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Vaccine. 2015 Jun 26;33(29):3407-14. doi: 10.1016/j.vaccine.2015.04.067. Epub 2015 Apr 30.

Field evaluation of measles vaccine effectiveness among children in the Democratic Republic of Congo.

Author information

1
Department of Epidemiology, UCLA Fielding School of Public Health, 650 S Charles E Young Drive, Los Angeles, CA 90095, USA. Electronic address: rhdoshi@ucla.edu.
2
Department of Microbiology, Kinshasa School of Medicine, B.P. 127 Kinshasa, Lemba, Kinshasa, Democratic Republic of the Congo. Electronic address: patrickmukadi@gmail.com.
3
Expanded Programme on Immunization, Ave de la Justice, Kinshasa, Democratic Republic of the Congo. Electronic address: shidicalixte5@yahoo.fr.
4
Expanded Programme on Immunization, Ave de la Justice, Kinshasa, Democratic Republic of the Congo. Electronic address: audrymwk@hotmail.fr.
5
Department of Epidemiology, UCLA Fielding School of Public Health, 650 S Charles E Young Drive, Los Angeles, CA 90095, USA. Electronic address: Nhoff84@ucla.edu.
6
Polio Program, Bill and Melinda Gates Foundation, 500 Fifth Avenue North, Seattle, WA 98109, USA. Electronic address: Sue.gerber@gatesfoundation.org.
7
Kinshasa School of Public Health, B.P. 127 Kinshasa, Lemba, Kinshasa, Democratic Republic of the Congo. Electronic address: okitow@yahoo.fr.
8
Division of Disease Control, Ministry of Public Health, Ave de la Justice, Kinshasa, Democratic Republic of the Congo. Electronic address: kebelailunga@gmail.com.
9
National Institute for Biomedical Research, Minister of Public Health, Avenue de la Democratie, Kinshasa, Democratic Republic of the Congo. Electronic address: muyembejj@gmail.com.
10
Department of Epidemiology, UCLA Fielding School of Public Health, 650 S Charles E Young Drive, Los Angeles, CA 90095, USA. Electronic address: arimoin@ucla.edu.

Abstract

BACKGROUND:

Large-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.

METHODS:

We 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.

RESULTS:

Among 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).

CONCLUSIONS:

Repeated 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.

KEYWORDS:

Democratic Republic of Congo; Immunization; Measles; Vaccine effectiveness; Vaccine preventable diseases

PMID:
25937449
DOI:
10.1016/j.vaccine.2015.04.067
[Indexed for MEDLINE]

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