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Global Efforts and Challenges toward Measles Elimination – Infectious Diseases
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class="site-main" id="main"> <article id="post-100" class="post-100 post type-post status-publish format-standard has-post-thumbnail hentry category-infections category-measle tag-covid-19-pandemic tag-global-health tag-immunization-programs tag-measles-elimination tag-surveillance-systems tag-vaccination-coverage tag-vaccine-hesitancy" itemtype="https://schema.org/CreativeWork" itemscope> <div class="inside-article"> <div class="featured-image page-header-image-single "> <img width="1200" height="628" src="https://infect.blog/archive/wp-content/uploads/2024/10/infect-min-scaled-e1728135017493.jpg" class="attachment-full size-full" alt="" itemprop="image" decoding="async" fetchpriority="high" /> </div> <header class="entry-header"> <h1 class="entry-title" itemprop="headline">Global Efforts and Challenges toward Measles Elimination</h1> <div class="entry-meta"> <span class="posted-on"><time class="entry-date published" datetime="2024-10-05T19:00:22+05:30" itemprop="datePublished">October 5, 2024</time></span> <span class="byline">by <span class="author vcard" itemprop="author" itemtype="https://schema.org/Person" itemscope><a class="url fn n" href="https://infect.blog/archive/author/infect/" title="View all posts by infect" rel="author" itemprop="url"><span class="author-name" itemprop="name">infect</span></a></span></span> </div> </header> <div class="entry-content" itemprop="text"> <p><span style="font-weight: 400;">Measles is one of the most contagious viral diseases of childhood and has been a major concern in global health for years. Even though there is an effective vaccine against measles, this disease remains an important cause of morbidity and mortality among children globally. It has set ambitious goals with its partners in global health to have all regions measles-eliminated by improving vaccination coverage and surveillance. However, vaccine hesitancy, along with health care access inequities and the hammer of worldwide disasters like COVID-19, jeopardizes the road to measles elimination. The current paper will focus on the global drive toward the elimination of measles, successes over the past two decades, and challenges that remain to these efforts.</span></p> <h3><b>Progress Toward Measles Elimination</b></h3> <p><span style="font-weight: 400;">The WHO Global Vaccine Action Plan passed the World Health Assembly in 2012, with a target to eliminate measles from five of the six WHO regions by 2020. Under this very plan, much headway has been made toward reducing the spread and mortality rate of measles. “During the period from 2000 to 2019, the incidence of measles dropped by 88% worldwide. During that time, an estimated 26.9 million deaths were prevented.” These great achievements were made possible due to the wide-scale use of the measles-containing vaccine and extensive vaccination campaigns carried out by many countries around the world.</span></p> <p><span style="font-weight: 400;">IA2030 has definitely been at the forefront of the push for progress on the measles agenda. In fact, IA2030 sees measles as a critical indicator of the immunization system and health systems’ capacity to deliver important vaccines to children. IA2030 emphasizes the need to attain and sustain high vaccination coverage. The prevention of outbreaks and maintenance of measles elimination require at least 95% coverage with two doses of MCV.</span></p> <p><span style="font-weight: 400;">This space has, however, not been uniform across all regions. There is outstanding progress noted in some countries, while others have regressed under the weight of political instability, resource constraints, and public health crises. The Americas and Western Pacific regions were on their way to the elimination of measles but faced major upticks due to vaccine hesitancy and reduced surveillance that followed suboptimal vaccination coverage.</span></p> <h3><b>Hesitancy to Vaccines and Gaps in Coverage</b></h3> <p><span style="font-weight: 400;">Vaccine hesitancy poses one of the toughest challenges in striving for the global elimination of measles. Measles vaccine efficacy has been established, and yet a number of countries show declining vaccination rates because of misplaced information and resultant mistrust against such vaccines. This mostly occurs in high-income countries where measles risks have increased with the reduced visibility of the disease.</span></p> <p><span style="font-weight: 400;">Besides vaccine hesitancy, there are other critical barriers to the achievement of measles elimination: gaps in coverage. Inadequate health infrastructure, supply chain problems, and socio-economic issues ensure easy access to vaccines in most low- and middle-income countries. Many factors exacerbate these gaps, such as conflicts, natural disasters, and other emergencies that impact service delivery and often disrupt it, resulting in consequent fallout and further spreading measles.