Measles: A Foremost Source Of Morbidity And Mortality

Measles still remains a foremost source of morbidity and mortality in Nigerian children, regardless-of being vaccine-avertable. The precarious scenery of measles has made it to garner such headlines like, “Nigeria to immunise 35 million children against measles – Official, October 3, 2013”, “Measles, child killer disease, ravages 12 Northern Nigerian States, March 17, 2013”, “Kebbi records 93 more cases of measles in rural areas, January 22, 2013”, “Bauchi records 80 per cent measles immunisation coverage, December 13, 2015”, "Measles: 515, 531 Ekiti children for immunisation, 19 Jan 2016", "16,000 Nigerian children under five die everyday in 2015 – WHO", and so many others.

The Nigerian Medical Association (NMA) said during the kick-off of the 2015 Annual Physicians’ Week on Sunday October 25 2015 that record exposed that escapable childhood maladies like measles remains one of the primary causes of death among Nigerian children with 2013 alone, recording 145, 700 measles deaths globally and about 400 deaths every day or 16 deaths every hour.

The United Nations International Children Emergency Fund (UNICEF) stated that measles killed 112 Nigerian children in 2015. This is not even as it said in 2014 that, there were nearly 150, 000 measles deaths worldwide – in-relation-to nearly 500 deaths every day or nearly 20 deaths every hour.

The UNICEF’s Dr. Emmanuel Idoko made this known in Abakaliki on January 19 2016, at a one-day media course-meeting on the 2016 Measles Vaccination Campaign (MVC). The worry is that there were 22, 567 suspected cases across the 36 states of the federation and Abuja in 2015.

Wrong attitude towards the fight

What the headlines mean is that Nigeria is trading on a dangerous path with measles characteristically; being that it is a communicable disease that proliferates swiftly among children.

Studies have sought to find out if there is any association between measles immunisation coverage and measles outbreak, because of the incessant news of measles that come out of Nigeria, but corruption and biddableness against the fight have been noticed as culprits why the battle is yet to be won.

The National Surveillance Officer, World Health Organisation (WHO), Dr Irene Isibor frowned at the 19^th Biennial Conference and Annual General Meeting of the Medical Women’s Association of Nigeria, held at the Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, saying that "due to people’s wrong attitude" most children in Nigeria still die from vaccine-preventable diseases such as measles.

“Everyday in 2015, 16,000 children under five years continue to die, mostly from preventable causes. Child survival must remain the focus of the post-2015 development agenda. The distribution of the estimated deaths among children under five years of age, from diseases that are preventable by vaccination in 2008 in Nigeria shows that measles accounts for 118, 000. she said.

The most vulnerable are children under nine months, which is the main reason children are supposed to habitually get measles vaccination at age nine months. Campaign survey has shown, however, that many children do not get it. Immunisation coverage dropped, hence, much effort is not made to increase measles immunisation in children between 9 and 59 months, bearing in mind that measles immunisation coverage in urban and rural areas was not markedly different, said experts.

Mr. Chukwuemeka Anthony Umeh at Hospitals Management Board, Bayelsa State, in a hypothesis made available to Pan African Medical Journalin 2013, said, "Efforts at immunising children against measles was intensified in Nigeria with nation-wide measles vaccination campaigns in 2005-2006, 2008 and 2011 targeting children between 9 and 59 months. However, there were measles outbreaks in 2010 and 2011 in Abia State."

Measles scare

Measles has become a cause for concern in Nigeria as many children are becoming victim, every day. It means that if nothing urgent is done measles may wipe a lot more children, apart from the number it has already recorded. Oyo State Government, for example, was thrown into mourning early this year when five children were lost to the disease.

Three million children between nine and 59 months were to be vaccinated during an exercise, scheduled for Nov. 21 to Nov. 25, 2015, according to Malam Hamza Ikara, Health Educator, Kaduna State Primary Healthcare Agency (SPHCA).

The World Health Organization (WHO), in partnership with the Ministry of Health in Taraba State, on November 14 2015 heralded plans to vaccinate no fewer than 760,128 children against measles in the state. The exercise was to hold between November 21 to November 25.

No fewer than 97,000 children were to be vaccinated against measles in the Dutse Local Government Council of Jigawa, Alhaji Sani Yusif, the Health Education Officer spoke through the council’s Information Officer, Malam Ya’u Garba in Dutse in November 2015.

The Chairman of Kebbi State Primary Healthcare Development Agency, Dr Farouk Wakili said his state’s campaign was targeted at 700,000 children.

Politics of Vaccination

While families and states and crusaders are crying over the children who lost their lives to measles, checks revealed that 25 million Nigerian children are yet to receive vaccination against measles. What this means is that the country should expect an increase in the number.

“There are still children among those suspected or confirmed cases of measles. Over 63 percent are zero doses, which means they have never had any immunisation,” said Dr Damaris Onwuka, the director of disease control and immunisation at the National Primary Health Care Development Agency

Conversely, there was a planned nationwide campaign to immunise at least 39 million children aged nine months to 59 months in November 2015. But that idea became a tall dream as the National Primary Health Care Development Agency did not meet up; it reiterated that the exercise would culminate into this year.

How more than 25 million children born in the last five years did not have any vaccination against measles, figures show, do not meet the eyes.

“National coverage of measles vaccine when combined with oral polio vaccination did not exceed 70 percent between 2003 and 2010. A first phase of the latest stand-alone measles vaccination will target children in 19 northern states and the FCT between Nov 21 and 25, 2015. A second phase from January 28 to February 1 next year (2016) will target 17 southern states,” Dr Chinedu Okoronkwo of the agency told News Agency of Nigeria (NAN).

Where the immunisation money goes

The irony is that governments at all levels and the international community are not paying lackadaisical approach in the combat against measles.

Monies are being budgeted and projected to curb the menace, but how the authorities responsible for the management the money have not been able to arrest the situation calls for concern.

“Around 10 percent of the entire campaign cost is borne by federal and state government, contributing $3.731 million to operational spending. The rest, including vaccines said to have arrived the country recently, is paid for by international donors through the Global Alliance for Vaccine Initiative, GAVI,” reported Daily Trust.

At least, indications are that the campaign against measles will cost an estimated $45.5 million.

Curbing the menace

To fight the scourge to standstill, Isibor pinpointed out three key steps to close the immunisation gap including integrating immunisation with other services such as post-natal care for mothers and babies, Daily Times reported.

The source added that others were strengthening of the health system to accommodate all categories, especially during crisis with regards to assuring that everyone can access vaccines and afford to pay for them.

“To fight this scourge and other such health conditions, the NMA called for immediate declaration of national emergency in the health sector; and put all machinery in place towards eradicating the negative health situation from the country,” reported NAN.

Odimegwu Onwumere is a Poet/Writer; he writes from Rivers State. ([email protected]). Tel: +2348057778358.