Measles Cases in Maban County Linked to Zero Dose Immunisation
Health Partners Treated 200+ Measles Cases, Protecting the Most Vulnerable Children
In Maban County, a remote area in South Sudan's North East where breathtaking landscapes embrace vibrant cultures lies the 'country' s largest refugee settlement of 200,000 refugees and returnees has faced outbreaks of measles over the last year.
The ongoing conflict in Sudan, which has displaced millions, with over 400,000 refugees and returnees fleeing into South Sudan as of November 2023, has exposed the area further to measles.
The recent measles outbreaks in Maban Camps primarily impacted children who fled the conflict in Sudan. Medics on the ground attributed the upsurge to zero-dose immunisation, especially with refugee and returnee children who have not been vaccinated since birth. Zero-dose immunisation refers to providing the first dose of a vaccine to children who have previously not received any childhood vaccinations.
As per current UNICEF data, 20.5 million children are still missing out on lifesaving vaccines globally. In countries like South Sudan, where access to vaccines and healthcare services is challenging, zero-dose immunisation plays a crucial role in safeguarding children's health. According to Global Vaccine Alliance (GAVI) 2021 data, the number of zero dose children in South Sudan was at 145,940.
In response, UNHCR which runs the Maban Refugee Camp together with UNICEF's health partners in Maban County, including Relief International (RI) and International Rescue Committee (IRC) have treated over 300 cases of measles in the area in the recent outbreak, with the majority being children who presented with associated complications such as fever, rushes, red eyes, conjunctivitis, pneumonia, diarrhoea.
Despite the challenges of attending to such a complex situation, Doro Primary Health Care Center, one of the health centers inside the camp – continues to provide crucial health care and immunisation services to thousands of refugees and host communities, playing a vital role in combating the spread of diseases such as measles.
According to Dr. Ochongodok John, a medical officer in charge of the facility, the centre's interventions have reduced the number of cases, highlighting the impact of proactive measures in managing the outbreak.
"In June, this inpatient ward was full of over 200 cases admitted at the facility. We had to send ten specimens to Juba National Public Health Laboratory for testing, and nine were confirmed positive for immunoglobin. Those children affected were mostly refugees/returnees and with less from the host community"."
"With our interventions, the cases have reduced. So far, we have two cases in the isolation ward. But the majority have been treated and discharged. Sadly, we had one death"," said John.
Angelina Nyigeu, a mother of six fleeing from the conflict in Sudan, painfully revealed that she lost her two children to measles on their long journey from Sudan to South Sudan while fleeing fighting.
"One of the children got sick with measles when we were still in Khartoum when the war just broke out. When we arrived in Madeni in Sudan on our way to South Sudan, my 3-year-old child died there, and another eight-month-old child died when we arrived in Renk in South Sudan side. The doctors told me the cause of their deaths was related to measles disease"," said Angelina.
Another local resident in Maban County, Marina Eve David, walked for days to reach Doro Primary Health Care due to a damaged bridge linking her village to Maban town. Her 10-year-old daughter was admitted for suspected measles cases at the center but she said her daughter was now recovering.
"A week ago, skin rashes appeared on her body, and she started coughing with a fever. She really suffered for four days before we reached the health care facility, but her situation has improved now since we got admitted in this facility"" Marina said.
She, however, admitted that four of her other kids had never been vaccinated since birth.
While acknowledging 'UNICEF's and partners support to refugees and the host communities in Maban County, Dr. Ochongodok John stated that Relief International has rolled out a large-scale measles vaccination campaign across the county to stop the spread of the disease.
""We also do screening of new arrivals and once we realise a child needs immunisation, he/she is immediately vaccinated there"," he said.
According to the World Health Organization, in South Sudan, outbreaks of measles remain a concern due to insufficient vaccination coverage, the non-introduction of the second dose of MCV (MCV2) and the absence of supplementary vaccination activities against measles in some areas over the past three years.
in Africa, it is resulting in suboptimal population immunity. UNICEF/WHO 2022 National Immunisation Coverage estimates states East and Southern Africa regional coverage of MCV1 was 73% compared to the target of 95% needed to prevent measles outbreaks.
South Sudan is also experiencing severe food insecurity, with 57% of the population (6.54 million people) being affected. This has increased the risk of malnutrition in children, thereby increasing the risk of severe measles and adverse outcomes, especially those with vitamin A deficiency or whose immune systems have been weakened by HIV or other chronic diseases.
Through the COVID-19 Emergency Vaccination Response and Health Systems Preparedness (CERHSP) project implemented in South 'Sudan's three States and two administrative areas, UNICEF in collaboration with Relief International (RI) and the International Rescue Committee (IRC) run 20 healthcare facilities serving a population of over 300,000 people in refugee settlement camps and the host community.
The recent measles vaccination campaign has seen 2,383,771 children across the country vaccinated against the disease, with 51 per cent being female.
CERHSP project implemented in partnership with the World Bank and the Ministry of Health, aims to strengthen health service delivery for the communities in South Sudan.
