American Journal of Epidemiology Vol. 127, No. 4: 788-794
Copyright © 1988 by The Johns Hopkins University School of Hygiene and Public Health
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MEASLES CONTROL EFFORTS IN URBAN AFRICA COMPLICATED BY HIGH INCIDENCE OF MEASLES IN THE FIRST YEAR OF LIFE
1International Health Program Office, Centers for Disease Control Atlanta, GA.
2World Health Organization Bujumbura, Burundi
3Expanded Programme on Immunization and the Combatting Childhood Communicable Diseases Program, Ministry of Health Kinshasa, Zaire
Reprint requests to Dr. William H. Taylor, Division of Chronic Disease Control, Center for Environmental Health, Centers for Disease Control, Atlanta, GA 30333
A measles vaccination coverage of between 50 and 60% has been achieved in Kinshasa, Zaire, from 1980–1985. During that interval, the annual number of measles cases and the incidence rate of measles reported by a surveillance system remained similar, and measles epidemics occurred in alternating years. The estimated number of measles cases in Kinshasa is 87,600 per year. Of reported measles cases, 27% occurred in children under nine months of age, younger than the recommended age at vaccination. Two results expected in a partially vaccinated population, a reduction in measles incidence greater than the level of vaccination coverage and a shift in the age distribution of measles to older children, have not been observed. Measles control in Kinshasa will require a vaccination coverage of higher than 60%. In addition, given the age-specific risk of measles infection here, a measies vaccine that would be effective when given before nine months of age would be an important element in controlling measles transmission. Because the epidemiology of measles in Kinshasa is a likely consequence of its urban environment, such a vaccine would represent a significant advance toward the control of measles in urban Africa.
immunity; measles; measles vaccine; vaccination
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