Table 4

Review of contributing risk factors for measles Morbidity and Mortality in displaced populations, 1979--2005

Potential risk factors involved

Possible solutions


1

Overcrowded and high density camps [4,8,20,37]

Improve camp planning and shelter


2

Poor vaccination status due to the continuous arrival of new refugees in camps [4,7,8,11,47,56]

Vaccination of refugees on arrival in camps


3

Poor vaccination status in the surrounding community [11]

Coordination of vaccination campaign in camps and in the surrounding community in collaboration with local public health authorities.


4

Narrow target age group for vaccination campaign [7,8,11,20,37,47]

Extension of population target to >15 years old


5

Primary vaccination failure due to vaccination in lower age group [7,8]

Revaccinate at 9 months


6

Lower vaccination coverage in high risk group [11]

Increase coverage in high risk age group guided by good quality of surveillance data


7

One time measles vaccination strategy [3]

Routine vaccination plus supplemental vaccination


8

Frequent visit of refugees between camps [3,8]

Restriction of refugees movement during outbreak period


9

Frequent movement of refugees in the neighbouring community and in other camps [3,11]

Restriction measures for visit from surrounding communities during outbreak period


10

Malnutrition and famine [4,8,20,37,47,56]

Consideration of vitamin A provision


11

Insecurity and inaccessibility to target zones [56]

Re-establish the routine vaccination service after the security situation is normalized.


12

No or limited surveillance system [4,37,47]

Improving surveillance approach for early case detection


13

Lack of laboratory confirmation of suspect cases[35]

Establishing appropriate laboratory testing


14

Association with other diseases [20,37]

Implementation of integrated management of childhood illness (IMCI)


IMCI = integrated management of childhood illness

Kouadio et al. BMC International Health and Human Rights 2010 10:5   doi:10.1186/1472-698X-10-5

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