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. 2017 Jun;37(6):1096-1107.
doi: 10.1111/risa.12669. Epub 2016 Jul 20.

The World Health Organization Measles Programmatic Risk Assessment Tool-Romania, 2015

Jennifer L Kriss  1 , Aurora Stanescu  2 , Adriana Pistol  2 , Cassandra Butu  3 , James L Goodson  1
Affiliations

The World Health Organization Measles Programmatic Risk Assessment Tool-Romania, 2015

Jennifer L Kriss et al. Risk Anal. 2017 Jun.

Abstract

Despite global improvement in annual measles incidence and mortality since 2000, progress toward elimination goals has slowed. The World Health Organization (WHO) European Region (EUR) established a regional goal for measles and rubella elimination by 2015. Romania is one of 13 EUR countries in which measles remains endemic. To identify barriers to meeting programmatic targets and to aid in prioritizing efforts to strengthen measles elimination strategy implementation, the WHO and U.S. Centers for Disease Control and Prevention developed a measles programmatic risk assessment tool that uses routinely collected data to estimate district-level risk scores. The WHO measles programmatic risk assessment tool was used to identify high-risk areas in order to guide measles elimination program activities in Romania. Of the 42 districts in Romania, 27 (64%) were categorized as very high or high risk. Many of the very-high-risk districts were clustered in the western part of the country or were clustered around the capital Bucharest in the southeastern part of the country. The overall risk scores in the very-high-risk districts were driven primarily by poor surveillance quality and suboptimal population immunity. The measles risk assessment conducted in Romania was the first assessment to be completed in a European country. Annual assessments using the programmatic risk tool could provide valuable information for immunization program and surveillance staff at the national level and in each district to guide activities to enhance measles elimination efforts, such as strengthening routine immunization services, improving immunization campaign planning, and intensifying surveillance.

Keywords: Elimination; Romania; measles; outbreak; risk assessment.

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Conflict of interest statement

Declaration of interests: None of the authors have a commercial or other financial interest associated with the information presented in this article.

Figures

Fig. 1.
Fig. 1.
Reported measles cases and estimated coverage with MCV1 and MCV2—Romania, 1980–2014. Source: WHO vaccine-preventable diseases: monitoring system 2015 global summary. WHO/UNICEF coverage estimates & official country estimates, Sep 2015. WHO/UNICEF coverage estimates are shown. Neither WHO-UNICEF nor country estimates available where line not shown NA = Data not available.
Fig. 2.
Fig. 2.
Overall risk score breakdowns of very-high-risk districts by risk category—Romania, 2012–2014.
Fig. 3.
Fig. 3.
Overall risk score breakdowns of high-risk districts by risk category—Romania, 2012–2014.
See this image and copyright information in PMC

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