A. Situation analysis
Description of the disaster
The measles epidemic in Tajikistan started in April 2017 gradually spreading out of Rudaki district to the capital city of Dushanbe and the surrounding districts as well as Khatlon oblast. In mid-April 2017, 263 registered cases of measles were reported, out of which 157 were laboratory confirmed. Based on official data, by 1 May, the number of notified and investigated cases rose from 263 to 345, with 246 (71%) patients hospitalized. No deaths were reported so far.
The trend of sharp increase in new cases is expected to continue. Out of the 48 new cases recorded during week 16 (17-23 April 2017), 96 per cent were unimmunized. The proportion of affected adults in this outbreak is somewhat higher (16.7%) than during the previous outbreak in 2009 (10.5%). The total proportion of unvaccinated persons affected by the epidemic among the total population increased from 81.9% in week 15 to 84% in week 16.
The group most affected by the epidemic are children between 1 to 9 years of age. This also corresponds to the cohort born after the last national measles and rubella (MR) immunization campaign conducted in 2009. Normally, the immunization centre of the Ministry of Health and Social Protection (MoHSP) carries out immunization on an annual basis in case of approx. 97 per cent of this cohort. The remaining three per cent however tends to remain nonimmunized, including migrants, gypsy and displaced people.
In response to the outbreak, the MoHSP is preparing to conduct a nationwide MR vaccination campaign targeting children aged 1 to 9 years from 15 to 26 May 2017 with the support of the Measles and Rubella Outbreak Response Initiative (MRI) Fund. The Government of Tajikistan already agreed on a draft decree declaring the national immunization campaign against measles with relevant ministries and submitted it for parliamentary approval.