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. 1991;69(2):213–219.

Measles epidemic in Harare, Zimbabwe, despite high measles immunization coverage rates.

R A Kambarami 1, K J Nathoo 1, F K Nkrumah 1, D J Pirie 1
PMCID: PMC2393090  PMID: 1860149

Abstract

Despite rapidly increasing measles immunization coverage in Harare city, measles remains endemic, and regular outbreaks occur. The most recent occurred in 1988, when the measles immunization coverage was 83%. We have carried out a retrospective study of the clinical and epidemiological features of this outbreak to assess whether the present immunization policy needs to be changed. Of 4357 cases of measles seen at primary health care centres and hospitals in Harare during the outbreak, 1399 (32%) were severe or involved complications that required hospital admission. The peak incidence occurred among under-2-year-olds, followed by that among 5-7-year-olds. Poor nutritional status was significantly more frequent among children who were hospitalized and among those who died. A total of 59% of all cases aged 9-59 months had documented evidence of measles immunization. The most frequent complications, which occurred most often among under-5-year-olds, were diarrhoea with dehydration, pneumonia, laryngotracheobronchitis, and convulsions, which together affected 56% of hospitalized cases. The hospital case fatality rate was low (1.43%). In Harare, measles transmission remains a problem, despite high measles immunization coverage rates; the failure rate for the standard Schwarz measles vaccine also appears to be high. There is a need to reduce the number of measles cases among under-9-month-olds and young children. Further studies into alternative measles vaccines and schedules are required.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aaby P., Bukh J., Hoff G., Leerhøy J., Lisse I. M., Mordhorst C. H., Pedersen I. R. High measles mortality in infancy related to intensity of exposure. J Pediatr. 1986 Jul;109(1):40–44. doi: 10.1016/s0022-3476(86)80569-8. [DOI] [PubMed] [Google Scholar]
  2. Aaby P., Bukh J., Lisse I. M., Smits A. J. Introduction of measles into a highly immunised West African community: the role of health care institutions. J Epidemiol Community Health. 1985 Jun;39(2):113–116. doi: 10.1136/jech.39.2.113. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Aaby P., Bukh J., Lisse I. M., Smits A. J. Overcrowding and intensive exposure as determinants of measles mortality. Am J Epidemiol. 1984 Jul;120(1):49–63. doi: 10.1093/oxfordjournals.aje.a113874. [DOI] [PubMed] [Google Scholar]
  4. Aaby P., Jensen T. G., Hansen H. L., Kristiansen H., Thårup J., Poulsen A., Sodemann M., Jakobsen M., Knudsen K., Clotilde da Silva M. Trial of high-dose Edmonston-Zagreb measles vaccine in Guinea-Bissau: protective efficacy. Lancet. 1988 Oct 8;2(8615):809–811. doi: 10.1016/s0140-6736(88)92780-8. [DOI] [PubMed] [Google Scholar]
  5. Dabis F., Sow A., Waldman R. J., Bikakouri P., Senga J., Madzou G., Jones T. S. The epidemiology of measles in a partially vaccinated population in an African city: implications for immunization programs. Am J Epidemiol. 1988 Jan;127(1):171–178. doi: 10.1093/oxfordjournals.aje.a114778. [DOI] [PubMed] [Google Scholar]
  6. Oruamabo R. S., Mbuagbaw L. T. Measles in Port Harcourt, Nigeria. Trop Doct. 1987 Apr;17(2):88–89. doi: 10.1177/004947558701700214. [DOI] [PubMed] [Google Scholar]
  7. Sinha N. P. Measles in children under six months of age: an epidemiological study. J Trop Pediatr. 1981 Apr;27(2):120–122. doi: 10.1093/tropej/27.2.120. [DOI] [PubMed] [Google Scholar]
  8. Taylor W. R., Mambu R. K., ma-Disu M., Weinman J. M. Measles control efforts in urban Africa complicated by high incidence of measles in the first year of life. Am J Epidemiol. 1988 Apr;127(4):788–794. doi: 10.1093/oxfordjournals.aje.a114860. [DOI] [PubMed] [Google Scholar]
  9. Whittle H. C., Mee J., Werblinska J., Yakubu A., Onuora C., Gomwalk N. Immunity to measles in malnourished children. Clin Exp Immunol. 1980 Oct;42(1):144–151. [PMC free article] [PubMed] [Google Scholar]
  10. Whittle H., Hanlon P., O'Neill K., Hanlon L., Marsh V., Jupp E., Aaby P. Trial of high-dose Edmonston-Zagreb measles vaccine in the Gambia: antibody response and side-effects. Lancet. 1988 Oct 8;2(8615):811–814. doi: 10.1016/s0140-6736(88)92781-x. [DOI] [PubMed] [Google Scholar]

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