TY - JOUR
T1 - Lessons learned from detecting and responding to recurrent measles outbreak in Liberia post Ebola-Epidemic 2016-2017
AU - Nagbe, Thomas
AU - Williams, George Sie
AU - Rude, Julius Monday
AU - Flomo, Sumor
AU - Yeabah, Trokon
AU - Fallah, Mosoka
AU - Skrip, Laura
AU - Agbo, Chukwuemeka
AU - Mahmoud, Nuha
AU - Okeibunor, Joseph Chukwudi
AU - Yealue, Kwuakuan
AU - Talisuna, Ambrose
AU - Yahaya, Ali Ahmed
AU - Rajatonirina, Soatiana
AU - Clarke, Adolphus
AU - Hamblion, Esther
AU - Nyenswah, Tolbert
AU - Dahn, Bernice
AU - Gasasira, Alex
AU - Fall, Ibrahima Socé
N1 - Funding Information:
The authors thank all National Public Health Institute of Liberia (NPHIL) staff, district and county surveillance officers, WHO field staff, Victoria Katawera, Jeremy Sissy and Mohammed Krommah of WHO country office-Liberia, Laboratory team at National Public Health Reference Laboratory Liberia, the staff of National EPI program at the Ministry of Health and County Child Survival Focal Persons from the 15 counties for the contribution that enabled documentation of this paper. Special thanks to WHO country and regional offices for supporting the development of Liberia experiences in IHR core capacities post Ebola outbreak against which we were encouraged and motivated to document this paper.
Publisher Copyright:
© Thomas Nagbe et al.
PY - 2019
Y1 - 2019
N2 - Introduction: measles is an acute viral disease that remains endemic in much of sub-Sahara Africa, including Liberia. The 2014 Ebola epidemic disrupted an already fragile health system contributing to low uptake of immunization services, population immunity remained low thus facilitating recurrent outbreaks of measles in Liberia. We describe lessons learnt from detecting and responding to recurrent outbreaks of measles two years post the 2014 Ebola epidemic in Liberia. Methods: we conducted a descriptive study using the findings from Integrated Diseases Surveillance and Response (IDSR) 15 counties, National Public Health Institute of Liberia (NPHIL), National Public Health Reference Laboratory (NPHRL) and District Health Information Software (DIHS2) data conducted from October to December, 2017. We perused the outbreaks line lists and other key documents submitted by the counties to the national level from January 2016 to December 2017. Results: from January 2016 to December 2017, 2,954 suspected cases of measles were reported through IDSR. Four hundred sixty-seven (467) were laboratory confirmed (IgM-positive), 776 epidemiologically linked, 574 clinically confirmed, and 1,137 discarded (IgM-negative). Nine deaths out of 1817 cases were reported, a case fatality rate of 0.5%; 49% were children below the age of 5 years. Twenty-two percent (405/1817) of the confirmed cases were vaccinated while the vaccination status of 55% (994/1817) was unknown. Conclusion: revitalization of IDSR contributed to increased detection and reporting of suspected cases of measles thus facilitating early identification and response to outbreaks. Priority needs to be given to increasing the uptake of routine immunization services, introducing a second dose of measles vaccine in the routine immunization program and conducting a high-quality supplementary measles immunization campaign for age group 1 to 10 years to provide protection for a huge cohort of susceptible.
AB - Introduction: measles is an acute viral disease that remains endemic in much of sub-Sahara Africa, including Liberia. The 2014 Ebola epidemic disrupted an already fragile health system contributing to low uptake of immunization services, population immunity remained low thus facilitating recurrent outbreaks of measles in Liberia. We describe lessons learnt from detecting and responding to recurrent outbreaks of measles two years post the 2014 Ebola epidemic in Liberia. Methods: we conducted a descriptive study using the findings from Integrated Diseases Surveillance and Response (IDSR) 15 counties, National Public Health Institute of Liberia (NPHIL), National Public Health Reference Laboratory (NPHRL) and District Health Information Software (DIHS2) data conducted from October to December, 2017. We perused the outbreaks line lists and other key documents submitted by the counties to the national level from January 2016 to December 2017. Results: from January 2016 to December 2017, 2,954 suspected cases of measles were reported through IDSR. Four hundred sixty-seven (467) were laboratory confirmed (IgM-positive), 776 epidemiologically linked, 574 clinically confirmed, and 1,137 discarded (IgM-negative). Nine deaths out of 1817 cases were reported, a case fatality rate of 0.5%; 49% were children below the age of 5 years. Twenty-two percent (405/1817) of the confirmed cases were vaccinated while the vaccination status of 55% (994/1817) was unknown. Conclusion: revitalization of IDSR contributed to increased detection and reporting of suspected cases of measles thus facilitating early identification and response to outbreaks. Priority needs to be given to increasing the uptake of routine immunization services, introducing a second dose of measles vaccine in the routine immunization program and conducting a high-quality supplementary measles immunization campaign for age group 1 to 10 years to provide protection for a huge cohort of susceptible.
KW - Alert and epidemic thresholds
KW - Immunization
KW - Integrated disease surveillance and response
KW - Measles
KW - Outbreak
UR - https://www.scopus.com/pages/publications/85071280647
UR - https://www.scopus.com/pages/publications/85071280647#tab=citedBy
U2 - 10.11604/PAMJ.SUPP.2019.33.2.17172
DO - 10.11604/PAMJ.SUPP.2019.33.2.17172
M3 - Article
C2 - 31402966
AN - SCOPUS:85071280647
SN - 1937-8688
VL - 33
JO - Pan African Medical Journal
JF - Pan African Medical Journal
M1 - 7
ER -