The Pan African Medical Journal (Mar 2020)

Measles outbreak in 2018-2019, Madagascar: epidemiology and public health implications

  • Marcellin Mengouo Nimpa,
  • Jean Claude Andrianirinarison,
  • Vincent Dossou Sodjinou,
  • Alfred Douba,
  • Yolande Vuo Masembe,
  • Fidiniaina Randriatsarafara,
  • Christiane Bodohanta Ramamonjisoa,
  • Armand Solofoniaina Rafalimanantsoa,
  • Richter Razafindratsimandresy,
  • Charlotte Faty Ndiaye,
  • Julio Rakotonirina

DOI
https://doi.org/10.11604/pamj.2020.35.84.19630
Journal volume & issue
Vol. 35, no. 84

Abstract

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INTRODUCTION: In October 4th, 2018, a measles outbreak was declared in Madagascar. This study describes the epidemiology of the outbreak and determines public health implications for measles elimination in Madagascar. METHODS: data have been collected using line list developed for the outbreak. Serum samples were collected within 30 days of rash onset for laboratory testing; confirmation was made by detection of measles immunoglobulin M (IgM) antibody. RESULTS: a total of 2,930 samples were analysed in the laboratory among which 1,086 (37%) were laboratory confirmed.Measles cases age ranged from a minimum of 1 month to a maximum of 88 years. The median and the mean were 7 years and 9 years respectively. Children between 1 to 9 years accounted for 50.6% of measles cases. Attack rate (39,014 per 1,000,000 inhabitants) and case fatality rate (1.2%) were highest among children aged 9-11 months. A total of 67.2% cases were unvaccinated. As of March 14th, 2019, all the 22 regions and 105 (92%) health districts out of 114 were affected by the measles outbreak in Madagascar. CONCLUSION: measles outbreak in Madagascar showed that the country is not on the track to achieve the goal of measles elimination by 2020.

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