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24-04-2012 | General practice | Article

Global measles mortality has dropped, but still room for improvement

Abstract

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MedWire News: Mortality from measles has decreased dramatically between 2000 and 2010, but rates could still be improved, show study results.

In 2008, the World Health Organization (WHO) set a target for a 90% reduction in measles mortality from 2000 by 2010.

The results from the current study, published in The Lancet, show that while measles mortality decreased by 74%, from 535,300 deaths in 2000 to 139,300 deaths in 2010, the hoped-for decrease of 90% was not reached.

Regionally, measles mortality decreased by more than 75% in all WHO regions except for Southeast Asia.

When measles mortality per country was assessed, Strebel and team found that 47% and 36% of the measles mortality in 2010 occurred in India and in the WHO Africa region, respectively.

Interestingly, the 36% rate for Africa in 2010 had decreased from 63% in 2000, but had increased significantly in India from a rate of 16% in 2000 to 47% in 2010.

Peter Strebel (WHO, Geneva, Switzerland) believe that the high measles mortality figures for India and Africa in 2010 may be due to the comparatively low vaccine coverage in the two countries of 74% and 76%, respectively.

In the same year, vaccine coverage in the Eastern Mediterranean, Europe, the Western Pacific, and the Americas was significantly higher with estimated rates of 85%, 95%, 97%, and 93%, respectively. The vaccine coverage in India and Africa was also substantially lower than the global average of 85%.

"Despite rapid progress in measles control from 2000 to 2007, delayed implementation of accelerated disease control in India and continued outbreaks in Africa stalled momentum towards the 2010 global measles mortality reduction goal," explain Strebel and team.

"Intensified control measures and renewed political and financial commitment are needed to achieve mortality reduction targets and lay the foundation for future global eradication of measles," they emphasize.

Writing in a linked commentary, Walter Orenstein (Emory University, Atlanta, Georgia, USA) and Alan Hinman (Center for Vaccine Equity, Task Force for Global Health, Decatur, Georgia, USA), comment: "Measles eradication is biologically feasible and while no formal eradication goal has yet been set, progress on the mortality reduction goal will lead to consideration for an eradication goal."

They add: "What is most needed is not more sophisticated ways to estimate mortality, but to measure mortality directly. As measles is considered for eradication, it will be critical to improve surveillance to the point that deaths and cases will actually be measured, not estimated."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Helen Albert

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