</span></p> <p><span style="font-weight: 400;">Moreover, COVID-19 has further increased these gaps in coverage. Its unprecedented disruption to routine immunization services across most countries caused millions of children to miss scheduled vaccine doses of MCV. From 86% in 2019, MCV immunization coverage went down to 81% globally in 2021 the lowest since 2008 further putting endangered people at risk from outbreaks, with regional increases expected in parts of the world already reporting low vaccination coverage.</span></p> <p></div></div> <div style="background: #f7f7f7;border: 1px solid rgba(0, 0, 0, 0.07);"> <div style="padding: 30px;"><div class="Adblock-main"> <div class="Adblock-head"> <h2>Yearwise Publication Trend on <b>“<a href="https://infect.blog/publication-trends/index/infections" target="_blank" title="infections - yearwise publication trends">infections</a>”</b></h2> </div> </div><div class="results-container"><div class="chart-block" style="padding:15px;"> <div class="left"> <div id="results" class="results"></div> </div> <div class="right"> <div class="chart-container"><canvas id="publicationChart"></canvas></div> </div> <div class="keywordsdiv"> <div style="text-align:center;"><b>Find publication trends on relevant topics</b> </div> <span class="gp-icon icon-tags"><svg viewBox="0 0 512 512" aria-hidden="true" xmlns="http://www.w3.org/2000/svg" width="1em" height="1em"><path d="M20 39.5c-8.836 0-16 7.163-16 16v176c0 4.243 1.686 8.313 4.687 11.314l224 224c6.248 6.248 16.378 6.248 22.626 0l176-176c6.244-6.244 6.25-16.364.013-22.615l-223.5-224A15.999 15.999 0 00196.5 39.5H20zm56 96c0-13.255 10.745-24 24-24s24 10.745 24 24-10.745 24-24 24-24-10.745-24-24z"></path><path d="M259.515 43.015c4.686-4.687 12.284-4.687 16.97 0l228 228c4.686 4.686 4.686 12.284 0 16.97l-180 180c-4.686 4.687-12.284 4.687-16.97 0-4.686-4.686-4.686-12.284 0-16.97L479.029 279.5 259.515 59.985c-4.686-4.686-4.686-12.284 0-16.97z"></path></svg></span> <span id="keyword-stats"></span> </div> </div></div></div><div class="inside-article"><style> table { margin: 0 0 1.5em; 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if (!statistics || Object.keys(statistics).length === 0) { resultsContainer.innerHTML = '<p>No data found.</p>'; return; } var tableHTML = `<div class='pub-scroll'> <table class='tablediv' border='1' cellspacing='0' cellpadding='0'> <tr> <th>Year</th> <th>Publication Count</th> </tr>`; Object.entries(statistics).sort(([yearA], [yearB]) => yearB - yearA).forEach(([year, count]) => { const displayCount = count === 0 ? 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In most countries, the surveillance system is weak, and measles cases are not recognized or reported. The completeness and sensitivity of surveillance systems are very variable, but only in very few countries have the recommended targets of case detection and reporting been met, while in many others, they fall wide off the mark.</span></p> <p><span style="font-weight: 400;">On the other hand, for 2021, among the 135 countries that reported on the discarded measles cases, only 35% of a sensitivity indicator target of at least two or more discarded cases per 100,000 were achieved. The underperformance manifests great weaknesses in the different health systems that need to be bridged to control and properly respond to measles transmission. The gaps need to be closed fast with strong coordination and surveillance systems that shall provide the chances necessary for the detection of all cases and managing them as soon as possible.</span></p> <p><span style="font-weight: 400;">The COVID-19 pandemic has badly affected the surveillance of measles to a great extent. Regular efforts were derailed, with diverted health workers and other resources; reporting on suspected measles cases fell, with delays in the confirmation of said cases by laboratory tests. In some African countries, the reported cases and collected specimens from 2019 dropped by more than 50 percent in the year 2020. This reduced quality of surveillance has made it an uphill task to determine and hence monitor and control measles outbreaks, particularly in remote and resource-constrained settings.</span></p> <h3><b>Global Health Threats and Measles Resurgence</b></h3> <p><span style="font-weight: 400;">Global health threats, not excluding the current COVID-19 pandemic, have also acted as significant impediments to attaining the goals set by the elimination of measles initiative. Critical disruptions to routine immunization services, access to health services, and general health system exhaustion have intensified because of the pandemic conditions. This has generally culminated in an increase in the caseload of measles in many nations, whatever gains were made in controlling the disease over the years.