Thilaka Chinnayah
Ministry of Health Malaysia
Title: ELIMINATION OF MEASLES IN MALAYSIA BY 2018: HOW CLOSE ARE WE?
Biography
Biography: Thilaka Chinnayah
Abstract
Measles Elimination Programme (MEP) in Malaysia was started in 2004 and targeted elimination by 2010. However, this target has not achieved and revised target was set as 2018. Study was carried out to determine the progress made towards the elimination of measles and factors affecting it.
By multistage stratification, we identified four to eight facilities from two districts (urban and rural) respectively, from each of seven states in all regions of country. Secondary data from 2006-2016 measles surveillance system were analyzed from web based reporting system (e-notification and e-measles). Outbreak reports, vaccine coverage at States, Districts and Health Centers were reviewed and personnel involved in measles surveillance and vaccination programme were interviewed. MEP Surveillance indicators for year 2016 were assessed.
Incidence of measles in 2016 was 3 per million populations (target 1/1million) with cyclical peak reported every 3–4 years. No gender differences among the cases. Measles were high in ≤15 years (76%) and among them 29% were children below one year. Fifty percent of the measles cases were not vaccinated. Main reason for non-vaccination being vaccine refusal and on alternative medicine (47%). MCV1 coverage for state and district level was above 95% but some health centers revealed lower coverage (75%-90%). Most of MEP surveillance targets were achieved except for only 72% (target >80%)laboratory results were available within four days of specimen received.
Measles is still endemic in Malaysia and the incidence showed 3-4 years of cyclical peak. Low vaccine coverage at the level of health center and delayed lab result hinder measles elimination. National measles supplementary immunization activity targeting children 1-15 years is recommended focusing on low coverage areas. In addition, a follow-up campaign every three years, strengthening health education on acceptance of vaccination and improving turn over time of laboratory will ensure measles elimination in Malaysia achieved by 2022.