Evaluating measles vaccination coverage in high incidence areas of the Western Cape Province, following the mass vaccination campaign

Master Thesis


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University of Cape Town

Measles virus is known to be one of the most contagious of infectious agents and despite considerable progress towards elimination, a number of Sub-Saharan African countries experienced epidemics in 2009-2011, including South Africa, in which there were over 18 000 confirmed cases. The South African measles vaccination programme started in 1975 with 1 dose schedule, and from 1996-8 has followed the World Health Organization-United Nations Children’s Fund strategy. This includes a 2 dose routine vaccination schedule for children at 9 and 18 months of age, supplementary mass vaccination campaigns (MVCs) for children conducted 4 yearly, improved case management and casebased laboratory surveillance. Administrative monitoring of routine vaccination coverage is problematic, and often overestimated, because of denominator and numerator inaccuracies. The potential for a significant outbreak in the Western Cape Province was therefore not recognized. Over 2000 cases were confirmed in the Western Cape epidemic which began in September 2009 and peaked in March 2010. The Metropole district was mainly affected and over 60% of the cases were under 5 years of age, with 29% aged 6 to 11 months. A MVC, against measles had already been planned; however as a result of the epidemic the targeted age group for measles vaccination was extended from 9 to 59 months, to include children from 6 months to 15 years. This was conducted nationally from 12 to 23 April 2010.

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