discussion
Despite regional challenges, 11 of the 22 EMR countries (50%) are making progress towards measles elimination, with 4 countries (18%) confirmed to be measles-free. Key characteristics of these four countries include ministries of health committed to measles elimination, maintaining high immunization rates (above 95%), and supporting strong surveillance systems and laboratories. Seven additional countries (Kuwait, Morocco, Palestine, Qatar, Saudi Arabia, Tunisia, and the United Arab Emirates) are close to elimination due to high measles vaccination coverage, low measles incidence, and high-quality surveillance. .
However, 11 EMR member states (50%) are facing conflict or humanitarian crises, preventing them from strengthening immunization systems and prioritizing measles eradication. These challenges have reduced the performance of immunization programs and created measles immunity disparities. Of particular concern are undervaccinated children (children who have not received their second dose of MCV) and undervaccinated children (children who have not received MCV or other vaccines). . These children typically live in difficult-to-reach areas and experience conflict-related insecurity, misinformation, and poor performance of vaccination campaigns. Areas with large numbers of unvaccinated or unvaccinated children are at increased risk of measles outbreaks and measles-related deaths.
In countries with weak health systems and measles immunity disparities, expand coverage of MCV1 and MCV2 and implement high-quality SIAs with a particular focus on reaching high-risk populations, including those living in conflict zones. It is necessary to. Strong global partnerships are needed to work together to build measles immunity and prevent measles deaths through routine immunization services and preventive SIA. However, implementing preventive SIAs in areas experiencing complex humanitarian emergencies requires collaboration between global and regional partners and stakeholders in all aspects of vaccination campaigns for these SIAs to be successful. Strong cooperation is required.
Furthermore, conducting surveillance is difficult in areas with political instability, insecurity, and complex operating environments. This challenge is often compounded by the lack of strong data systems, which prevents data from being used for effective reporting, analysis, and action. As a result, outbreak responses may not be timely and effective. Additionally, poor quality immunization and surveillance data in many countries hampers the ability to assess measles immunity gaps and plan timely campaigns to prevent outbreaks. Overcoming these challenges requires partnerships and support at global, national and local levels to optimize surveillance and ensure rapid detection and response to measles cases and outbreaks.
Limitations
The findings of this report have at least three limitations. First, the quality and consistency of data varies widely across countries, so administrative reporting can be inaccurate. Second, measles cases are underestimated because not all measles patients seek medical care, not all cases are reported or investigated, and the quality of measles surveillance varies by country. There is a possibility. Finally, this report did not consider measles mortality, as few EMR countries monitor or report measles-related deaths.
Implications for public health practice
Following the COVID-19 pandemic, the EMR has seen an increase in measles cases. This was due to inadequate vaccination, widening immunity disparities and poor measles surveillance performance. These countries should continue or increase routine measles vaccination activities and SIAs, and restart efforts to conduct timely case-based surveillance and clinical testing. Supporting countries with weak health systems and reaching undervaccinated and unvaccinated children with two or more doses of MCV is critical to achieving regional measles elimination.
