Field evaluation of measles vaccine effectiveness among children in the Democratic Republic of Congo |
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| Institution: | 1. Texas Children''s Center for Vaccine Development, Baylor College of Medicine, Houston, TX, USA;2. Médecins Sans Frontières, Rio de Janeiro, Brazil;3. Center for Sustainable Development, Columbia University, New York, NY, USA;4. Koc University Research Center for Infectious Diseases, Istanbul, Turkey;5. University of the West Indies, Mona, Kingston, Jamaica;6. Nuffield Department of Medicine, Jenner Institute, Oxford University, Oxford, UK;7. Middle East Technical University, Ankara, Turkey;8. College of Medicine, King Saud University, Riyadh, Saudi Arabia;9. Christian Medical College, Vellore, India;10. PATH Essential Medicines, PATH, WA, USA;11. International Vaccine Institute, Seoul, South Korea;12. University of Houston College of Medicine, Houston, TX, USA;13. London School of Hygiene and Tropical Medicine, London, UK;14. Institute of Social and Preventive Medicine, University of Bern, Switzerland;15. ISGlobal-Barcelona Institute for Global Health-Hospital Clinic-University of Barcelona, Spain;p. University of North Carolina, Gillings School of Global Public Health, Chapel Hill, NC, USA;q. Johns Hopkins University School of Medicine, Baltimore, MD, USA;r. Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany;s. Center for Vaccine Development, Bamako, Mali;t. University of Maryland, MD, USA;u. Drugs for Neglected Diseases Initiative, Geneva, Switzerland;v. Center for Global Development, Washington, DC, USA;w. Harvard Medical School, Boston, MA, USA;x. Affiliate Professor, Technology and Operations Management, INSEAD, France |
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| Abstract: | BackgroundLarge-scale measles outbreaks in areas with high administrative vaccine coverage rates suggest the need to re-evaluate measles prevention and control in the Democratic Republic of Congo (DRC). Monitoring of measles Vaccine Effectiveness (VE) is a useful measure of quality control in immunization programs. We estimated measles VE among children aged 12–59 months in the Democratic Republic of Congo (DRC) using laboratory surveillance data from 2010–2012.MethodsWe used the case-based surveillance system with laboratory confirmation to conduct a case-control study using the test negative design. Cases and controls were selected based on presence (n = 1044) or absence (n = 1335) of measles specific antibody IgM or epidemiologic linkage. Risk factors for measles were assessed using unconditional logistic regression, stratified by age.ResultsAmong children 12–59 months, measles vaccination was protective against measles aOR (95% C)], 0.20 (0.15–0.26) and estimated VE was 80% (95% CI 74–85%). Year of diagnosis, 2011: 6.02 (4.16–8.72) and 2012; 8.31 (5.57–12.40) was a risk factor for measles when compared to 2010. Compared to Kinshasa, children in Bas-Congo, Kasai-Oriental, Maniema and South Kivu provinces all had higher odds of developing measles. Measles VE was similar for children 12–23 months and 24–59 months (80% and 81% respectively).ConclusionsRepeated occurrences of measles outbreaks and lower than expected VE estimates suggest the need to further evaluate measles vaccine efficacy and improve vaccine delivery strategies in DRC. |
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| Keywords: | Measles Vaccine effectiveness Immunization Democratic Republic of Congo Vaccine preventable diseases |
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