Measles is one of the many child killer diseases snatching children from the warm embrace of their mothers. In Nigeria, there is a high rate of child mortality and measles is a major contributor. JOYCE REMI-BABAYEJU examines the rationale behind the upcoming National Measles Vaccination Campaign.
MEASLES is one of the deadliest viruses that affect and cuts short the lives of millions of children worldwide. This is evident in outbreaks of measles across the world, particularly in low and medium incomes countries like Nigeria Africa and Asian countries.
Measles is one viral disease that is no respecter of persons or even economies, as an epidemic could spread across country boarders. Apart from being found in African continent, it also ravages civilised societies such as the United Satates of America and the likes.
Measles kills, at least, 145,700 under – five children worldwide yearly. It has been medically proven to be a human viral disease that hangs in the air for as long as it could be contracted by unprotected population of under-five children. The only antidote to measles is the measles vaccines which is safe and cost effective to protect children, especially the under-fives from early mortality.
According to the World Health Organization, WHO, measles is a highly contagious viral disease and it remains an important cause of death among young children globally, despite the availability of a safe and effective vaccine. It remains an important cause of death among young children globally, despite the availability of a safe and effective vaccine.
Under the Global Vaccine Action Plan, measles and rubella are targeted for elimination in five WHO Regions by 2020.
Measles is transmitted via droplets from the nose, mouth or throat of infected persons. Initial symptoms, which usually appear 10–12 days after infection, include high fever, a runny nose, bloodshot eyes, and tiny white spots on the inside of the mouth. Several days later, a rash develops, starting on the face and upper neck and gradually spreading downwards.
Severe measles is more likely among poorly nourished children, especially those with insufficient vitamin A, or whose immune systems have been weakened by HIV/AIDS or other diseases. The most serious complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhoea and related dehydration, and severe respiratory infections such as pneumonia.
It has been proven that Routine measles vaccination for children, combined with mass immunisation campaigns in countries with low routine coverage, are key public health strategies to reduce global measles deaths.
Global measles deaths have decreased by 79 percent worldwide in recent years — from 651,600 deaths in 2000 to 134,200 in 2015. Measles is still common in many developing countries, particularly in parts of Africa and Asia.
An estimated 9.7 million children were affected by measles in 2015. At least 95% of measles deaths occur in countries with low per capita incomes and weak health infrastructures.
In a few days, the National Primary Health Care Development Agency, NPHCDA, will commence the National Measles Campaign across the country apparently to war against another outbreak of the disease in unprotected communities.
The Executive Director of the NPHCDA, Dr. Faisal Shuaib at a press briefing on the 2017/ 2018 Measles Vaccination Campaign had raised alarm about the measles burden on the country and government’s plan to mitigate it across the country via a Measles Vaccination Campaign in this last quarter of the year 2017 to the first quarter of 2018.
Faisal said, ‘’ Measles is one of the leading causes of deaths among children, especially children under five years old. The high burden of deaths from measles is in spite of the availability of safe and effective vaccines through our routine immunisation system.’’
Still, Faisal noted that Nigeria still accounts for a significantly high measles burden despite successes achieved in the reduction of measles morbidity and mortality via interventions like immunization of children.
According to the NPHCDA boss, Nigeria has experienced an increased number of measles outbreaks from 166 affecting 140 Local Government Areas to 183 affecting 158 LGAs in 2015 and 2016 respectively.
Speaking further, he said surveillance data from the agency shows that there was a steady increase in measles incidence among children under five years in the Northern part of the country from 190 million in 2014 to 52 million in 2016.
The trend of measles caseloads among children of five years and children aged from 5 and less than 10 years in the North has been rising steadily since 2014, cumulating in 79.4% and 19.1% respectively in 2016.
In the Sothern states of the Federation, though the incidence decreased from 111 million in 2014 to 11 million in 2016, the incidence is still above the desired less than 5 per million populations.
Summarily, the proportion of measles cases among the under five is 59.4% and 5-10 years is 18.7%.
Also due to low routine measles immunisation coverage and low follow up mechanism in 2013 which was 74% and 2015 put at 84.5% have resulted in a population immunity profile that has allowed increased transmission of measles virus among children under the age of 10.
Also insurgency in the North-East region of the country has created a lot of gaps in immunization exercise coupled with movements of Internally Displaced Persons, IDPs.
The polio outbreak recorded which truncated the nation’s polio free status was found in IDP camps in Borno State. This was a very devastating setback for Nigeria, Africa and the rest of the world. Nigeria, no doubt, has experienced a number of measles disease outbreaks and it seems that there is no hope at the end of the tunnel of interventions.
Although Nigeria was almost certified as a polio- free nation before the outbreak in Borno State, the number of disease outbreaks in the country is still counting, especially Lassa fever, Ebola, and now Monkeypox.
The current outbreak of Monkeypox and subsequent vaccination exercises carried out by the military and the Federal Government is met by opposition.
In some parts of the country where vaccination is ongoing, there are media reports of outright rejection with malicious falsehood that vaccines are harmful to children and that the military medical intervention at this time could be very sad and counterproductive.
Measles campaign at this time in the country is very necessary because of the number of casualties recorded whenever there is an outbreak and we need not wait for such. This is one score point for government with the commencement of vaccination for children at this point in time.
The 2017/2018 Measles vaccination campaign is necessary because of the incidence rate and outbreaks of measles among children.
According to the ED of NPHCDA the measles vaccination campaign will focus on children between the ages of 9 to 59 months and it will be implemented in phases from October 2017 to March 2018 with a 95% national coverage target.
The agency has assured the populace that the campaign will commence in all the North West States from October 26 to 31 2017 while the North East will be implemented from February 1 to 6, 2017.
The North Central States will be implemented from February 1 to 6 2018 while all southern states will be implemented from 8th to 13 of March 2018. The agency said as preparations for the measles campaign, it has established a National Measles Technical Committee that would ensure adequate and also engage in training of trainers for the micro planning from national to the ward level.
Government needs to do more sensitisation to dispel and wade-off misconceptions and harmful beliefs on vaccination exercises in the country, especially now before the commencement of the measles vaccination campaign in order to achieve the desired result.