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Abstract

Introduction: Measles Elimination Programme (MEP) in Malaysia was started in 2004 and targeted elimination by 2010. However, this target has not achieved and revised target was set as 2018. Study was conducted to assess the measles elimination progress and factors affecting it. Methodology: By multistage stratification, two districts (urban and rural) were identified from each of seven states in all regions of country. Measles data from 2006-2016 were analyzed from web based surveillance system (e-notification, e-measles). Outbreak reports, immunisation coverage were reviewed and personnel involved in surveillance and immunisation programme were interviewed. MEP Surveillance indicators for 2016 were assessed. Results: Measles incidence in 2016 was 3 per million populations (target 1/1million) with cyclical peak every 3�4 years. No gender differences reported. Measles were high in �15 years (76%), among them 29% were children below one year. Fifty percent of cases were not vaccinated. Reason for non-vaccination being vaccine refusal and preference for alternative medicine. MCV1 coverage for state and district level was above 95% but few health centers revealed lower coverage (75%-90%). All MEP targets achieved except for reporting of laboratory result within 4 days (achieved 72%, target >80%). Conclusion and Recommendations: Measles is still endemic in Malaysia and showed triennial peak. Low vaccine coverage at the health centers and delayed laboratory result hinder measles elimination. Measles supplementary immunization activity (children 1-15 years) for low coverage areas with three yearly mopping up campaign, health education on importance of immunisation and prompt reporting of laboratory result will ensure measles elimination in Malaysia is achieved by 2022.

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