Measles is still one of the most common infectious killers of children in the world, especially in developing countries. In Iran, during the prevaccine era, 150,000-500,000 cases of measles were reported annually, with a death rate of 10%-15%. After the establishment of Expanded Program on Immunization program in 1984, vaccination rates for the first and second doses of measles vaccine increased to >90% by the mid-1990s, and the number of measles cases decreased to 2652 in 1996. In response to increased numbers of cases in older age groups during 1996-2002, a nationwide measles-rubella vaccination campaign was conducted in 2003, and 33,100,000 persons (99%) aged 5-25 years were vaccinated. During 2004-2009, 221 laboratory-confirmed measles cases (<1 case per million population) were detected, primarily in rural areas and among migrant groups who traveled to or came from high-incidence countries. High routine immunization coverage, low disease incidence, and surveillance system data suggest that interruption of endemic virus transmission might have already been achieved in Iran, but challenges remain and continued efforts are needed to sustain this accomplishment.
Background: Supplementary Immunization Activities (SIAs) have been considered as a strategic key towards elimination of measles and rubella. This study aimed at identifying the coverage of vaccination in target population children. Methods: The study was carried out in South-East of Iran on a total of 6838 randomly selected children. Information was collected by trained interviewers using a validated questionnaire. The data was analyzed through descriptive statistics (i.e. frequencies and percentages) and 95% confidence interval. Results: Overall, 98.7% of children were vaccinated during SIAs campaign. Vaccination cards were available for about two-thirds of the participants at the time of home visits while 95.3% of them reportedly received an immunization card. Refusal to vaccinate (31%), not informed (24.2%), children being sick (22.4%), and travel (20.2%) were the main reasons for not vaccinating children (n = 86) during the campaign. The main sites for vaccination were school (46.5%) and health centers (46.4%). Fever (44.8%) and severe pain at the injection site (36.2%) were reported as the most frequent complications by the study participants. Prevention of measles and rubella (66.6%) and health staff recommendations (31.4%) were the main vaccination incentives. Conclusions: To sum up, Supplementary Immunization Activities (SIAs) are a good approach towards high coverage of immunization and attain measles and rubella elimination.
Few studies have addressed the seroepidemiological profile of rubella among a representative population of young adult women. This study aims to determine the immunity and susceptibility rate against rubella in a representative population of women in reproductive age in Iran through serological evaluation. This cross-sectional study was conducted in 2012 on 804 pre-marriage women in Iran. Multi-stage random sampling was used for choosing study sample. Serologic test were used to assess subjects' immunity to rubella and their titers of IgG antibody against rubella with Elisa method was measured. In total, 98.4% (95% CI: 97.1% -97.3%) of study participants were immune against rubella. Five women (0.6%) were in borderline category and 1% (8 women) was susceptible to rubella. The proportion of immune people in low and high incidence regions was 99.3% (95% CI: 97.8-99.9%), and 97.5% (95% CI: 95.5-95.89%), respectively (P = 0.05). Our data indicated that level of immunity to rubella in women of reproductive age in Iran is satisfactory. This finding indicates the achievement of Iran to the goal of high level of serum immunity against rubella among young women.
Background: During the past years, due to the increase in immunization coverage and promotion of surveillance data, the incidence of measles decreased. This study aimed to determine the measles incidence risk, to conduct spatial mapping of annual measles incidence, and to assess the transition threat in different districts of Iran. Methods: A historical cohort study with retrospective data was conducted. The measles surveillance data containing 14 294 cases suspected of having measles in Iran were analyzed during 2014-2016. WHO Measles Programmatic Risk Assessment Tool was applied to calculate and map the incidence of measles in each district, to determine the annual incidence rate, and to conduct spatial threat assessment risk. Threat assessment was measured based on factors influencing the exposure and transmission of measles virus in the population. The annual measles incidence rate and spatial mapping of incidence in each Iranian district was conducted by Measles Programmatic Risk Assessment Tool. Data were analyzed by descriptive statistics in Excel 2013 and Arc GIS 10.3. Results: Of 14 294 suspected cases, 0.6% (CI 95%: 0.599-0.619) were identified as clinically compatible measles, 0.280 (CI 95%: 0.275-0.284) as confirmed rubella, 0.52% (CI 95%: 0.516-0.533) as epi-linked measles, 4.6% (CI 95%: 0.450-0.464) as lab-confirmed measles, and 94% (CI 95%: 93.93-94.11) were discarded. The annual incidence rate in cases per 100 000 populations increased from 0.0726, (CI 95%; 0.0714-0.0738) in 2014 to 0.1154 (CI 95%; 0.1135-0.1173) in 2016, and the 3-year incidence rate during the study period was 1.032 (CI 95%; 1.017-1.047) and the annual average was 0.3442 (CI 95%; 0.3387-0.3496). Conclusion: The average annual incidence rate of measles in Iran was low, but after a 11-fold increase in the number of measles cases in 2015, the number of measles cases decreased to more than 7-times in 2016. However, maintaning a high immunization coverage of measles and timely vaccination can be effective in reaching the goal of measles elimination.
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