The Impact of immunization control activities on measles outbreaks in Akwa Ibom State, South-South, Nigeria

Bassey, E.B.; Moses, A.E.; Udo, S.M. and Umo, A.N. (2010) The Impact of immunization control activities on measles outbreaks in Akwa Ibom State, South-South, Nigeria. Online Journal of Health and Allied Sciences, 9 (1). ISSN 0972-5997

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Abstract

Background: The increase of vaccination rates means that fewer children will be vulnerable to vaccine preventable diseases such as measles, which will invariably result in a drop in the infant mortality and morbidity rates. Objective: To assess the impact of the implementation of measles reduction strategies from 2006 to 2008 using the quarterly national program for immunization (NPI) in Akwa Ibom state, Nigeria. Method: Following informed consent, individuals presenting with febrile rash illnesses were routinely bled and tested for measles specific IgM using commercially available ELISA kit-MV-ELISA (Enzygnost; Behring Diagnostics, Marburg, Germany) in accordance with the manufacturer’s instructions. Results: A total of four hundred and four individuals comprising of 216 vaccinated and 188 un-vaccinated, presenting with febrile rash illness were screened for measles specific IgM antibodies as indication of active infection between January 2006 and December 2008 out of which 122 (30.2%) had detectable levels of measles antibodies. Among the vaccinated and unvaccinated groups, 32 (14.8%) and 90 (47.9%) respectively were detected with measles IgM antibodies. The highest and lowest antibody levels were detected in 2006 (vaccinated: 54.7%; unvaccinated: 78.4%) and 2008 (vaccinated: 1.2%; unvaccinated: 12%) respectively. The distribution of measles burden by year show an overall decline in prevalence from 70% in 2006, 8.9% in 2007 to 3.7% in 2008. While, children under the age of 5 similarly had a decline in measles incidence of 73.3%, 10.7% and 3.3% respectively. Sex distribution of infection within the 3-year period shows that more females (37.4%) than males (21.2%) expressed measles IgM antibodies, and active infection was detected more in the rural (31.4%) than urban area (27.7%). However, findings indicate a tremendous decline in active infection in the rural areas from 67% in 2006 to 0% in 2008, and in the urban areas from 78% in 2006 to 9.3% in 2008 among both vaccinated and unvaccinated groups. A highly significant reduction in measles infection was observed more among males than females (P=0.009). Infection distribution by location did not show any significant difference (P=0.65) even though more individuals in the rural areas were noted with active infection. Conclusion: The study shows a highly significant reduction in measles burden among vaccinated individuals (P=0.0001) and invariably increases protective coverage of measles vaccination most especially among children under 5 years of age (P=0.0066) in the state. Findings justify effort by government and WHO in carrying immunization campaigns in children, 5-years and below irrespective of vaccination status and experience.

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