The elimination of measles in Iran

Namaki, Saeed; Gouya, Mohammad Mehdí; Zahraei, Seyed Mohsen; Khalili, Neda; Sobhani, Hossein; Akbari, Mohammad Esmaeil

doi:10.1016/s2214-109x(20)30002-4

Cited by 13 publications

(20 citation statements)

References 7 publications

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“…In fact, the none appearance of an intermittent measles virus transmission from the last known indigenous case for at least 36 months can be considered as the measles eradication approval criteria. Eradication of measles has been a global health concern since the infection spreading through travel is unavoidable until the virus is eradicated unless, in extremely susceptible populations, complementary vaccination is implemented [31].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the focus reduction neutralization and ELISA tests compared to the plaque reduction neutralization test for the detection of antibodies against measles virus

yaghoobizad

Norouzbabaei

Shafiei-Jandaghi

et al. 2022

Preprint

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Measles is an infectious febrile sickness. Despite the existence of effective vaccination, eradicating measles remains a global priority. It is required to set up a sensitive and specific test to identify measles-specific antibodies in order to estimate the level of community protection against measles. Although the plaque reduction neutralization test (PRNT), the gold standard test, is technically challenging, it is not suitable for routine use. The enzyme-linked immunosorbent assay (ELISA) was also unable to detect weak antibody responses in people vaccinated against measles. As a result, the FRNT (focus reduction neutralization test) was established and validated. In eight assay runs, the samples were analyzed in triplicate by PRNT, FRNT, and ELISA. In a total of 50 samples analyzed, 38/50 samples were positive by standard PRNT, 37/50 samples by FRNT, and 19/50 samples were positive by ELISA. The results showed that ELISA was not sensitive enough to identify low levels of anti-measles antibodies, and that ELISA and both neutralization assays had a weak agreement. The two neutralization assays, on the other hand, had a perfect correlation. Finally, the PRNT and FRNT have similar sensitivity. For characterizing the immunological response to measles and vaccination efficacy trials, FRNT seems to be a good alternative to PRNT. Therefore, it will be very important to validate the negative and equivocal ELISA results with this standard test in the final stages of eradication.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the focus reduction neutralization and ELISA tests compared to the plaque reduction neutralization test for the detection of antibodies against measles virus

yaghoobizad

Norouzbabaei

Shafiei-Jandaghi

et al. 2022

Preprint

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“…Our data showed a signi cant change point in 2003 when the health policy-makers started one of the major immunization campaigns against measles and rubella in three phases including catch-up, keep-up, and follow-up. This operation yielded to an impressive reduction in measles incidence rate [9]. In other words, the large rate of immunization coverage in all Iranian cities and villages is among the most signi cant reasons for the reduced incidence of measles based on the WHO risk evaluation method [28].…”

Section: Discussionmentioning

confidence: 99%

“…The estimated annual measles occurrence rate in Iran was small, however in 2016, following a rise in the frequency of positive measles reports in 2015, the incidence rate of measles experienced a signi cant decreased in the next year [8]. As the Eastern Mediterranean region witnessed the largest increase in measles cases in 2019, Iran was granted a measles exclusion status in October 2019 [9]. Although the number of new cases has been diminished signi cantly in the center of Iran during the recent years, the central parts of Iran such as Markazi province -with the highest risk point in Iranian districts [10]-might nd a considerable increase in the number of measles cases in a near future similar to what Brazil, Madagascar, Ukraine, Yemen, Philippines, and Venezuela experienced [6].…”

Section: Introductionmentioning

confidence: 99%

“…Although forecasting analysis con rmed the continuing procedure of constant low number of new cases for the next two years in addition to this fact that the number of new measles cases had dramatically decreased over the recent decade in Iran which yielded this country to receive the elimination certi cate, there are many European and Americas regions who have lost their certi cate in 2018 and 2019 [9]. This is an alarm for the health policy makers to continue the restrictions on measles infection such as preventing contact with suspicious cases and strict oversight of immigration systems from neighbor countries which are the most deterministic factors to continue the measles elimination strategy.…”