</span></p> <p><span style="font-weight: 400;">For example, in 2019 there was a step-by-step increase in measles cases worldwide, with officially reported cases increasing from 18 per 1 million population in 2016 to 120 per 1 million population in 2019. Decreases in vaccination coverage, combined with disruptions in surveillance systems, raise the number of cases. Very large and serious outbreaks happened in 22 countries. Such results bring out clearly the precious state of the elimination efforts globally.</span></p> <p><span style="font-weight: 400;">The pandemic further showed that although most countries in the region were making tremendous efforts to improve their programs for vaccination and surveillance, the gains, in general, remained fragile. Restoring elimination momentum will require strategies taken by countries to include the restoration and strengthening of immunization programs, even as they face ongoing global health challenges.</span></p> <p><span style="font-weight: 400;">Several approaches would be needed to meet measles elimination targets. These involve improvements in the coverage of immunization, strengthening surveillance systems, and really getting to the root causes of vaccine hesitancy and coverage gaps.</span></p> <h3><b>Improving Vaccine Coverage</b></h3> <p><span style="font-weight: 400;">Therefore, the core of the goal for measles elimination is strengthening coverage. Areas that have low vaccination coverage shall increase the covered portion towards the target of 95% with two doses of MCV. It may demand focused campaigns in order to include them through the integration of measles vaccination into routine health services as well as strengthening the available strategies that promote vaccine access in marginalized areas.</span></p> <p><span style="font-weight: 400;">Public health campaigns that mobilize against misinformation and emphasize the importance of immunization can end vaccine hesitancy. Such campaigns are undertaken with the participation of community leaders and healthcare workers with social influence to inculcate the principles of vaccine trust and build their uptake.</span></p> <p></div></div> <div style="background: #f7f7f7;border: 1px solid rgba(0, 0, 0, 0.07);"> <div style="padding: 30px;"><div class="Adblock-main"> <div class="Adblock-head"> <h2>Recent Publications on <b>“<a href="https://infect.blog/recent-publications/index/infections" target="_blank" rel="noopener" title="infections - yearwise publication list">infections</a>”</b></h2> </div> </div> <div class="pb-main"><div class="article-scroll"><div id="results_recent" class="results"></div></div><div class="keywordsdiv" style="margin: 0px 15px;margin-top:20px;"> <div style="text-align:center;"><b>Find publications on relevant topics</b> </div> <span class="gp-icon icon-tags"><svg viewBox="0 0 512 512" aria-hidden="true" xmlns="http://www.w3.org/2000/svg" width="1em" height="1em"><path d="M20 39.5c-8.836 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framework-8-incorporated zwitterionic hydrogel with multifunctional properties for infected wound healing.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38945331", "publishedDate": "2024" }, { "title": "Transgenerational impacts of early life adversity: from health determinants, implications to epigenetic consequences.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38945418", "publishedDate": "2024" }, { "title": "14-3-3 Family of Proteins: Biological Implications, Molecular Interactions, and Potential Intervention in Cancer, Virus and Neurodegeneration Disorders.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38946063", "publishedDate": "2024" }, { "title": "Implementation and Performance of a Point-of-Care COVID-19 Test Program in 4,000 California Schools.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38945441", "publishedDate": "2024" }, { "title": "Population pharmacokinetics of flucloxacillin as intermittent bolus infusion in patients with Staphylococcus aureus bloodstream infection.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38946285", "publishedDate": "2024" }, { "title": "Gelatin\u2011sodium alginate composite hydrogel doped with black phosphorus@ZnO heterojunction for cutaneous wound healing with antibacterial, immunomodulatory, and angiogenic properties.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38945324", "publishedDate": "2024" }, { "title": "Molecular epidemiology, genetic diversity, antibiotic resistance and pathogenicity of complex from bacteremia patients in a tertiary hospital in China for nine years.