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EndNote
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Assessment of the Epidemiology and Burden of Measles in Southern Mozambique
Inácio Mandomando
Inácio Mandomando
Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique; Barcelona Centre for International Health Research (CRESIB), Hospital Clínic/IDIBAPS, Universitat de Barcelona, Spain; Center for Vaccine Development (CVD), University of Maryland School of Medicine, Baltimore, Maryland; Direcção Nacional da Saúde, Ministério da Saúde, Maputo, Mozambique
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Denise Naniche
Denise Naniche
Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique; Barcelona Centre for International Health Research (CRESIB), Hospital Clínic/IDIBAPS, Universitat de Barcelona, Spain; Center for Vaccine Development (CVD), University of Maryland School of Medicine, Baltimore, Maryland; Direcção Nacional da Saúde, Ministério da Saúde, Maputo, Mozambique
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Marcela F. Pasetti
Marcela F. Pasetti
Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique; Barcelona Centre for International Health Research (CRESIB), Hospital Clínic/IDIBAPS, Universitat de Barcelona, Spain; Center for Vaccine Development (CVD), University of Maryland School of Medicine, Baltimore, Maryland; Direcção Nacional da Saúde, Ministério da Saúde, Maputo, Mozambique
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Lilian Cuberos
Lilian Cuberos
Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique; Barcelona Centre for International Health Research (CRESIB), Hospital Clínic/IDIBAPS, Universitat de Barcelona, Spain; Center for Vaccine Development (CVD), University of Maryland School of Medicine, Baltimore, Maryland; Direcção Nacional da Saúde, Ministério da Saúde, Maputo, Mozambique
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Sergi Sanz
Sergi Sanz
Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique; Barcelona Centre for International Health Research (CRESIB), Hospital Clínic/IDIBAPS, Universitat de Barcelona, Spain; Center for Vaccine Development (CVD), University of Maryland School of Medicine, Baltimore, Maryland; Direcção Nacional da Saúde, Ministério da Saúde, Maputo, Mozambique
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Xavier Vallès
Xavier Vallès
Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique; Barcelona Centre for International Health Research (CRESIB), Hospital Clínic/IDIBAPS, Universitat de Barcelona, Spain; Center for Vaccine Development (CVD), University of Maryland School of Medicine, Baltimore, Maryland; Direcção Nacional da Saúde, Ministério da Saúde, Maputo, Mozambique
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Betuel Sigauque
Betuel Sigauque
Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique; Barcelona Centre for International Health Research (CRESIB), Hospital Clínic/IDIBAPS, Universitat de Barcelona, Spain; Center for Vaccine Development (CVD), University of Maryland School of Medicine, Baltimore, Maryland; Direcção Nacional da Saúde, Ministério da Saúde, Maputo, Mozambique
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Eusébio Macete
Eusébio Macete
Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique; Barcelona Centre for International Health Research (CRESIB), Hospital Clínic/IDIBAPS, Universitat de Barcelona, Spain; Center for Vaccine Development (CVD), University of Maryland School of Medicine, Baltimore, Maryland; Direcção Nacional da Saúde, Ministério da Saúde, Maputo, Mozambique
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Delino Nhalungo
Delino Nhalungo
Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique; Barcelona Centre for International Health Research (CRESIB), Hospital Clínic/IDIBAPS, Universitat de Barcelona, Spain; Center for Vaccine Development (CVD), University of Maryland School of Medicine, Baltimore, Maryland; Direcção Nacional da Saúde, Ministério da Saúde, Maputo, Mozambique
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Karen L. Kotloff
Karen L. Kotloff
Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique; Barcelona Centre for International Health Research (CRESIB), Hospital Clínic/IDIBAPS, Universitat de Barcelona, Spain; Center for Vaccine Development (CVD), University of Maryland School of Medicine, Baltimore, Maryland; Direcção Nacional da Saúde, Ministério da Saúde, Maputo, Mozambique
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Myron M. Levine
Myron M. Levine
Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique; Barcelona Centre for International Health Research (CRESIB), Hospital Clínic/IDIBAPS, Universitat de Barcelona, Spain; Center for Vaccine Development (CVD), University of Maryland School of Medicine, Baltimore, Maryland; Direcção Nacional da Saúde, Ministério da Saúde, Maputo, Mozambique
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Pedro L. Alonso
Pedro L. Alonso
Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique; Barcelona Centre for International Health Research (CRESIB), Hospital Clínic/IDIBAPS, Universitat de Barcelona, Spain; Center for Vaccine Development (CVD), University of Maryland School of Medicine, Baltimore, Maryland; Direcção Nacional da Saúde, Ministério da Saúde, Maputo, Mozambique
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Measles has been a major killer among vaccine-preventable diseases in children < 5 years of age in developing countries. Despite progress in global efforts to reduce mortality, measles remains a public health problem. Hospital-based measles surveillance was conducted in Manhica, Mozambique (July 2001–September 2004). Suspected cases and community-based controls were enrolled, and blood was collected for immunoglobulin M (IgM) confirmation. Two hundred fifty-three suspected cases and 477 controls were enrolled, with 85% (216 of 253) cases reported during a measles outbreak. Measles-IgM confirmation was 30% among suspected cases and 5% in controls. Fifty-eight percent (14 of 24) of laboratory-confirmed cases had records indicating previous measles vaccination. Mortality was 3% (8 of 246) among cases and 1% among controls (6 of 426). Forty-five percent (33 of 74) of cases were < 24 months of age and 22% occurred in infants < 9 months of age and were associated with a high case-fatality rate (25%). Our data suggest that improved diagnostics, new tools to protect infants < 9 months of age, and a supplemental dose of measles vaccine could assist measles control.
