An Epidemiological Study of Measles Incidence and Vaccination Coverage in Urban Slums of Ahmedabad, India

Measles is an infectious disease caused by Morbillivirus,1 which usually affects children with more than 80% secondary attack rate. However, multiple outbreaks of the disease have even been reported among adults in urban slums, disaster relief camps, during international travel, etc.2-5 The disease is characterised by the presence of fever, cough, and coryza, followed by the appearance of a typical rash.1 The disease is transmitted by the airborne route. Being a viral disease large proportions of cases are self-limiting, still, multiple deaths have been reported because of disease-associated complications.6 In developing countries like India, more than 2 million children die of measles every year. Live attenuated measles vaccination is an effective means of reducing the incidence of measles in many countries and presently the age of immunisation with measles vaccine is nine months with two doses of measles vaccination have been suggested as a strategy to control measles. Measles vaccination was introduced in India under the universal immunisation (UIP) during 1985-86. Vaccination coverage increased to 87% in 1994-95 resulting in a decline in measles incidence from 160216 cases in 1985 to 61381 cases in 1996.7 In spite of extensive immunisation coverage under the universal immunisationprogram (UIP) in Gujarat, measles still remains a major cause of childhood morbidity and mortality. Gujarat is one of the industrialised states of India. Ahmedabad is the biggest city in Gujarat. Urbanisation has led to migration from a rural area which resulted in the growth of urban slums. Overcrowding, lack of hygiene and sanitation facilities may lead to spread of infectious diseases like measles. Lack of awareness and health seeking behaviour further leads to low vaccine coverage of measles thus children living in urban slums are vulnerable to measles. Poor treatment seeking behaviour due to cultural beliefs leads to higher chances of complications of measles and might be resulted in death. There is a paucity of measles incidence and vaccination coverage data due to non-reporting of the cases.8-9 For effective immunisation programme, it’s implementation and monitoring baseline data are required and with this background the present study was conducted to assess the incidence of measles and vaccination coverage in the slums of Ahmedabad city.