Rapid diagnostic tests to address challenges for global measles surveillance

Brown, David W.; Warrener, Lenesha; Scobie, Heather M.; Donadel, Morgane; Waku‐Kouomou, Diane; Mulders, Mick N.; Rota, Paul A.

doi:10.1016/j.coviro.2020.05.007

Cited by 34 publications

(20 citation statements)

References 31 publications

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“…Measles surveillance, which is currently extremely insensitive, needs substantial investment to improve the investigation of suspect cases and root cause analysis of outbreaks. Laboratory confirmation is greatly constrained by the need to transport specimens to central laboratories; hence, the roll-out of point of care diagnostics [ 58 ] should help increase the specificity of reporting in more remote areas. As routine coverage improves and the interval between measles outbreaks lengthens, there is a risk of unrecognized accumulation of susceptible persons in older ages [ 6 ]; hence, it is important to use multiple sources of data to identify population immunity gaps.…”

Section: Discussionmentioning

confidence: 99%

Vaccination strategies for measles control and elimination: time to strengthen local initiatives

Cutts

Ferrari

Krause

et al. 2021

BMC Med

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Background Through a combination of strong routine immunization (RI), strategic supplemental immunization activities (SIA) and robust surveillance, numerous countries have been able to approach or achieve measles elimination. The fragility of these achievements has been shown, however, by the resurgence of measles since 2016. We describe trends in routine measles vaccine coverage at national and district level, SIA performance and demographic changes in the three regions with the highest measles burden. Findings WHO-UNICEF estimates of immunization coverage show that global coverage of the first dose of measles vaccine has stabilized at 85% from 2015 to 19. In 2000, 17 countries in the WHO African and Eastern Mediterranean regions had measles vaccine coverage below 50%, and although all increased coverage by 2019, at a median of 60%, it remained far below levels needed for elimination. Geospatial estimates show many low coverage districts across Africa and much of the Eastern Mediterranean and southeast Asian regions. A large proportion of children unvaccinated for MCV live in conflict-affected areas with remote rural areas and some urban areas also at risk. Countries with low RI coverage use SIAs frequently, yet the ideal timing and target age range for SIAs vary within countries, and the impact of SIAs has often been mitigated by delays or disruptions. SIAs have not been sufficient to achieve or sustain measles elimination in the countries with weakest routine systems. Demographic changes also affect measles transmission, and their variation between and within countries should be incorporated into strategic planning. Conclusions Rebuilding services after the COVID-19 pandemic provides a need and an opportunity to increase community engagement in planning and monitoring services. A broader suite of interventions is needed beyond SIAs. Improved methods for tracking coverage at the individual and community level are needed together with enhanced surveillance. Decision-making needs to be decentralized to develop locally-driven, sustainable strategies for measles control and elimination.

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Section: Discussionmentioning

confidence: 99%

Vaccination strategies for measles control and elimination: time to strengthen local initiatives

Cutts

Ferrari

Krause

et al. 2021

BMC Med

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“…Field validation was useful in identifying environmental conditions (temperature and humidity) that needed to be adjusted for in the results. An existing lateral flow-based RDT for measles IgM detection has been field-validated with high sensitivity and specificity compared to ELISA, and this test is being commercialized, along with commercial development of a rubella IgM RDT; these tests have the potential use by non-expert users as part of MR surveillance [ 21 ]. Compared to a lateral flow device, the advantages of the DMF-ELISA include the ability to readily print cartridges at low cost and the ability to customize the system ad-hoc for use with different assay configurations based on need.…”

