Globally, measles remains a major cause of death among young children, despite the availability of a safe and effective vaccine. A highly contagious viral disease, measles occurs all over the world, though with a higher prevalence rate in developing countries. Nigeria, for instance, ranks among countries with the highest cases of measles infection in the world say the World Health Organisation (WHO). In 2011, 51 cases of new infections were recorded daily placing the country among the top three of countries with the highest infection with 18, 843.
The countries that ranked ahead of Nigeria are The Democratic Republic of Congo (DRC) with 134, 042 infections and India with 29,339 infections.
While measles affects mostly children, adults can have the disease stated Dr Idowu Ogunkoya. “It is not limited to a particular age group but it is more common among children because of the fact that the immunity of children is low and as such, it can easily be transferred. Adults too can have it especially when their immunity is low. There are some herbal treatment for it which the person infected can use to bath to get a cure. Such herbs as ejirin as called by the Yorubas. The western medicine has quite a number of antibiotics for the treatment of measles,” he said.
When measles appear, the disease show visible symptoms as Dr O. Salau noted: “The symptoms include skin rashes which spread from the face down to the feet. And the spreading across the body of these rashes, takes between three and five days. Sometimes when it is severe, the victim may develop abdominal pain, redness of the eyes, sore throat too and so on. it is in the family of chicken pox, Ebola and others. It can be managed. It is deadly that is why we do supportive treatment, and then wait for it to take its course. It actually has its course and it usually runs its course after the treatment. Yes measles is associated with high temperature, fever, it is high temperature related. It affects children of five and less more than others.”
Rejecting vaccination
To health experts and practitioners, vaccination remains the best form of defence against measles. “What causes it is a viral infection, that is why vaccination against measles has to be taken seriously in a country like Nigeria. That is because with the immunisation, the body develops antibodies in defence of the body against the measles infection,” said Dr Babajide Saheed. Indeed, at the stakeholders meeting of the Nigerian Medical Association, (NMA) held in Abuja in August this year, the body posited that immunisation against vaccine preventable diseases (VPDs) which includes measles, has been identified as one of the most cost effective interventions in saving lives, especially amongst children under five years of age.
It further noted that studies have revealed that in Nigeria, $17billion USD in economic losses can be averted with more than 600,000 lives saved over the next 10 years by scaling up vaccine coverage to 90% (for Measles, Hib, PCV, Rotavirus and Pertussis).
However, despite the importance of vaccination in fighting the disease, findings indicate that certain factors stand in the way of curbing the measles burden in the country. One of these is the attitude of some parents who view the regular immunization drive of government and other health organisations with great suspicion and even hostility. Last year, when a major outbreak of measles occurred in some Northern states in the country, former Minister of State for Health, Muhammad Pate blamed the outbreak on parents’ refusal to immunise their children. At the time, he noted: “The measles outbreak is a manifestation of the refusal of parents to immunise children; for years we have been saying routine immunisation is very important; the federal government provided free vaccines and it has been working with the state governments.”
Supporting this view was the former President, Nigerian Medical Association Dr Osahon Enabulele who stated that non acceptance of immunisation inmsome parts of the country was a major challenge. “We’ve been having challenges with the issue of acceptance in that part of the country, which is quite sad really,” he said. He added that the provision of funds by the relevant authorities would not ordinarily translate to reduction in measles without acceptance of immunization.
“What do you do when you provide all the funds and buy all the vaccine and the people refuse to use them? Government should educate and sensitise the people on the benefit of the vaccines,” he said.
To reduce the prevalence rate in the country, he called for a change of mindset as well as cultural and religious beliefs that lead to the rejection of vaccination in some parts of the country, particularly the North. According to him, “we should not deny innocent children the chance to healthy lives because of religious and cultural beliefs.”
Reducing the burden
Considering the seriousness of the disease which could lead to death, experts advocate early treatment when it occurs. Stated Dr Babajide Saheed: “There are many problems related to untreated measles; it can affect the eyes, it can cause someone to become deaf, have headache, have skin problem, discolouration of the skin and a dysfunctional body. More than that, it can even lead to death. That is if the victim is overwhelmed with the infection, that person can die. Therefore, the person has top take early treatment.”
To experts, this is a message that needs to be urgently passed to parents of under five year olds (the most vulnerable group to measles) and other stakeholders in order to improve the immunization coverage in the country and reduce the burden. Indeed, findings from the 2013 measles campaign in the country (coverage survey & surveillance) show low coverage in 27 States including Kano (69%), FCT (70%), Borno (72%) Taraba (79%), Zamfara (74%), Yobe (78%), Sokoto (79%), Edo (76%) among others with non compliance in Kebbi, Kano, Sokoto and Kaduna.
On the annual immunization campaign by the government, Ogunkoya stated: “I think the immunisation going right now is effective and we have to give kudos to the government because measles today is not too common in the cities; though, it is still common in the rural areas where hygiene is not being observed as it ought to be done.
How dangerous is measles? It is dangerous because it kills children. It takes over the immunity system, breaks it down and gives room for other sicknesses and diseases to enter the body and that can happen within seven days depending on the severity.
The symptoms are high temperature, rashes, headache and so on.
I think that government can do more though they are doing well in respect to the treatment of measles.”
Also speaking on the immunisation campaign by government, Salau said: “Since the government is intensifying efforts with immunisation, one can say that they are trying but the chain continues because not everybody has been reached by the government officials.” To other experts, increased funding, more public enlightenment to educate parents on the importance of immunising their children, better storage facilities for vaccines, creation of access stations in communities where people are able to access the immunisation in nine months (instead of the one-off door-to-door campaign that is the current practice), among other policies, will go a long way in reducing the measles burden in the country.
