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. 2019 Aug 22;19(1):1153.
doi: 10.1186/s12889-019-7500-z.

Measles seroprevalence after reactive vaccination campaigns during the 2015 measles outbreak in four health zones of the former Katanga Province, Democratic Republic of Congo

Patrick Keating  1   2 , Antonio Isidro Carrion Martin  3   4 , Alexandre Blake  2 , Pauline Lechevalier  5 , Florent Uzzeni  6 , Etienne Gignoux  2 , Chibuzo Okonta  5 , Céline Langendorf  2 , Sheilagh Smit  7 , Steve Ahuka  8 , Melinda Suchard  7 , Elizabeth Pukuta  8 , Marie-Amélie Degail  2 , Lisa Hansen  1 , Jerry Kibanza-Kyungu  9 , Iza Ciglenecki  6 , Sandra Cohuet  2
Affiliations

Measles seroprevalence after reactive vaccination campaigns during the 2015 measles outbreak in four health zones of the former Katanga Province, Democratic Republic of Congo

Patrick Keating et al. BMC Public Health. .

Abstract

Background: Measles continues to circulate in the Democratic Republic of Congo, and the country suffered from several important outbreaks over the last 5 years. Despite a large outbreak starting in the former province of Katanga in 2010 and the resulting immunization activities, another outbreak occurred in 2015 in this same region. We conducted measles seroprevalence surveys in four health zones (HZ) in the former Katanga Province in order to assess the immunity against measles in children 6 months to 14 years after the 2015 outbreak.

Methods: We conducted multi-stage cluster surveys stratified by age group in four HZs, Kayamba, Malemba-Nkulu, Fungurume, and Manono. The age groups were 6-11 months, 12-59 months, and 5-14 years in Kayamba and Malemba-Nkulu, 6-59 months and 5-14 years in Manono and Fungurume. The serological status was measured on dried capillary blood spots collected systematically along with vaccination status (including routine Extended Program of Immunization (EPI), and supplementary immunization activities (SIAs)) and previous self-reported history of suspected measles.

Results: Overall seroprevalence against measles was 82.7% in Kayamba, 97.6% in Malemba-Nkulu, 83.2% in Manono, and 74.4% in Fungurume, and it increased with age in all HZs. It was 70.7 and 93.8% in children 12-59 months in Kayamba and Malemba-Nkulu, and 49.8 and 64.7% in children 6-59 months in Fungurume and Manono. The EPI coverage was low but varied across HZ. The accumulation of any type of vaccination against measles resulted in an overall vaccine coverage (VC) of at least 85% in children 12-59 months in Kayamba and Malemba-Nkulu, 86.1 and 74.8% in children 6-59 months in Fungurume and Manono. Previous measles infection in 2015-early 2016 was more frequently reported in children aged 12-59 months or 6-59 months (depending on the HZ).

Conclusion: The measured seroprevalence was consistent with the events that occurred in these HZs over the past few years. Measles seroprevalence might prove a valuable source of information to help adjust the timing of future SIAs and prioritizing support to the EPI in this region as long as the VC does not reach a level high enough to efficiently prevent epidemic flare-ups.

Keywords: Democratic Republic of Congo; Immunity; Measles; Seroprevalence; Vaccination.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
National surveillance data in Fungurume, Kayamba, Malemba-Nkulu and Manono from 2011-to 2017, with the vaccination campaigns in 2015 and 2016 indicated with a transparent ribbon
Fig. 2
Fig. 2
Measles seroprevalence among children aged 6 months to 14 years by age group in Kayamba, Malemba-Nkulu, Fungurume and Manono, DRC, 2016. EPI: Extended Programme on Immunization. SIA: Supplementary Immunization Activities. The number at the bottom of the bars indicate the coverage based on card or oral reporting
Fig. 3
Fig. 3
Vaccine coverage by age group, type of vaccination campaign and method of reporting in Kayamba, Malemba-Nkulu, Fungurume and Manono, DRC, 2016*. *Fungurume did not benefit from a recent reactive campaign before the survey. EPI: Extended Programme on Immunization. SIA: Supplementary Immunization Activities. The number at the bottom of the bars indicate the coverage based on card or oral reporting
Fig. 4
Fig. 4
Past measles history by age group, time and place of diagnosis in Kayamba, Malemba-Nkulu, Fugurume, Manono, DRC, 2016. HC: Health Centre. EPI: Extended Programme on Immunization. SIA: Supplementary Immunization Activities. The number at the bottom of the bars indicate the coverage based on card or oral reporting
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