A review of data on measles cases from sentinel surveillance sites in north-western Nigeria.

This review was carried out to evaluate the impact of the revised Expanded Programme on Immunisation (EPI) against measles in the six north-western states of Nigeria through the sentinel surveillance system. The revised EPI was launched in all states by 1985, with a strategy of phased acceleration to reach all local government areas by 1987, and to achieve 80% vaccine coverage of children under two years, with 50% reduction in EPI disease morbidity by 1990. Results of the review showed a dramatic decrease in measles cases in each state: 70% overall from 1985 to 1988. Of 918 cases with known measles vaccination status, 90.6% were unvaccinated and 9.4% had documented immunisation. One concern is that 19% of cases occur in unimmunised infants under nine months. Although a suitable vaccine for children under nine months is available, it is not yet in use in Nigeria and these cases are therefore not preventable. At present, our best strategy is to increase coverage through a vigorous EPI campaign, concentrating on underserviced and hard-to-reach areas, and to strengthen surveillance so that measles outbreaks are identified early and action taken.