Author Notes
Financial support: This project was supported by grants from the Bill & Melinda Gates Foundation to Myron Mike Levine. Denise Naniche was supported by a grant from the Spanish Ministry of Education and Health (Ramon y Cajal).
Authors' addresses: Inácio Mandomando, Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique and Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique, E-mails: inacio.mandomando@manhica.net or imandomando2004@yahoo.com.br. Denise Naniche, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic/IDIBAPS, Universitat de Barcelona, Barcelona, Spain, E-mail: dsuzanne@clinic.ub.es. Marcela F. Pasetti, Center for Vaccine Development (CVD), University of Maryland School of Medicine, Baltimore, MD, E-mail: mpasetti@medicine.umaryland.edu. Lilian Cuberos, Center for Vaccine Development (CVD), University of Maryland School of Medicine, Baltimore, MD, E-mail: lcuberos@hotmail.com. Sergi Sanz, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic/IDIBAPS, Universitat de Barcelona, Barcelona, Spain, E-mail: ssanz@clinic.ub.es. Xavier Valles, Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique, E-mail: xvalles@gmail.com. Betuel Sigaúque, Centro de Investigaçao em Saúde de Manhiça (CISM), Maputo, Mozambique, and Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique, E-mail: betuel.sigauque@manhica.net. Eusebio Macete, Centro de Investigaçao em Saúde de Manhiça, CISM, and Direcção Nacional da Saúde, Ministério da Saúde, Maputo, Mozambique, E-mail: eusebio.macete@manhica.net. Delino Nhalungo, Centro de Investigaçao em Saúde de Manhiça, CISM, Maputo Mozambique, E-mail: delino.nhalungo@manhica.net. Karen L. Kotloff, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, E-mail: kkotloff@medicine.umaryland.edu. Myron M. Levine, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, E-mail: mlevine@medicine.umaryland.edu. Pedro L. Alonso, Centro de Investigaçao em Saúde de Manhiça (CISM), Maputo, Mozambique and Barcelona Center for International Health Research (CRESIB), Hospital Clínic/IDIBAPS, Universitat de Barcelona, Barcelona, Spain, E-mail: palonso@clinic.ub.es.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Stein CE, Birmingham M, Kurian M, Duclos P, Strebel P, 2003. The global burden of measles in the year 2000–a model that uses country-specific indicators. J Infect Dis 187 (Suppl 1): S8–S14.
-
2.
Bryce J, Boschi-Pinto C, Shibuya K, Black RE, 2005. WHO estimates of the causes of death in children. Lancet 365: 1147–1152.
-
3.
Centers for Disease Control and Prevention, 2009. Progress toward measles control—African region 2001–2008. Morb Mortal Wkly Rep 58: 1036–1041. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5837a3.htm. Accessed April 6, 2010.
-
4.
WHO, UNICEF, The World Bank, 2009. State of the World's Vaccines and Immunization. Third edition. Geneva: WHO, 123–126.
-
5.
Zarocostas J, 2007. Mortality from measles fell by 91% in Africa from 2000 to 2006. BMJ 335: 1173.
-
6.
Kouadio IK, Koffi AK, Attoh-Toure H, Kamigaki T, Oshitani H, 2009. Outbreak of measles and rubella in refugee transit camps. Epidemiol Infect 137: 1593–1601.
-
7.
