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. 2024 Feb:139:176-182.
doi: 10.1016/j.ijid.2023.12.007. Epub 2023 Dec 18.

Trends of measles in Tanzania: A 5-year review of case-based surveillance data, 2018-2022

Fausta Michael  1 , Mariam M Mirambo  2 , Gerald Misinzo  3 , Omary Minzi  4 , Medard Beyanga  5 , Delphinus Mujuni  1 , Florence S Kalabamu  6 , Elias N Nyanda  7 , Mary Mwanyika-Sando  8 , Daniel Ndiyo  9 , Richard Kasonogo  10 , Abbas Ismail  11 , Andrew Bahati  1 , Farida Hassan  12 , Eliangiringa Kaale  13 , John J Chai  14 , Pricillah Kinyunyi  1 , Furaha Kyesi  1 , Florian Tinuga  1 , Dhamira Mongi  1 , Abdul Salehe  15 , Bonaventura Muhindi  1 , Joseph Mdachi  1 , Richard Magodi  1 , Mwendwa Mwenesi  1 , Honest Nyaki  1 , Betina Katembo  5 , Kelvin Tenga  5 , Magdalena Kasya  5 , Willliam Mwengee  16 , Stephen E Mshana  17
Affiliations

Trends of measles in Tanzania: A 5-year review of case-based surveillance data, 2018-2022

Fausta Michael et al. Int J Infect Dis. 2024 Feb.

Abstract

Objectives: Tanzania observed a gradual increase in the number of measles cases since 2019 with a large outbreak recorded during 2022. This study describes the trend of measles in Tanzania over a 5-year period from 2018-2022.

Methods: This was a descriptive study conducted using routine measles case-based surveillance system including 195 councils of the United Republic of Tanzania.

Results: Between 2018 and 2022 there were 12,253 measles cases reported. Out of 10,691 (87.25%) samples tested by enzyme-linked immunosorbent assay, 903 (8.4%) were measles immunoglobulin M positive. The highest number of laboratory-confirmed measles cases was in 2022 (64.8%), followed by 2020 (13.8%), and 2019 (13.5%). Out of 1279 unvaccinated cases, 213 (16.7%) were laboratory-confirmed measles cases compared to 77/723 (10.6%) who were partially vaccinated and 71/1121 (6.3%) who were fully vaccinated (P < 0.001). Children aged between 1-4 years constituted the most confirmed measles cases after laboratory testing, followed by those aged 5-9 years. There was a notable increase in the number of laboratory-confirmed measles cases in children <1 year and 10-14 years during 2022 compared to previous years. The vaccination coverage of the first dose of measles-containing vaccine (MCV1) was maintained >90% since 2013 while MCV2 increased gradually reaching 88% in 2022.

Conclusions: Accumulation of susceptible children to measles due to suboptimal measles vaccination coverage over the years has resulted in an increase in the number of laboratory-confirmed measles cases in Tanzania with more cases recorded during the COVID-19 pandemic. Strengthening surveillance, routine immunization, and targeted strategies are key to achieving the immunity levels required to interrupt measles outbreaks.

Keywords: Measles; Outbreaks; Tanzania.

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Conflict of interest statement

Declaration of competing interest The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Trends of reported fever and rash illness (FRI) cases and confirmed measles cases from 2018-2022. The number of reported FRI cases (measles suspected cases) is indicated in pink, the actual number of FRI cases that were tested for measles confirmation in the laboratory is indicated in green, and the number of confirmed measles cases is indicated in red. The number of reported and tested FRI cases is plotted in the left ordinate (y-axis) while the number of confirmed measles cases is plotted in the right ordinate (y-axis).
Figure 2
Figure 2
Geographical distribution of laboratory-confirmed and epidemiologically-linked cases, January 2018-December 2022. The laboratory-confirmed measles cases are indicated by red dots; the epidemiologically linked cases are indicated by blue dots. Boundaries between councils are indicated by grey lines.
Figure 3
Figure 3
Age group distribution of laboratory-confirmed measles cases in 2018-2022.
See this image and copyright information in PMC

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