles epidemic in 1993 found a mean CFR of 7.4% in children aged under 5 y [20]. In an urban area of Nigeria in 1995, a CFR of 3.3% was found in the population [19].…”

Section: Discussionmentioning

confidence: 99%

Unacceptably High Mortality Related to Measles Epidemics in Niger, Nigeria, and Chad

Grais¹,

Dubray²,

Gerstl³

et al. 2007

PLoS Med

121

101

View full text Add to dashboard Cite

show abstract

“…[3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] To our knowledge, no nationally representative study of measles CFRs has previously been conducted in a measles-endemic country.…”

Section: Introductionmentioning

confidence: 99%

“…Localized CFR estimates in south-east Asia 4,[9][10][11]13,15,16 and globally 3,[5][6][7][8]12,14,[18][19][20] have varied from less than 1% to 25%, but many studies were conducted before implementation of the Integrated Management of Childhood Illness strategy and recommendations to administer vitamin A to all measles cases. Therefore, many of these studies may not reflect the current situation.…”

Section: Introductionmentioning

confidence: 99%

Measles deaths in Nepal: estimating the national case-fatality ratio

Joshi¹,

Luman

Nandy

et al. 2009

Bull World Health Org

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“…Other than some rare isolates from Cameroon and Gabon from the early 1980s and The Gambia from the 1990s, no field isolates have been investigated in sub-Saharan West Africa [9][10][11]. Yet, children from this region may well experience some of the highest measles-related morbidity and mortality with case-fatality rates sometimes above 5% [12][13][14].…”

mentioning

confidence: 99%

Limited Diversity of Measles Field Isolates after a National Immunization Day in Burkina Faso: Progress from Endemic to Epidemic Transmission?

et al. 2003

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Despite recent National Immunization Days in Burkina Faso, the rural province of Houët reported >400 measles cases in 2001 (82% not vaccinated). Phylogenetic analysis of 58 measles virus field isolates plus the first sequences from the Democratic Republic of the Congo and the Republic of Congo are reported. All viruses were genotype B3, which is common in the region. In Houët, there were two geographically confined genetic variants, suggesting two independent importation events. Strain diversity in Houët (1.5%) and the Congos was limited in comparison with Ibadan, Nigeria (4.6%), where measles is endemic. Strain variability, assessed by heteroduplex mobility assay, confirmed these findings. Despite large local pools of susceptible persons even after several rounds of vaccination, the limited strain diversity suggests that parts of rural Burkina Faso may be moving from an endemic to an epidemic transmission pattern of measles virus.

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Priorities in global measles control: report of an outbreak in N'Djamena, Chad

Cited by 15 publications

References 7 publications

Unacceptably High Mortality Related to Measles Epidemics in Niger, Nigeria, and Chad

Unacceptably High Mortality Related to Measles Epidemics in Niger, Nigeria, and Chad

Measles deaths in Nepal: estimating the national case-fatality ratio

Limited Diversity of Measles Field Isolates after a National Immunization Day in Burkina Faso: Progress from Endemic to Epidemic Transmission?

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