Date: Thu 13 Dec 2018
Source: Midi Madagasikara [online translation, abridged, edited]
With 44 districts, 20 regions and 10,294 affected people, the measles epidemic has reached its peak. The districts of Antananarivo Renivohitra and Ambato Boeny are the most affected. As the stock of vaccine is exhausted except vaccines for infants up to 9 months old already scheduled to be vaccinated in health facilities according to the vaccination schedule, the importation of new vaccine doses is under way.
A milestone of 10 000 cases in all age groups has now been crossed. The measles epidemic affecting children, adolescents and adults hit a large part of the Antananarivo district, with 5971 cases, and that of Ambato Boeny, where 782 cases were recorded. In total, 44 districts in Madagascar are affected by this epidemic, which started about 3 months ago. With 20 affected regions out of 22, the epidemic has spread across the island; the exceptions are the 2 regions of Ihorombe and Anosy.
The resurgence of measles cases is explained by gaps in vaccination. Indeed, the number of children vaccinated at 9 months (the age indicated for vaccination against measles in Madagascar) has been steadily decreasing.
As the number of vulnerable or unvaccinated people is high, so too is the risk of people developing the disease. Since the beginning of the current epidemic, nearly 70% of measles cases are children and adolescents aged 1-14 years, with a clear predominance of unvaccinated people in the age group of less than one year.
Similarly, 55% of all cases are unvaccinated or of unknown vaccination status. "It's only in the face of this growing epidemic that people are realizing the importance of immunization. And yet routine vaccination has for years included that against measles from 9 months. Similarly, Mother and Child Health Week (MSM) is an opportunity to carry out catch-up vaccination," says Dr Manitra Rakotoarivony. Completely free vaccines in public health facilities are accessible to every child from 9-11 months.
Currently, in the face of the epidemic situation, measles vaccines are out of stock for older subjects. According to the Ministry of Public Health, the doses still available are intended only for children who will soon reach the age of 9 months and who are scheduled, according to the appointments already set during their last immunization session, to be soon vaccinated against measles. The health authorities had to use the safety stock to meet the growing needs of the growing epidemic in Antananarivo. However, an import of new batches of vaccines is under way.
Measles is not the only epidemic currently affecting Antananarivo. The current epidemiological situation indicates that the district of Antananarivo Renivohitra is also in a rubella epidemic, as well as 2 other districts, namely Ambanja and Amboasary South, with at least 5 cases per district confirmed in one month.