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Strategies for Measles Control Progress and future plans<br />
Principles of accelerated measles control strategies in India<br />Improve and sustain routine immunization coverage<br />...
Disproportionate burden of measles mortality in India<br />67%<br />164,000 estimated Measles Deaths in 2008<br />= 1000 d...
Global Context: Worldwide measles vaccination delivery strategies, mid-2010<br />Govt of India decision in 2010 <br />to i...
Enhanced AEFI surveillance during the Measles catch-up campaigns<br /><ul><li>304 minor AEFIs and 40 serious AEFIs reported
All serious AEFIs reported and correctly managed
NO DEATHS – VACCINE OR PROGRAMME RELATED</li></li></ul><li>Lessons learned and areas for improvement <br />Coordination an...
Presentation outline<br />Global context<br />Introduction of MCV2<br />Routine services<br />Catch-up campaigns<br />Scal...
2006<br />2007<br />2009<br />2010<br />  2011<br />Scale-up of laboratory enhanced measles outbreak surveillance<br />
Serologically confirmed# measles, rubella and mixed outbreaks, India(Andhra Pradesh, Gujarat, Karnataka, Kerala, Madhya Pr...
Vaccination status and age distribution of serologically confirmed measles cases 2010*, India<br />           Vaccinated  ...
85 % < 10 yrs of age</li></ul>Cases from serologically confirmed measles and mixed outbreaks<br />* data as on 15th Apr, 2...
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Measles Control and AEFI

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Part of a presentation by P Haldar

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Measles Control and AEFI

  1. 1. Strategies for Measles Control Progress and future plans<br />
  2. 2. Principles of accelerated measles control strategies in India<br />Improve and sustain routine immunization coverage<br />Provide a second opportunity for measles immunization to all eligible children<br />Sensitive, laboratory supported measles outbreak surveillance for case/outbreak confirmation<br />Fully investigate all detected measles outbreaks and ensure appropriate case management<br />
  3. 3. Disproportionate burden of measles mortality in India<br />67%<br />164,000 estimated Measles Deaths in 2008<br />= 1000 death<br />Dots are randomly distributed in countries<br />Data source: WHO/IVB, November 2009<br />
  4. 4. Global Context: Worldwide measles vaccination delivery strategies, mid-2010<br />Govt of India decision in 2010 <br />to introduce MCV2<br />MCV1 & MCV2, no SIAs (40 member states or 21%)<br />MCV1, MCV2 & one-time catch-up (36 member states or 19%)<br />MCV1, MCV2 & regular SIAs (57 member states or 28%)<br />MCV1 & regular SIAs (59 member states or 31%)<br />Single dose (1 member state or 1%)<br />
  5. 5. Enhanced AEFI surveillance during the Measles catch-up campaigns<br /><ul><li>304 minor AEFIs and 40 serious AEFIs reported
  6. 6. All serious AEFIs reported and correctly managed
  7. 7. NO DEATHS – VACCINE OR PROGRAMME RELATED</li></li></ul><li>Lessons learned and areas for improvement <br />Coordination and planning<br />Better coordination of the three primary department of Health, Education and ICDS<br />Clear timelines of availability of logistics <br />Communication and advocacy<br />IEC and interpersonal communication<br />IAP, IMA<br />Private schools<br />Vaccination in urban areas<br />Injection waste management<br />Supervision needs to be improved at all levels<br />
  8. 8. Presentation outline<br />Global context<br />Introduction of MCV2<br />Routine services<br />Catch-up campaigns<br />Scale-up of laboratory measles surveillance<br />Summary and way forward<br />
  9. 9. 2006<br />2007<br />2009<br />2010<br /> 2011<br />Scale-up of laboratory enhanced measles outbreak surveillance<br />
  10. 10. Serologically confirmed# measles, rubella and mixed outbreaks, India(Andhra Pradesh, Gujarat, Karnataka, Kerala, Madhya Pradesh, Rajasthan, Tamil Nadu and West Bengal)<br />2009<br />2010*<br />68<br />56<br />41<br />196<br /> 16<br /> 4<br />216 outbreaks<br />165 outbreaks<br />#Outbreak confirmation for Measles: 2009 ≥ 1 cases IgM positive for measles, Similarly for Rubella <br /> Outbreak confirmation for Measles: 2010 ≥ 2 cases IgM positive for measles, Similarly for Rubella <br />* data as on 15th Apr, 2011<br />
  11. 11. Vaccination status and age distribution of serologically confirmed measles cases 2010*, India<br /> Vaccinated Not Vaccinated Unknown <br />Total cases: 8,956<br /><ul><li>63 % no or unknown vax status
  12. 12. 85 % < 10 yrs of age</li></ul>Cases from serologically confirmed measles and mixed outbreaks<br />* data as on 15th Apr, 2011<br />
  13. 13. Way forward<br />State review meetings and a national review meeting to inform operational strategies<br />Starting coverage evaluation surveys in selected states<br />Expand laboratory supported measles surveillance to document the impact of the campaigns<br />Initiate planning and preparation to cover remaining districts of phase 1 states and pilot districts of UP in phase II. <br /><ul><li>Cover remaining districts of UP in the third phase, 2012</li></li></ul><li>Thank you<br />

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