WHEN Minister of Health, Brian Chituwo, launched the National Measles Vaccination campaign in Lusaka on June 1, his remarks indicated that there had been a steady increase over the years in cases of measles among children.

Dr Chituwo, however, attributed this sad development to low immunisation coverage as some children missed the routine immunisation while malnutrition and HIV had also taken its toll on the disease.

Dr Chituwo indicated that the nation had yet decided to take another national measles immunisation drive to ensure that all children under the age of five years were vaccinated against the disease that they were free from it.

The Health minister observed that measles was a highly contagious and killer disease which was predominant among children under the age of five years.

Measles can also lead to pneumonia, blindness, can precipitate malnutrition in a child that had previously been well and can even cause death.

This year's national vaccination exercise starts from July 9 to July 14 and will be complemented with vitamin A supplementation and deworming, with the Government targeting about two million children aged between nine months to five years.

Deworming, which promotes good nutrition and health, will be administered to children aged one to five years targeting 1.8 million.

FUNDING

The total cost of the measles campaign for 2007 has been pegged at US$3,050,478.

The United Nations, which is a major partner in the campaign through the United Nations Emergency Children's Fund (UNICEF), has pledged $1,007,425 and the World Health Organisation (WHO) $510,314.

The Government of Zambia will contribute $182,255 towards the 2007 national measles immunisation campaign while there is still a deficit of $550,000 for which partners and stakeholders have been called upon to enable the campaign to succeed and save the Zambian children from the disease.

According to data made available to the Press by the National Measles Immunisation campaign, in Zambia measles is one of the five major causes of childhood illnesses and deaths.

It contributed significantly to under-five morbidity and mortality during the period 1995 to 2002.

The ministry of Health states that more than 124,256 cases of measles were reported with 38,396 admissions.

The majority of these cases occurred in under-fives and older children and a significant proportion of the rest of the cases were among children aged 5-15 years.

Due to this, a nationwide measles vaccination campaign was conducted in 2003 and over 95 per cent coverage was achieved of the targeted five million children aged between six months and 15 years.

Subsequently, recorded measles deaths reduced to zero in 2004.

But in the period between 2005 and 2006, measles cases began to rise steadily again as a result of low immunisation coverage in some districts and the normal 15 per cent of children who failed to seroconvert, as well as those who were missed by routine immunisation.

The table on outpatients, admissions and cases of fatality as reflected in the year 2002-2006 is as follows:

2002: Outpatient attendance 25,086; outpatient admissions (225); fatality rate (22)

2003: Outpatient attendance 16,793; out patient admissions 98; cases of fatality 11

2004: Outpatient attendance 37; out patient admissions 37; cases of fatality rate 0

2005: Outpatient attendance 48; out patient admissions 48; cases of fatality rate 0

2000: Outpatient attendance 189; outpatient admissions 189; cases of fatality rate 0

From the table above the explanation could be that there had been a decrease in measles outpatient attendance, admissions and fatality rates as recorded between 2002 and 2006.

More than one child out of every 50 reported cases of those who were hospitalised with measles died from the disease.

The actual incidence in the communities is unknown but could be much higher.

A sharp decline was recorded between the period 2003 and 2005, which can be attributed to a steady rise in routine immunisation, and the 2003 national measles immunisation campaign.

However, it was observed that there was a rise in sporadic cases of measles between 2005 and 2006 due to the accumulating number of unprotected children as a result of the combination of the 15 per cent for whom the vaccine did not result in seroconversion and those missed by the routine vaccination campaigns.

Despite the increases in measles cases, there have been recorded achievements in the immunisation programme.

Between 1992 and 2005, measles vaccination coverage increased from 77 per cent to 82 per cent with the Government still committed to supporting the Expanded Programme on immunisation (EPI) and is now contributing to the purchase of vaccines and supplies.

The country successfully carried out a national immunisation measles campaign which resulted in a reduction of cases of mortality and morbidity.

The country also successfully built technical capacity among health workers.

Because of the successful national immunisation campaign Zambia even received an award for exemplary implementation of the campaign in 2003.

For the current immunisation campaign to succeed there is need for a stronger partnership to exist between the Government, UN agencies, other donor partners ,the public and private sectors.

"It is our hope that the partnership will grow even stronger in this measles campaign and in the future," the report says.

Working Towards National Goal

The national goal is to achieve 95-100 per cent measles immunisation coverage for all children less than five years of age and eliminate the occurrence of measles cases in Zambia.

This goal can only be achieved through strengthening routine immunisation and supplemental immunisation campaigns.

It is the Government policy to facilitate sector-wide involvement in public health campaigns such as this one.

Zambian children are vulnerable to vaccine preventable diseases, in particular measles.

Given the current resource constraints in the health sector, it is critical that stakeholders and partners participate through making substantial contributions to the promotion of child health.

It must be noted that the 2003 measles campaign emerged victorious as a result of the significant contributions of all partners and stakeholder's.

The success of the 2007 campaign depends on the partners and stakeholders to again contribute generously for the national measles campaign.

The objective of this year's national measles campaign is to:

-Vaccinate against measles at least 95 per cent of all children aged nine months-59 months (2 million children) regardless of whether they were immunised for measles before or not.

-Provide vitamin A supplementation to at least 90 per cent of children 6 months -59 months of age (2.1 million children).

-Provide mebendazole (deworming) at least 90 per cent of children aged 12 months -59 (1.8 million children)

-Retreat 500,000 mosquito nets in three provinces (western, Southern and North western) involving 15 of the 25 districts where mass ITN distribution took place in 2006.

-Strengthen the partnerships for immunisation between the Government, communities, NGOs, the private sector and development partners.

-Strengthen measles surveillance and improve the use of health information for action.

-Mobilise caretakers to take their children for measles vaccination between 9 and 14 July.

What has been done so far to prepare the country for the national measles campaign is that an inter agency Coordinating Committee had approved, the proposal and the national measles campaign proposal had been submitted to donors for their attention.

Technical planning meetings have been and are still being held.

Measles vaccines , vitamin A supplements and mebendazole for deworming have already been ordered.

In addition there is ongoing production of social mobilisation materials while a social mobilisations planning meeting was held in April.

Others are technical training for central supervisors, provincial facilitators, district trainers, rural health centre staff and volunteers is scheduled to take place this month.

The partners and donors meeting is scheduled to be held this month as well to generate the additional resources needed for a successful campaign to take place.

A field guide and guidelines for health workers and volunteers will be finalised this month.

The printing, distributing and airing of social mobilisation material will also be part of the programme.

A meeting for media personnel will be held to acquaint them on how the exercise would be carried out throughout the health and vaccination centres and an information pack will be printed for distribution for creation of awareness to the general public.

For the 2007 national measles campaign to succeed and the battle against measles to be won there is need for stakeholders to partner with the Government and the UN agencies in ensuring that all children aged nine months to five years are vaccinated against measles from the nearest health centre or vaccination centre.