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38946894", "publishedDate": "2024" }, { "title": "Genetics of resistance to trimethoprim in cotrimoxazole resistant uropathogenic : integrons, transposons, and single gene cassettes.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38946902", "publishedDate": "2024" }, { "title": "Incidence and prevalence of hepatitis C and B infections among men who have sex with men and transgender women enrolled in a United States HIV vaccine trial.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38947062", "publishedDate": "2024" }, { "title": "Characterization of the family-level Borreliaceae pan-genome and development of an episomal typing protocol.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38947078", "publishedDate": "2024" }, { "title": "Seroprevalence of SARS-CoV-2 and risk factors for infection among children in Uganda: a serial cross-sectional study.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38947039", "publishedDate": "2024" }, { "title": "Factors Affecting the Effectiveness and Safety of Polymyxin B in the Treatment of Gram-negative Bacterial Infections: A Meta-Analysis of 96 Articles.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38945178", "publishedDate": "2024" }, { "title": "Oncogenic HPV-induced high expression of ESM1 predicts poor prognosis and regulates aerobic glycolysis in cervical cancer.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38947495", "publishedDate": "2024" } ]; var keywordsArray = ["measles elimination","global health","vaccination coverage","vaccine hesitancy","surveillance systems","COVID-19 pandemic","immunization programs"]; displayResults_recent(recent_papers); displayKeywordPapers(keywordsArray); // function stripslashes(str) { // if (typeof str === 'string') { // return str.replace(/\/g, ''); // } // } </script></p> <h3><b>Strengthened surveillance systems</b></h3> <p><span style="font-weight: 400;">Strengthened surveillance has to become increasingly efficient in monitoring and outbreak management. Countries can commit resources to the training of the health workforce, optimization of laboratory capacity, and strengthening their mechanisms for the collection and reporting of data. This could result in efficiency gains through strengthened integration of measles surveillance with other health programs, such as rubella and other vaccine-preventable programs.</span></p> <p><span style="font-weight: 400;">Healthcare surveillance needs to be re-established and strengthened in the wake of the COVID-19 pandemic. This would involve providing working assistance to clear the backlog of cases, improving transportation and laboratory testing in particular, and ensuring that prompt investigations of all suspect cases are completed.</span></p> <h3><b>Responding to Global Health Emergencies</b></h3> <p><span style="font-weight: 400;">The key to the global health crisis is proactive and resilient health systems. Success in measles elimination is assured. Success depends on the development of country plans for the maintenance of routine immunization. services and sustaining elevated population immunity during health emergencies. with special strategies for rapid response, alternative vaccine delivery modes, and the timely availability of essential health resources.</span></p> <p><span style="font-weight: 400;">Moreover, international cooperation can be supportive of fighting global health crises. Intervention by WHO and partners needs to be constantly technical and financial for those countries in need that are continuously suffering from the consequences of the conflict, the effects of natural calamities and adversities, and the state of emergencies that disrupt health services.</span></p> <h3><b>Conclusion</b></h3> <p><span style="font-weight: 400;">In the past two decades, the global eradication of measles has gained success in most parts of the world, but because of the persistent challenges, the actual goal has not been achieved. Measles is again out of control due to vaccine hesitancy, gaps in coverage, weak surveillance systems, and other health crises worldwide, such as the COVID-19 pandemic. These, then, are the challenges that must be surmounted to eliminate measles through increased vaccination coverage, strengthened surveillance, and resilient health systems ready for global crises. Further, with continued commitment and collaboration across borders, the world will be nearer to the end of measles, leading to a healthier future for every child.</span></p> <p></p> <h3><b>References</b></h3> <ol> <li>Minta, A.A., 2022. <a href="https://www.cdc.gov/mmwr/volumes/71/wr/mm7147a1.htm">Progress toward regional measles elimination—worldwide, 2000–2021.</a> <i>MMWR. Morbidity and mortality weekly report</i>, <i>71</i>.</li> <li>Dixon, M.G., 2021. <a href="https://www.cdc.gov/mmwr/volumes/70/wr/mm7045a1.htm">Progress toward regional measles elimination—worldwide, 2000–2020.