The Impact of Measles on Infant Mortality Rates in Africa

Questions:

1. Describe the global importance of health in your selected article or case study?

2.Describe the intervention to address this infectious disease, its cost-effectiveness, and impact?

3.How could lessons learned from this problem be used to address this same health issue—or a similar health issue—in another location?

Measles is one of the most contagious infant diseases in the world. It ranked amongst the top four of infant killer diseases with acute respiratory infections, malaria, and diarrhea (Jin, 2015). Nearly nine out of ten kids died of measles under the age of five. Malnutrition as well as vitamin A deficiency is biggest reason behind the deaths from this disease (Aliyu, 2015). An estimation of 454,000 deaths due to measles in 2004, nearly 216,000 was recorded in sub-Saharan Africa. The virus of measles spreads through air, attacking surfaces of the body, like lungs, lining of intestines, and the cornea. The infection symptoms include diarrhea and pneumonia. The visible signs include cough, chills fever, runny nose, and redness of lips, rims to the eyes, rashes, and breathing difficulties. Then chances of a child to get infected and died to measles are five to fifteen percent in developing countries but during out breaks the chances are very high. After recovering from this disease they suffer serious health complications throughout their life like blindness, hearing loss, damage to nerve etc (Welaga et al., 2012). Starting of the vaccination program in 1980s makes it a regular practice to vaccinate children in maximum parts of the world and leads to decrease the mortality rate by eighty percent. This practice removes the death causing disease from the largest areas like America, Mongolia, but South Africa and south Asia are still showing the death toll being high. The main reason behind this is lest child visits, this medication is unavailable to so many children of these areas. The sub-Saharan coverage of this vaccine is even lower than other vaccinations like diphtheria, tetanus, and pertussis (Verguet et al., 2012). Only four of fifteen African countries were serving this medication to children lower than one year of age. Measles is a very contagious disease that vaccination should be provided to above ninety percent of the population. At Lower coverage levels, so much susceptible individuals can lead to develop a pool of infection to spread the virus. Ninety per coverage leads to create heard immunity i.e. high immunity levels in a specific community. So many countries have started monitoring campaigns to increase the surveillance of this disease. WHO trained surveillance staffs at district levels and laboratory protocols were created. Most of the funds were different national government budgets. South Africa decided to sponsor its own vaccinisation campaigns with supports from UNICEF, WHO, USCDCP etc (Chen, 2011).  The total cost has not been published but roughly it was estimated to be $1.10 per vaccination. To generate an awareness and demand for vaccination community based mobilizations were implied. Different volunteers and communities were educated as caretakers were employed to aware the population about the importance for measles vaccination and routine immunization.

The Importance of Effective Vaccination Programs

To tackle this situation, an initiative was proposed across the sub-Sahara. Governments of All the measles affected countries started working in Africa to provide immunization to this disease. Basically the Centers for Disease Control and Prevention, the UN Foundation, WHO, UNICEF started implementation of accelerated disease control practices across the continent. Low cost-per-dose vaccine reduces child mortality from measles.  High levels of vaccination should be affordable as well as available in the developing countries, making measles a rare disease in the richest countries.  The cost of this vaccine is not the problem as each vaccine costs very less, with safe injection equipments, other issues such as practice keeps this coverage very low(‘Timing of Measles Immunization and Effective Population Vaccine Coverage’, 2012). Vaccination should be given after the age of nine because kid carries antibodies from their mother till that period. That antibody from the mother protects the baby passively and therefore fails to trigger the active immune responses. The geographical condition of the patient is also an issue because if the patient lives in remote areas where immunisation clinics are mile away then the family cannot make this long journey. By the year 2000, six of the seven African countries had completed the catch up campaigns. In the year 1996, 60000 cases were recorded where as in year 2000 the number comes down to 117, almost hundred percent decrease. The number of reported deaths in measles had been 167 in 1996; which falls down by year 2000 to zero. The Overall measles transmission and deaths is remained at very low levels in the group of seven South African countries since the year 2000.  In most instances, those affected patients have not been immunised, including the children whose parents refuse vaccination on religious basis and others from families where private doctors had advised them to not to participate in the catch-up campaigns. Governments were decided to support the strategy, and also started to support it in parts because the measles vaccinisation is highly cost-effective. The total cost of increasing routine coverage from sixty to eighty percent had been estimated at $2.40 per annum of healthy life gained (‘Measles, mumps and rubella virus vaccine’, 2010).  Interventions that cost less than the gross national income (GNI) per capita for each and every year of healthy life gained were considered to be cost-effective. The seven South African countries involved in this elimination strategy had generally higher incomes sources than in much of the other African nations, although political instability and HIV AIDS have seriously affected much of their economies (Sheikh et al., 2012). While Malawi is notably so much poor, with GNI of just $162 per capita, Namibia, South Africa, and Swaziland have the GNIs of $1,000 per capita. In contrast, the Democratic Republic of the Congo has a GNI of $90 per capita.

