Measles is a highly contagious disease and is one of the leading causes of death in young children despite the fact that an effective vaccine is available. Measles in 2013 accounted for around 145,700 deaths globally or 16 deaths every hour. 1
In Pakistan, even though the vaccine is administered to children twice during their lifetime, at the ages of 9 months and 2 years,Reference Niazi and Sadaf 2 the country is currently among the top 5 countries worldwide with the lowest rates of immunization and vaccination, which makes it an even harder task to fight this disease.Reference Gillani 3 Last year alone in Pakistan, over 25,000 cases of measles were reported that took the lives of 321 people. Through May of 2014, around 1329 cases had been reported, which at that time had led to 13 deaths. 4
Frequent epidemics and the rise in the number of cases of measles throughout Pakistan are mainly due to the following reasons: (1) failure of Pakistan’s immunization program, (2) Pakistan’s corrupt health care system, (3) the lack of basic infrastructure facilities, (4) many parents in Pakistan refusing vaccination of their children for various reasons, (5) and repeated natural disasters. The availability of fewer vaccinators, malnutrition in Pakistan’s children, and the uncontrolled migration of unvaccinated refugees further enhance the number of cases seen every year.Reference Niazi and Sadaf 2 , Reference Khan and Qazi 5
The regions of Sind and Punjab led in the number of cases reported during 2013. A report by Transparency International suggested Sind’s health care system to be one of the most corrupt sectors in the province.Reference Khan and Qazi 5 Corruption eventually leads to a lower vaccination rate.
The EPI or “expanded programme on immunization,” which was launched in Pakistan in 1978, had a coverage of 54% in 2012–2013 and is said to be steadily declining. Although measles itself gets cured on its own, the main causes of concern in Pakistan are the complications of the disease, which can be a problem in children who are malnourished. In Pakistan, 40% of the children are malnourished. 4
Vaccination rates even vary with region, with a higher number generally seen in the cities. Education and awareness about the disease and its prevention could further dramatically increase the rate of immunization and decrease the rate of disease. If the government wants to prevent future outbreaks, a multidimensional approach should be adopted. There is a dire need for mass vaccination of children, and this effort should be held regularly and not be confined to particular days of the year. An EPI coverage of over 90% could prevent a large number of cases from occurring in the future.Reference Javed, Bibi, Chishti and Siddique 6 An increase in the number of vaccination centers along with the availability of vaccines to medical doctors would further help in this regard.Reference Riaz 7
It seems that if the recent rise in the number of cases of measles is not controlled soon, measles could overtake polio as one of the major health concerns in Pakistan.
