Lessons learned from detecting and responding to recurrent measles outbreak in Liberia post Ebola-Epidemic 2016-2017

Introduction: measles is an acute viral disease that remains endemic in much of sub-Sahara Africa, including Liberia. The 2014 Ebola epidemic disrupted an already fragile health system contributing to low uptake of immunization services, population immunity remained low thus facilitating recurrent outbreaks of measles in Liberia. We describe lessons learnt from detecting and responding to recurrent outbreaks of measles two years post the 2014 Ebola epidemic in Liberia.Methods: we conducted a descriptive study using the findings from Integrated Diseases Surveillance and Response (IDSR) 15 counties, National Public Health Institute of Liberia (NPHIL), National Public Health Reference Laboratory (NPHRL) and District Health Information Software (DIHS2) data conducted from October to December, 2017. We perused the outbreaks line lists and other key documents submitted by the counties to the national level from January 2016 to December 2017.Results: from January 2016 to December 2017, 2,954 suspected cases of measles were reported through IDSR. Four hundred sixty-seven (467) were laboratory confirmed (IgM-positive), 776 epidemiologically linked, 574 clinically confirmed, and 1,137 discarded (IgM-negative). Nine deaths out of 1817 cases were reported, a case fatality rate of 0.5%; 49% were children below the age of 5 years. Twenty-two percent (405/1817) of the confirmed cases were vaccinated while the vaccination status of 55% (994/1817) was unknown.Conclusion: revitalization of IDSR contributed to increased detection and reporting of suspected cases of measles thus facilitating early identification and response to outbreaks. Priority needs to be given to increasing the uptake of routine immunization services, introducing a second dose of measles vaccine in the routine immunization program and conducting a high-quality supplementary measles immunization campaign for age group 1 to 10 years to provide protection for a huge cohort of susceptible

Accelerated malaria control towards its elimination in the African Region

Africa is the continent most affected by malaria; accounting for 86of the estimated 247 million malaria episodes and 91of malaria deaths worldwide in 2006. In high endemic countries in the Region; it is estimated that malaria reduces economic growth by an annual average rate of 1.3; mainly as a result of absences from work or school. The poorest people are the most exposed to malaria and its complications owing to their inadequate housing; bad living conditions and limited access to health care. This paper describes ways of accelerating implementation of malaria prevention and control interventions towards eventual elimination. The principal ways forward described are:1 updating malaria policies and strategic plans;2 strengthening national malaria control programmes;3 procuring and supplying quality antimalarial commodities;4 accelerating the delivery of key interventions for universal coverage and impact;5 consolidating malaria control achievements in high endemic countries;6 moving from control to pre-elimination and elimination when appropriate;7 strengthening surveillance; monitoring and evaluation;8 scaling up partnership coordination and alignment as well as resource mobilization; and9 strengthening malaria research