Measles is the one of the significant cause for death in southern African countries. The Govt. is taken supportive measures to diminish the gigantism of the death cases from the measles. Measles is a kind of infectious disease that is caused by Measles virus. Mainly children are affected by the disease.

Successful Intervention Strategies to Combat Measles in Africa

Despite of having the specific vaccine the disease killed too many children till now. An effective surveillance program for the disease prevention should be developed and modulated. Continuous health monitoring and epidemiological survey report should be done in a regular interval to overcome the disease affection.

The Govt. should take a medical expert team for working in the endemic regions. The doctors under the special team should always monitor the statistics on the morbidity and mortality pattern of the disease. An intervention program is also constructed by the medical expert team and some experienced community health representatives should be recruited to take the survey concerning the disease. The Government should take the initiatives to provide the emergency medicines and vaccines to the affected people via the community health representative (Crawshaw et al., 2014).

Routine health check-up along with the emergency critical care units is constructed in such a way in the endemic situation; the affected people will get the treatment with rapid action. The ministry of health should build up a conceptual framework to diminish the disease affection. Govt. should provide the emergency medicine and vaccinations to the peoples affected at the early stages of the disease sufferings (‘Five-Year Follow-up of Community Pediatrics Training Initiative’, 2014).

 The inclusive disease surveillance schemes should be formulated to establish a committed highway of information regarding the disease suffering required for anticipation at the community level. In addition to that rapidity of execution should also be considered as relevant issues in reference to the disease occurrence. There is a dreadful need for escalating research infrastructures in the department of emergency medicines and the community health in the hospitals and the health centers as well as various research organizations to build up a research modulation to avert the disease occurrence. In addition to that, a high-quality scheme of directive should be initiated to successful public health outcomes. This kind of initiative declines the exposure to infection throughout enforcement of hygienic conventions like water quality monitoring, slaughterhouse hygiene and also the food protection (‘The Community Part in Health Center Program’, 2014).

Recognition of the health objectives and goals are another relevant strategy to direct the activities of health monitoring system in many countries like United States, ‘The Healthy People 2010’ recommends a straightforward but influential initiative by providing health objectives in a schematic format that facilitates different clusters to merge their endeavor and work as a squad. 

References

Aliyu, I. (2015). Gangrenous peri-orbital cellulitis in Nigerian children with post-measles malnutrition. Sudanese J Ophthalmol, 7(1), 22. doi:10.4103/1858-540x.158994

Chen, W. (2011). Comparison of LiST measles mortality model and WHO/IVB measles model. BMC Public Health, 11(Suppl 3), S33. doi:10.1186/1471-2458-11-s3-s33

Crawshaw, L., Fèvre, S., Kaesombath, L., Sivilai, B., Boulom, S., & Southammavong, F. (2014). Lessons from an Integrated Community Health Education Initiative in Rural Laos. World Development, 64, 487-502. doi:10.1016/j.worlddev.2014.06.024

Five-Year Follow-up of Community Pediatrics Training Initiative. (2014). PEDIATRICS, 134(1), X9-X9. doi:10.1542/peds.2013-3357d

Jin, J. (2015). Measles Vaccination. JAMA, 313(13), 1386. doi:10.1001/jama.2015.1555

Measles, mumps and rubella virus vaccine. (2010). Reactions Weekly, &NA;(1302), 33. doi:10.2165/00128415-201013020-00100

Sheikh, A., Patel, P., Scherzer, L., Neumann, C., Anabwani, G., & Tolle, M. (2012). Measles in HIV-infected children in southern Africa. South African Family Practice, 54(2), 163-166. doi:10.1080/20786204.2012.10874197

Timing of Measles Immunization and Effective Population Vaccine Coverage. (2012). PEDIATRICS, 130(3), X34-X34. doi:10.1542/peds.2012-0132d

The Community Part in Health Center Program. (2014). Am J Public Health, 104(11), 2067-2069. doi:10.2105/ajph.2014.104112067

Verguet, S., Jassat, W., Hedberg, C., Tollman, S., Jamison, D., & Hofman, K. (2012). Measles control in Sub-Saharan Africa: South Africa as a case study. Vaccine, 30(9), 1594-1600. doi:10.1016/j.vaccine.2011.12.123

Welaga, P., Nielsen, J., Adjuik, M., Debpuur, C., Ross, D., & Ravn, H. et al. (2012). Non-specific effects of diphtheria-tetanus-pertussis and measles vaccinations? An analysis of surveillance data from Navrongo, Ghana. Tropical Medicine & International Health, 17(12), 1492-1505. doi:10.1111/j.1365-3156.2012.03093.x