McMorrow ML, Gebremedhin G, van den Heever J, Kezaala R, Harris BN, Nandy R, Strebel P, Jack A, Cairns KL, 2009. Measles outbreak in South Africa, 2003–2005. S Afr Med J 99: 314–319.
-
8.
Grais RF, Dubray C, Gerstl S, Guthmann JP, Djibo A, Nargaye KD, Coker J, Alberti KP, Cochet A, Ihekweazu C, Nathan N, Payne L, Porten K, Sauvageot D, Schimmer B, Fermon F, Burny ME, Hersh BS, Guerin PJ, 2007. Unacceptably high mortality related to measles epidemics in Niger, Nigeria, and Chad. PLoS Med 4: e16.
-
9.
Tapia MD, Sow SO, Medina-Moreno S, Lim Y, Pasetti MF, Kotloff K, Levine MM, 2005. A serosurvey to identify the window of vulnerability to wild-type measles among infants in rural Mali. Am J Trop Med Hyg 73: 26–31.
-
10.
Jani JV, Holm-Hansen C, Mussa T, Zango A, Manhica I, Bjune G, Jani IV, 2008. Assessment of measles immunity among infants in Maputo City, Mozambique. BMC Public Health 8: 386.
-
11.
Moss WJ, Monze M, Ryon JJ, Quinn TC, Griffin DE, Cutts F, 2002. Prospective study of measles in hospitalized, human immunodeficiency virus (HIV)-infected and HIV-uninfected children in Zambia. Clin Infect Dis 35: 189–196.
-
12.
Moss WJ, Fisher C, Scott S, Monze M, Ryon JJ, Quinn TC, Griffin DE, Cutts FT, 2008. HIV type 1 infection is a risk factor for mortality in hospitalized Zambian children with measles. Clin Infect Dis 46: 523–527.
-
13.
Taha TE, Graham SM, Kumwenda NI, Broadhead RL, Hoover DR, Markakis D, van Der Hoeven L, Liomba GN, Chiphangwi JD, Miotti PG, 2000. Morbidity among human immunodeficiency virus-1-infected and -uninfected African children. Pediatrics 106: E77.
-
14.
Cliff J, Simango A, Augusto O, Van Der Paal L, Biellik R, 2003. Failure of targeted urban supplemental measles vaccination campaigns (1997–1999) to prevent measles epidemics in Mozambique (1998–2001). J Infect Dis 187 (Suppl 1): S51–S57.
-
15.
Ministério da Saúde, Mozambique. Governo e parceiros satisfeitos com a campanha nacional de vacinação. Available at: http://www.misau.gov.mz/pt/programas/pav_programa_alargado_de_vacinacao/governo_e_parceiros_satisfeitos_com_os_resultados_da_campanha_nacional_de_vacinacao. Accessed February 15, 2010.
-
16.
Ministério de Saúde, Mozambique, Campanha contra Sarampo, 2005. Available at: http://www.misau.gov.mz/pt/programas/pav_programa_alargado_de_vacinacao. Accessed February 15, 2010.
-
17.
Mandomando IM, Naniche D, Pasetti MF, Valles X, Cuberos L, Nhacolo A, Kotloff KL, Martins H, Levine MM, Alonso P, 2008. Measles-specific neutralizing antibodies in rural Mozambique: seroprevalence and presence in breast milk. Am J Trop Med Hyg 79: 787–792.
-
18.
Jani JV, Jani IV, Araujo C, Sahay S, Barreto J, Bjune G, 2006. Assessment of routine surveillance data as a tool to investigate measles outbreaks in Mozambique. BMC Infect Dis 6: 29.
-
19.
Estimaciones y datos sobre VIH y SIDA, 2007 y, 2001. Available at: http://www.unaids.org/en/media/unaids/contentassets/restore/jc1510_2008_global_report_pp211_234_es.pdf. Accessed March 2, 2010.
-
20.
Scott S, Cumberland P, Shulman CE, Cousens S, Cohen BJ, Brown DW, Bulmer JN, Dorman EK, Kawuondo K, Marsh K, Cutts F, 2005. Neonatal measles immunity in rural Kenya: the influence of HIV and placental malaria infections on placental transfer of antibodies and levels of antibody in maternal and cord serum samples. J Infect Dis 191: 1854–1860.
-
21.
Farquhar C, Nduati R, Haigwood N, Sutton W, Mbori-Ngacha D, Richardson B, John-Stewart G, 2005. High maternal HIV-1 viral load during pregnancy is associated with reduced placental transfer of measles IgG antibody. J Acquir Immune Defic Syndr 40: 494–497.
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