</a> <i>MMWR. Morbidity and mortality weekly report</i>, <i>70</i>.</li> <li>Patel, M.K., 2020. <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6945a6.htm?s_cmm6945a6_w">Progress toward regional measles elimination—worldwide, 2000–2019.</a> <i>MMWR. Morbidity and Mortality Weekly Report</i>, <i>69</i>.</li> <li>Masresha, B., Luce, R., Katsande, R., Dosseh, A., Tanifum, P., Lebo, E., Byabamazima, C. and Kfutwah, A., 2021. <a href="https://www.ajol.info/index.php/pamj/article/view/221689">The impact of the COVID-19 pandemic on measles surveillance in the World Health Organisation African Region, 2020.</a> <i>Pan African Medical Journal</i>, <i>39</i>(1).</li> <li>Eilertson, K.E., Fricks, J. and Ferrari, M.J., 2019. <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/sim.8290">Estimation and prediction for a mechanistic model of measles transmission using particle filtering and maximum likelihood estimation.</a> <i>Statistics in Medicine</i>, <i>38</i>(21), pp.4146-4158.</li> <li>Sbarra, A.N., Mosser, J.F., Jit, M., Ferrari, M., Ramshaw, R.E., O’Connor, P., Krause, L.K., Rogowski, E.L. and Portnoy, A., 2022. <a href="https://www.medrxiv.org/content/10.1101/2022.10.05.22280730v2">Estimating national-level measles case fatality ratios: an updated systematic review and modelling study.</a> <i>medRxiv</i>, pp.2022-10.</li> <li>Santos, H., Eilertson, K., Lambert, B., Hauryski, S., Patel, M. and Ferrari, M., 2021. <a href="https://www.medrxiv.org/content/10.1101/2021.08.31.21262916v5">Ensemble model estimates of the global burden of measles morbidity and mortality from 2000 to 2019: a modeling study.</a> <i>medRxiv</i>, pp.2021-08.</li> </ol> <p></div></div> <div style="background: #f7f7f7;border: 1px solid rgba(0, 0, 0, 0.07);"> <div style="padding: 30px;"><div class="Adblock-main"> <div class="Adblock-head"> <h2>Top Experts on “<b style="color:#000;font-size:22px;">infections</b>“</h2> </div> </div><div class="author-main"><div id="results_author"></div><div style="text-align: center;"><a class="register-button" href="https://infect.blog/expert-search" target="_blank" rel="noopener">Find experts on any field</a></div></div><div class="inside-article" style="background: none;border: none;box-shadow: none;margin-top: -70px;"> <style> .author-block { padding: 15px; margin-bottom: 10px; text-align: left; font-size: 15px; line-height: 1.2; background: #FFF; border-bottom: solid 1px #ccc; margin-left: 15px; margin-right: 15px; } .author-block h3 { margin: 0 0 10px; color: #227cdc; } .author-block p { margin: 5px 0; } .author-b { display: flex; justify-content: space-between; flex-wrap: wrap; margin-bottom:10px; } .author-b .ainfo { flex: 1 1 30%; box-sizing: border-box; text-align: left; background: #dcdcdc; padding: 7px 14px; border-radius: 5px; margin-top: 3px; margin-right: 10px; } @media (max-width: 768px) { .author-b .ainfo { flex: 1 1 100%; margin: 10px 0; } } </style> <script> function displayResults_author(authors) { var resultsContainer = document.getElementById('results_author'); resultsContainer.innerHTML = ''; if (!authors || Object.keys(authors).length === 0) { resultsContainer.innerHTML = '<p>No authors found.</p>'; return; } Object.values(authors).slice(0, 10).forEach(author => { if (author.affiliation.length > 400) { return; } var authorBlock = document.createElement('div'); authorBlock.className = 'author-block'; var author_name=author.name; let key_replace = author_name.replace(/ /g, '-'); key_replace = key_replace.toLowerCase(); var authorHTML = ` <h3><a href="https://infect.blog/author/index/${key_replace}\/${author.aid}" target="_blank" title="${author.name}">${author.name}</a></h3> <div class="author-b"> <div class="ainfo"><strong>H-Index:</strong> ${author.hindex}</div> <div class="ainfo"><strong>Publication Count:</strong> ${author.paper_count}</div> <div class="ainfo"><strong>Citation Count:</strong> ${author.citation_count}</div> </div> <p><strong>Affiliation:</strong> ${author.affiliation}</p> `; authorBlock.innerHTML = authorHTML; resultsContainer.appendChild(authorBlock); }); } function displayKeywordAuthors(keywords) { var resultsContainer = document.getElementById('keyword-authors'); resultsContainer.innerHTML = ''; if (!keywords || keywords.length === 0) { resultsContainer.innerHTML = '<p>No data found.</p>'; return; } var keywordHTML = ''; keywords.forEach(key => { let key_replace = key.replace(/ /g, '-'); key_replace = key_replace.toLowerCase(); keywordHTML += `<a href="https://infect.blog/expert-search/index/${key_replace}" target="_blank" title="${key}">${key}</a>`; }); resultsContainer.innerHTML = keywordHTML; } // Call the function with the PHP data var authors_data = { "RNTfK4wBWBy50K-rBwd3": { "aid": "RNTfK4wBWBy50K-rBwd3", "name": "N. 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