creators_name: Bassey, EB creators_name: Moses, AE creators_name: Udo, SM creators_name: Umo, AN creators_id: bassey69@yahoo.com editors_name: Kakkilaya, Srinivas editors_id: Kakkilaya BS type: journale datestamp: 2010-09-13 03:53:32 lastmod: 2011-03-11 08:57:43 metadata_visibility: show title: The Impact of Immunization Control Activities on Measles Outbreaks in Akwa Ibom State, South-South, Nigeria ispublished: pub subjects: OJHAS full_text_status: public keywords: Measles vaccination, measles-specific IgM, Akwa Ibom state abstract: Background: The increase of vaccination rates means that fewer children will be vulnerable to vaccine preventable diseases such as measles, which will invariably result in a drop in the infant mortality and morbidity rates. Objective: To assess the impact of the implementation of measles reduction strategies from 2006 to 2008 using the quarterly national program for immunization (NPI) in Akwa Ibom state, Nigeria. Method: Following informed consent, individuals presenting with febrile rash illnesses were routinely bled and tested for measles specific IgM using commercially available ELISA kit-MV-ELISA (Enzygnost; Behring Diagnostics, Marburg, Germany) in accordance with the manufacturer’s instructions. Results: A total of four hundred and four individuals comprising of 216 vaccinated and 188 unvaccinated, presenting with febrile rash illness were screened for measles specific IgM antibodies as indication of active infection between January 2006 and December 2008 out of which 122 (30.2%) had detectable levels of measles antibodies. Among the vaccinated and unvaccinated groups, 32 (14.8%) and 90 (47.9%) respectively were detected with measles IgM antibodies. The highest and lowest antibody levels were detected in 2006 (vaccinated: 54.7%; unvaccinated: 78.4%) and 2008 (vaccinated: 1.2%; unvaccinated: 12%) respectively. The distribution of measles burden by year show an overall decline in prevalence from 70% in 2006, 8.9% in 2007 to 3.7% in 2008. While, children under the age of 5 similarly had a decline in measles incidence of 73.3%, 10.7% and 3.3% respectively. Sex distribution of infection within the 3-year period shows that more females (37.4%) than males (21.2%) expressed measles IgM antibodies, and active infection was detected more in the rural (31.4%) than urban area (27.7%). However, findings indicate a tremendous decline in active infection in the rural areas from 67% in 2006 to 0% in 2008, and in the urban areas from 78% in 2006 to 9.3% in 2008 among both vaccinated and unvaccinated groups. A highly significant reduction in measles infection was observed more among males than females (P=0.009). Infection distribution by location did not show any significant difference (P=0.65) even though more individuals in the rural areas were noted with active infection. Conclusion: The study shows a highly significant reduction in measles burden among vaccinated individuals (P=0.0001) and invariably increases protective coverage of measles vaccination most especially among children under 5 years of age (P=0.0066) in the state. Findings justify effort by government and WHO in carrying immunization campaigns in children, 5-years and below irrespective of vaccination status and experience. date: 2010-07-30 date_type: published publication: Online Journal of Health and Allied Sciences volume: 9 number: 1 publisher: Dr. B.S. Kakkilaya refereed: TRUE referencetext: 1. Akramuzzaman SM, Cutts FT, Hossain MJ et al. Measles vaccine effectiveness and risk factors for measles in Dhaka, Bangladesh. Bull World Health Organ 2002;80(10):776-782. 2. Jani JV, Holm-Hansen C, Mussá T et al. Assessment of measles immunity among infants in Maputo City, Mozambique. BMC Public Health 2008;8:386. doi:10.1186/1471-2458-8-386 3. 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Measles antibody levels in children of rural and urban areas of Nigeria following vaccination campaign. Epidemiology and infection. 1987;99:85-9. citation: Bassey, EB and Moses, AE and Udo, SM and Umo, AN (2010) The Impact of Immunization Control Activities on Measles Outbreaks in Akwa Ibom State, South-South, Nigeria. [Journal (On-line/Unpaginated)] document_url: http://cogprints.org/6989/1/2010-1-3.pdf