Section: Discussionmentioning

confidence: 99%

Use of a rapid digital microfluidics-powered immunoassay for assessing measles and rubella infection and immunity in outbreak settings in the Democratic Republic of the Congo

et al. 2022

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The Democratic Republic of the Congo (DRC) has a high measles incidence despite elimination efforts and has yet to introduce rubella vaccine. We evaluated the performance of a prototype rapid digital microfluidics powered (DMF) enzyme-linked immunoassay (ELISA) assessing measles and rubella infection, by testing for immunoglobulin M (IgM), and immunity from natural infection or vaccine, by testing immunoglobulin G (IgG), in outbreak settings. Field evaluations were conducted during September 2017, in Kinshasa province, DRC. Blood specimens were collected during an outbreak investigation of suspected measles cases and tested for measles and rubella IgM and IgG using the DMF-ELISA in the field. Simultaneously, a household serosurvey for measles and rubella IgG was conducted in a recently confirmed measles outbreak area. DMF-ELISA results were compared with reference ELISA results tested at DRC’s National Public Health Laboratory and the US Centers for Disease Control and Prevention. Of 157 suspected measles cases, rubella IgM was detected in 54% while measles IgM was detected in 13%. Measles IgG-positive cases were higher among vaccinated persons (87%) than unvaccinated persons (72%). In the recent measles outbreak area, measles IgG seroprevalence was 93% overall, while rubella seroprevalence was lower for children (77%) than women (98%). Compared with reference ELISA, DMF-ELISA sensitivity and specificity were 82% and 78% for measles IgG; 88% and 89% for measles IgM; 85% and 85% for rubella IgG; and 81% and 83% for rubella IgM, respectively. Rubella infection was detected in more than half of persons meeting the suspected measles case definition during a presumed measles outbreak, suggesting substantial unrecognized rubella incidence, and highlighting the need for rubella vaccine introduction into the national schedule. The performance of the DMF-ELISA suggested that this technology can be used to develop rapid diagnostic tests for measles and rubella.

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“…Rapid diagnostic tests are commonly used in other surveys are typically for antigen detection, as opposed to antibody which serosurveys detect, very commonly used in malaria, Chlamydia and more recently in SARS-CoV-2 POCTs to rapidly generate results [ 10 ]. A study has explored the potential value of rapid measles antibody (specifically IgM) testing in global measles surveillance [ 11 ]. Another study, has explored the value of rapid antibody testing for HIV in community and outreach settings [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…A study has explored the potential value of rapid measles antibody (specifically IgM) testing in global measles surveillance [11]. Another study, has explored the value of rapid antibody testing for HIV in community and outreach settings [12].…”

Section: Plos Onementioning

confidence: 99%

Experiences of sharing results of community based serosurvey with participants in a district of Maharashtra, India

Salvi¹,

Itta

Lachyan³

et al. 2022

PLoS ONE

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A growing number of organisations, including medical associations, recommend that research subjects should be given the option of being informed about the general outcome and results of the study. We recently completed a study involving nine serosurveys from 2018 to 2020 in five districts of India among three age groups (children 9 months to < 5 years; 5 to < 15 years of age, and women 15 to < 50 years of age before and after the measles and rubella (MR) vaccination campaigns). In Palghar district of Maharashtra all individuals in 30 selected clusters were enumerated, and 13 individuals per age group were randomly sampled. We established the procedures to return the results to the respondents for each stage of the survey. Of the 1,166 individuals selected for the measles and rubella serosurvey, 971 (83%) agreed to participate and were enrolled. Participants were informed that they will only be contacted if they test seronegative for measles and/or rubella antibodies. Overall, 140 individuals enrolled in the survey tested seronegative for IgG antibodies to measles and/or rubella viruses; were provided the reports and informed to seek medical advice. Upon follow up by phone, 10% (14) of the 140 participants reported to have been vaccinated. In this paper we discuss the procedures, experiences and considerations in returning results to participants in a community-based measles and rubella serosurvey. Although the lessons learned are specific to post measles-rubella vaccine campaign serosurvey in India, they might be helpful to those contemplating sharing results to participants of large scale survey settings.

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Rapid diagnostic tests to address challenges for global measles surveillance

Cited by 34 publications

References 31 publications

Vaccination strategies for measles control and elimination: time to strengthen local initiatives

Vaccination strategies for measles control and elimination: time to strengthen local initiatives

Use of a rapid digital microfluidics-powered immunoassay for assessing measles and rubella infection and immunity in outbreak settings in the Democratic Republic of the Congo

Experiences of sharing results of community based serosurvey with participants in a district of Maharashtra, India

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