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Measles Control and AEFI
 

Measles Control and AEFI

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Part of a presentation by P Haldar

Part of a presentation by P Haldar

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    Measles Control and AEFI Measles Control and AEFI Presentation Transcript

    • Strategies for Measles Control Progress and future plans
    • Principles of accelerated measles control strategies in India
      Improve and sustain routine immunization coverage
      Provide a second opportunity for measles immunization to all eligible children
      Sensitive, laboratory supported measles outbreak surveillance for case/outbreak confirmation
      Fully investigate all detected measles outbreaks and ensure appropriate case management
    • Disproportionate burden of measles mortality in India
      67%
      164,000 estimated Measles Deaths in 2008
      = 1000 death
      Dots are randomly distributed in countries
      Data source: WHO/IVB, November 2009
    • Global Context: Worldwide measles vaccination delivery strategies, mid-2010
      Govt of India decision in 2010
      to introduce MCV2
      MCV1 & MCV2, no SIAs (40 member states or 21%)
      MCV1, MCV2 & one-time catch-up (36 member states or 19%)
      MCV1, MCV2 & regular SIAs (57 member states or 28%)
      MCV1 & regular SIAs (59 member states or 31%)
      Single dose (1 member state or 1%)
    • Enhanced AEFI surveillance during the Measles catch-up campaigns
      • 304 minor AEFIs and 40 serious AEFIs reported
      • All serious AEFIs reported and correctly managed
      • NO DEATHS – VACCINE OR PROGRAMME RELATED
    • Lessons learned and areas for improvement
      Coordination and planning
      Better coordination of the three primary department of Health, Education and ICDS
      Clear timelines of availability of logistics
      Communication and advocacy
      IEC and interpersonal communication
      IAP, IMA
      Private schools
      Vaccination in urban areas
      Injection waste management
      Supervision needs to be improved at all levels
    • Presentation outline
      Global context
      Introduction of MCV2
      Routine services
      Catch-up campaigns
      Scale-up of laboratory measles surveillance
      Summary and way forward
    • 2006
      2007
      2009
      2010
      2011
      Scale-up of laboratory enhanced measles outbreak surveillance
    • Serologically confirmed# measles, rubella and mixed outbreaks, India(Andhra Pradesh, Gujarat, Karnataka, Kerala, Madhya Pradesh, Rajasthan, Tamil Nadu and West Bengal)
      2009
      2010*
      68
      56
      41
      196
      16
      4
      216 outbreaks
      165 outbreaks
      #Outbreak confirmation for Measles: 2009 ≥ 1 cases IgM positive for measles, Similarly for Rubella
      Outbreak confirmation for Measles: 2010 ≥ 2 cases IgM positive for measles, Similarly for Rubella
      * data as on 15th Apr, 2011
    • Vaccination status and age distribution of serologically confirmed measles cases 2010*, India
      Vaccinated Not Vaccinated Unknown
      Total cases: 8,956
      • 63 % no or unknown vax status
      • 85 % < 10 yrs of age
      Cases from serologically confirmed measles and mixed outbreaks
      * data as on 15th Apr, 2011
    • Way forward
      State review meetings and a national review meeting to inform operational strategies
      Starting coverage evaluation surveys in selected states
      Expand laboratory supported measles surveillance to document the impact of the campaigns
      Initiate planning and preparation to cover remaining districts of phase 1 states and pilot districts of UP in phase II.
      • Cover remaining districts of UP in the third phase, 2012
    • Thank you