Progress towards elimination of measles in Kenya, 2003-2016

Abstract

INTRODUCTION: Measles is targeted for elimination in the World Health Organization African Region by the year 2020. In 2011, Kenya was off track in attaining the 2012 pre-elimination goal. We describe the epidemiology of measles in Kenya and assess progress made towards elimination. METHODS: We reviewed national case-based measles surveillance and immunization data from January 2003 to December 2016. A case was confirmed if serum was positive for anti-measles IgM antibody, was epidemiologically linked to a laboratory-confirmed case or clinically compatible. Data on case-patient demographics, vaccination status, and clinical outcome and measles containing vaccine (MCV) coverage were analyzed. We calculated measles surveillance indicators and incidence, using population estimates for the respective years. RESULTS: The coverage of first dose MCV (MCV1) increased from 65% to 86% from 2003-2012, then declined to 75% in 2016. Coverage of second dose MCV (MCV2) remained 50% since introduction in 2013. During 2003-2016, 26,188 suspected measles cases were reported, with 9043 (35%) confirmed cases, and 165 deaths (case fatality rate, 1.8%). The non-measles febrile rash illness rate was consistently 2/100,000 population, and ?80% of the sub-national level investigated a case in 11 of the 14 years. National incidence ranged from 4-62/million in 2003-2006 and decreased to 3/million in 2016. The age specific incidence ranged from 1-364/million population and was highest among children aged 1 year. CONCLUSION: Kenya has made progress towards measles elimination. However, this progress remains at risk and the recent declines in MCV1 coverage and the low uptake in MCV2 could reverse these gains.

Keywords

• measles
• surveillance
• elimination
• kenya