Measles surveillance and control in Tunisia: 1979–2000

Bahri, Olfa; Halima, Myriam Ben; Ghorbal, M. Ben; Dali, Kaouther; Arrouji, Z; Khammassi, Selma; Triki, H.; Slim, Aminé

doi:10.1016/s0264-410x(02)00483-8

Cited by 10 publications

(4 citation statements)

References 6 publications

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“…However, in 1992, an outbreak occurred in school-aged children and incidence climbed to 141/ 100,000. In 1993, measles incidence declined to 16/100,000 and by 2000 Tunisia registered the lowest incidence ever reported of 0.5/100,000 (figure 1) [7].…”

Section: Resultsmentioning

confidence: 97%

“…After measles vaccination was established in Tunisia in 1979, routine measles vaccination coverage with the first dose for children by age 1 year gradually increased but remained !80% until 1987. Since 1992, vaccination coverage for the first dose of measles vaccine has been 190% with the exception of 1994 and 1996, when coverage decreased to 87% and 86%, respectively (figure 1) [7]. Since 1990, coverage for each dose has been 180%.…”

Section: Resultsmentioning

confidence: 99%

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Progress toward Interruption of Endemic Measles Transmission in Tunisia

Garbouj¹,

Slim

Ghorbal³

et al. 2003

J INFECT DIS

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Progress toward Interruption of Endemic Measles Transmission in Tunisia

Garbouj¹,

Slim

Ghorbal³

et al. 2003

J INFECT DIS

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“…National measles surveillance reports from 1997-2002 showed about 95% of cases were less than 15 years of age [MOH, 2002] and 60% 5-14 years old. A changing age distrution of cases is the expected outcome of an immunization both as a direct effect of protection in those vaccinated and indirect consequences of reduced risk of infecton in the unvaccinated [Anderson and May, 1991;Bahri et al, 2003]. The surveillance data and the present laboratory-based findings suggest that greater impact would be achieved if measles supplemental immunization would be delivered to all children 9 months-14 years, that is, raising the upper age from the current 59 months.…”

Section: Discussionmentioning

confidence: 99%

Serological and molecular epidemiology of measles virus outbreaks reported in Ethiopia during 2000–2004

et al. 2006

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Twenty-eight outbreaks in six regions and two major cities in Ethiopia from 2000 to 2004 were investigated, with the collection of 207 venous blood and/or oral fluid samples. Measles diagnosis was confirmed by detection of measles-specific IgM and/or detection of measles virus by polymerase chain reaction (PCR). Of 176 suspected cases tested for specific measles IgM, 142 (81%) were IgM positive. Suspected cases in vaccinated children were much less likely to be laboratory confirmed than in unvaccinated children (42% vs. 83%, P < 0.0001). Of 197 samples analyzed by RT-PCR measles virus genome was detected in 84 (43%). A total of 58 wild-type measles viruses were characterized by nucleic acid sequence analysis of the nucleoprotein (N) and hemagglutinin (H) genes. Two recognized genotypes (D4 and B3) were identified. Each outbreak comprised only a single genotype and outbreaks of each genotype tended to occur in distinct geographical locations. B3 was first observed in 2002, and has now been the cause of three documented outbreaks near to the border of Sudan. D4 genotype was previously observed in an outbreak in 1999 and occurs in more diverse locations throughout the country. These data yield insights into geographical and age-related sources of continued transmission. Refinement of measles control measures might include targeting older age groups (5-14 years) and strengthening routine immunization particularly where importation of cases is a concern.

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“…Tunisia started measles elimination activities were started since 1998 including supplemental vaccination campaigns of children under 16 years in 1998 and 2001 . Laboratory-confirmed measles cases were very rare before the 2002 outbreak which was associated with a nosocomial transmission in one hospital and accounted for a total of 87 cases (Bahri et al, 2003;Garbouj et al, 2003). At the same time, an outbreak was ongoing in Libya with 3890 reported cases, which was unfortunately not virologically investigated (WHO, 2003b).…”

Section: Discussionmentioning

confidence: 99%