Measles outbreak in 2018-2019, Madagascar: epidemiology and public health implications

Pan Afr Med J. 2020 Mar 19:35:84. doi: 10.11604/pamj.2020.35.84.19630. eCollection 2020.

Abstract

Introduction: In October 4th, 2018, a measles outbreak was declared in Madagascar. This study describes the epidemiology of the outbreak and determines public health implications for measles elimination in Madagascar.

Methods: Data have been collected using line list developed for the outbreak. Serum samples were collected within 30 days of rash onset for laboratory testing; confirmation was made by detection of measles immunoglobulin M (IgM) antibody.

Results: A total of 2,930 samples were analysed in the laboratory among which 1,086 (37%) were laboratory confirmed. Measles cases age ranged from a minimum of 1 month to a maximum of 88 years. The median and the mean were 7 years and 9 years respectively. Children between 1 to 9 years accounted for 50.6% of measles cases. Attack rate (39,014 per 1,000,000 inhabitants) and case fatality rate (1.2%) were highest among children aged 9-11 months. A total of 67.2% cases were unvaccinated. As of March 14th, 2019, all the 22 regions and 105 (92%) health districts out of 114 were affected by the measles outbreak in Madagascar.

Conclusion: Measles outbreak in Madagascar showed that the country is not on the track to achieve the goal of measles elimination by 2020.

Keywords: Madagascar; Measles; epidemiology; outbreak.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Disease Outbreaks*
  • Female
  • Humans
  • Immunoglobulin M / blood
  • Infant
  • Madagascar / epidemiology
  • Male
  • Measles / epidemiology*
  • Measles / prevention & control
  • Measles Vaccine / administration & dosage*
  • Middle Aged
  • Public Health*
  • Young Adult

Substances

  • Immunoglobulin M
  • Measles Vaccine