Effect Evaluation Of Measles Control And Prevention In Jining City

Background:Measles is an acute respiratory infectious disease which seriously endangers the child’s physical health, and it’s highly contagious, so it easily leads to outbreaks. With only one serotype of measles virus, the virus has stable antigenicity. Human can produce lasting immunity after infection with measles, and humans are the only host, what’s more, there are safe and effective vaccines to prevent measles, therefore, the Elimination of measles is feasible in theory and technology. Smallpox and Polio are the first and second infectious disease that has been eradicated and will be eradicated respectively by The World Health Organization (hereinafter referred to as WHO) and the next infectious disease to be eliminated by WHO is measles. The successful experience and results of elimination of measles in WHO America region since2000also confirms this. Currently, the WHO Europe region and Eastern Mediterranean region proposed the goal of measles eradication in2007and2010respectively. In2005, all countries in the WHO Western Pacific region including China committed themselves to eradicating measles in2012.Immunization programme refers to the projects, plans and strategies of vaccinating susceptible population with effective vaccines according to national infectious disease prevention and control planning. The implementation of the immunization programme is the main strategy for control and elimination of vaccine against infectious diseases. The measles vaccine is one of the fourteen vaccines that managed by the national immunization program. Keeping high coverage of measles vaccine is a good way to control the spread of measles. Along with the widespread use of measles vaccine, particularly after the implementation of children plan immunity, significant progress was achieved in measles control in Jining city. Compared with the year of1978without the plan immunity, the morbidity and mortality of measles both reduced by more than95%in the1990s in Jining city. In particular, in1995the annual reported incidence of measles dropped to0.65/105which was the lowest level historically.The next few years due to the decline of routine immunization coverage rate in some places and lower sensitivity of monitoring system, the onset of measles rebound, and some places even appeared local outbreaks of measles. Following the national ministry of health and Shandong province, Jining city issued Jining’s measles surveillance programme. After extensive joint effort, the incidence of measles declined to a low level since2000. While in2006Jining city raised the goal of measles eradication in2012.Objectives:To statistics the number of cases, morbidity and mortality of mea sles in different measles control stages since the foundation of Jining city and analyze the relationship with the increasing of vaccination rates. Furthermore, to evaluate the effect of measles control in Jining city, and on the next step to give some suggestions to maintain the low incidence of measles. Methods:Main way of literature. Measles incidence information mainly comes from surveillance data of provinces, cities and counties. Demographic data is provided by the Bureau of statistics, population census, and annual report of immunization program in Jining city. Disease surveillance information is fro m the AFP surveillance system, and later indicator comes from the China dis ease prevention and control system of measles. Coverage monitoring informati on comes from the coverage report of Jining city. We set up the database us ing EXCEL software, and the statistical description was computed by SAS st atistical software. Comparison of incidences and the statistics of surveillance i ndicators are analyzed by χ2test and P value less than0.05is considered to having statistically significant difference. Results:Measles control activities are divided into five phases in Jining city and in five stages the vaccination coverage rate has been at a high level. Th e incidence and mortality declined greatly, and dropped obviously at the early stage. The incidence of measles was very low at the control and elimination of measles phases, meanwhile there were no death cases. In2012the incide nce of measles was less than1/106under our control and measles vaccination coverage reached95%or more. The quality of measles surveillance reach a high level so as to meet eliminate measles requirement. The effect of measles control in Jining city is good specifically reflecting in the following aspects:1. In terms of incidence rate, the incidence has declined gradually for many years, and Jining has obtained the great victory of eliminating measles. Accor ding to the overall goal of measles eradiation, the incidence of measles in Ji ning should be less than1/100in2012. Actually there are only2cases in Ji ning in2012and the incidence is0.23/105(the population was8490000). Acc ording to the annual goal in action plan, the incidence of measles in2010sh ould be at the range of20/106～25/106and the incidence in Jining is10.56/106. The incidence of measles in2011should be at the range of5/106～10/106and the incidence in Jining is3.66/106. The incidence of measles in2012s hould be less than1/106and the incidence in Jining is0.23/106.2. In terms of vaccine coverage rate, the coverage rate has been in a higher level for many years. Especially the coverage rates of the first, second and th ree doses are99.92%(101292/101374),99.90%(104979/105080),99.92%(92732/92803)respectively and have reached the target of action plan which requires95%. We have selected some clinics in which the immunization wor k is weak to investigate the coverage rate, and the entire coverage rate is ov er95%. But work quality is different among counties and some counties still need to improve measles vaccination.3. In terms of surveillance indicators, at the measles elimination stage surveill ance indicators are in good levels, and surveillance quality is good. The cove rage rates of supplementary immunization are over95%in many years except the year of2006(92.26%). CDC can find and investigate cases, collect seru m and make laboratory diagnosis. Epidemiological investigation and specimen collection can be performed in time after a breakout. Jining measles laborato ry certification is assessed by WHO and blind review is carried out with Sha ndong center for disease control and prevention annually.Surveillance quality is good and population immunization level is high.Conclusions:Measles control in Jining city is effective. Both incidence and mortality of measles have declined greatly at five different phases. In Jining city the measles coverage rate is always in high level and the surveillance sy stem keeps working in high quality. In recent years measles incidence has de clined to a very low level and the target of measles eradication in2012has been completed successfully.