Manoochehr Karami1, Seyed Mohsen Zahraei2, Azam Sabouri2, Rambod Soltanshahi2, Azam Biderafsh3, Naser Piri4, Jong-Koo Lee5. 1. Social Determinants of Health Research Center & Department of Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran. 2. Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran. 3. Departments of Social Medicine, Qom University of Medical Sciences, Qom, Iran. abiderafsh@yahoo.com. 4. Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran. 5. Departments of Family Medicine, Seoul National University, College of Medicine, Seoul, Republic of Korea.
Abstract
BACKGROUND: Documentation of achieving the goal of measles elimination to justify to international organizations including the WHO is a priority for public health authorities. This study aimed to address the status of Iran in the achievement of the measles elimination goal from 2012-2014. STUDY DESIGN: A descriptive study METHODS: Data on the measles outbreaks were extracted from the national notifiable measles surveillance system in Iran from 2012 to 2014. The required documents regarding the achievement of measles elimination, including Effective Reproduction Number (R) and the distribution of outbreak size, was addressed. The R was calculated using the proportion of imported cases as 1 - P, where P is equal to the proportion of cases that were imported. The distribution of the measles outbreaks size was described using descriptive statistics to show their magnitudes. The proportion of large outbreaks with more than 10 cases was considered as a proxy of the R value. RESULTS: The total number of measles cases was 232 cases (including 186 outbreak related cases) in 2012 and 142 cases in 2014, including108 outbreak related cases. The distribution of the measles outbreak size of occurred outbreaks from that period indicated that there were 37 outbreaks with three or more than three cases. The R value in 2012 was 0.87 and the corresponding value for 2014 was 0.76. CONCLUSIONS: According to the magnitude of effective reproduction number and distribution of outbreaks' size, measles has been eliminated in Iran. However, it is necessary to consider the potential endemic activity of measles because of no authorized immigration.
BACKGROUND: Documentation of achieving the goal of measles elimination to justify to international organizations including the WHO is a priority for public health authorities. This study aimed to address the status of Iran in the achievement of the measles elimination goal from 2012-2014. STUDY DESIGN: A descriptive study METHODS: Data on the measles outbreaks were extracted from the national notifiable measles surveillance system in Iran from 2012 to 2014. The required documents regarding the achievement of measles elimination, including Effective Reproduction Number (R) and the distribution of outbreak size, was addressed. The R was calculated using the proportion of imported cases as 1 - P, where P is equal to the proportion of cases that were imported. The distribution of the measles outbreaks size was described using descriptive statistics to show their magnitudes. The proportion of large outbreaks with more than 10 cases was considered as a proxy of the R value. RESULTS: The total number of measles cases was 232 cases (including 186 outbreak related cases) in 2012 and 142 cases in 2014, including108 outbreak related cases. The distribution of the measles outbreak size of occurred outbreaks from that period indicated that there were 37 outbreaks with three or more than three cases. The R value in 2012 was 0.87 and the corresponding value for 2014 was 0.76. CONCLUSIONS: According to the magnitude of effective reproduction number and distribution of outbreaks' size, measles has been eliminated in Iran. However, it is necessary to consider the potential endemic activity of measles because of no authorized immigration.
Keywords:
Elimination; Infectious Diseases; Iran; Measles; Reproductive number