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confidence: 99%

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Evaluating Measles Incidence Rates Using Machine Learning and Time Series Methods in the Center of Iran; 1997-2020

Nazari¹,

Fathi²,

Sharahi³

et al. 2020

Preprint

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Background: Measles is a feverish condition labeled among the most infectious viral illnesses in the globe. Despite the presence of a secure, accessible, affordable and efficient vaccine, measles continues to be a worldwide concern. Methods: This study uses machine learning and time series methods to assess factors that placed people at a higher risk of measles. This historical cohort study contained the Measles incidence in Markazi Province, the center of Iran, from April 1997 to February 2020. Logistic regression, linear discriminant analysis, random forest, artificial neural network, bagging, support vector machine, and naïve Bayes were used to make the classification. Zero-inflated negative binomial regression for time series was utilized to assess development of measles over time. Results: The prevalence of measles was 14.5% over the recent 24 years and a constant trend of almost zero cases was observed from 2002 to 2020. The order of independent variable importance were recent years, age, vaccination, rhinorrhea, male sex, contact with measles patients, cough, conjunctivitis, ethnic, and fever. Younger age, less probability of contact and no fever is associated with less odds of zero cases. Only 7 new cases were forecasted for the next two years. Bagging and random forest were the most accurate classification methods. Conclusion: Even if the numbers of new cases are almost zero during the recent years, it has been showed that age and contact are responsible for non-occurrence of measles. October and May are prone to have new cases for 2021 and 2022.

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“…Notably, vaccination coverage is relatively high in Iran. Also, a high immunization coverage in children has been one of the major achievements of the health system in Iran for many years [30], and recently, it has succeeded to receive a certificate in the elimination and eradication of some infectious diseases (including polio [31,32], measles, and rubella [33]). Vaccination in Iran is performed free of charge in all state-owned health centers.…”

Section: Ii-the Subnational Levelmentioning

confidence: 99%

The Effective Coverage of Maternal and Child Primary Health Care Services and its Relationship with Health Expenditures: An Analysis at Sub-National Level in Iran

Abdalmaleki

Abdi

Sazgarnejad

et al. 2021

Preprint

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Backgrounds: Measuring the effective coverage of essential health services is necessary for monitoring progress towards Universal Health Coverage (UHC). So, this study aimed to assess the geographic variations in key maternal and child indicators (as essential health services) provided at the primary health care (PHC) level in terms of their crude and effective coverage, and also to investigate the relationship between the effective coverage and health expenditures in the national and sub-national level of Iran. Methods: This study was a secondary analysis, which analyzed the spatial distribution of six key maternal and child health indicators using the latest available data of Demographic Health Survey-DHS (2010) across 31 provinces of Iran. Moreover, two composite indicators, the crude, and the effective coverage were calculated. The median cut-off was used to compare provinces situations. Furthermore, the relationship between coverage indicators and total health expenditure per capita was evaluated. Results: At the national level, the crude and the effective composite coverage were 89.56 and 77.22%, respectively. Also, the medians of composite crude and effective service coverage in the provinces were 90.25 and 77.62%, respectively. There was no significant difference between urban and rural areas. Conclusions: in this study, we found that there is a significant gap between crude and effective service coverage of the selected indicators. Overall, coverage indicators of maternal services were higher compared to those of children. In addition, geographic variations in key Indicators of maternal and child health services coverage among provinces were almost high. Although the services are free of charge in the rural areas, they did not have higher coverage than those of urban areas. PHC services in Iran are far away from reaching the desired coverage and achieving UHC.

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The elimination of measles in Iran

Cited by 13 publications

References 7 publications

Evaluation of the focus reduction neutralization and ELISA tests compared to the plaque reduction neutralization test for the detection of antibodies against measles virus

Evaluation of the focus reduction neutralization and ELISA tests compared to the plaque reduction neutralization test for the detection of antibodies against measles virus

Evaluating Measles Incidence Rates Using Machine Learning and Time Series Methods in the Center of Iran; 1997-2020

The Effective Coverage of Maternal and Child Primary Health Care Services and its Relationship with Health Expenditures: An Analysis at Sub-National Level in Iran

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