Utah Valley Global Health Group

A blog about global health for those living in Utah Valley and their friends.

Archive for the ‘Measles’ Category

Of Mormons and Measles

Posted by ryanlindsay on December 6, 2008

According to a recent WHO press release, the Measles Initiative is working with a 74% reduction in measles cases since 2000. The Church of Jesus Christ of Latter-Day Saints has donated at least 3 million dollars to the initiative. Members of the church have also given of their time at vaccine events in Angola, Ghana, Kenya, Madagascar, Namibia, Nigeria, Sierra Leone, Swaziland, Uganda and Zimbabwe. Presiding Bishop David H. Burton has said that “over 54,000 Church members volunteered to help organize the effort.”

Beyond monetary contributions, I would like to see more initiatives like this Measles vaccination program that tap into local congregations to mobilize communities. Could this serve as a model for future initiatives?

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Posted in Global Health and Mormonism, humanitarian aid, Measles | Tagged: , , , , | 4 Comments »

Recent Successes

Posted by chads on February 8, 2007

There are a number of recent global health successes that show that, yes, in fact, well-planned, coordinated global health interventions do save lives:

-According to a recent Lancet article, between 1999 and 2005, mortality owing to measles was reduced by 60%, from an estimated 873,000 deaths (uncertainty bounds 634,000-1,140,000) in 1999 to 345,000 deaths (247,000-458,000) in 2005. An article in the magazine Economist gives a good summary. See Malaria under the categories on the side bar for other posts about measles, immunization campaigns, and the LDS Church’s involvement in that campaign.

-According to Dr. Constance Bart-Plange, Programme Manager of the National Malaria Control Programme in Ghana, malaria deaths in children in the country has reduced by half between 2003 and the end of 2006. (To my knowledge, this data has not been published or subject to peer review. These preliminary results, however, are promising.)

As soon as I find some time, I will post a review on a highly recommended book that highlights a number of other global health success stories: Millions Saved.

Posted in Malaria, Measles, News | 3 Comments »

Packards’ Experience with the Measles Initiative

Posted by chads on January 2, 2007

NOTE: This is the final of a series of posts on measles. I have already posted a brief summary of the global measles problem, an introduction to the LDS church and the Measles Initiative, and an evidence-based answer to the question “How effective are mass measles vaccination campaigns?”

There are a handful of people that I have either heard about or met that leave such an impression on me that I am left with no other choice than to evaluate my life and make changes. The Packards fit into that category. They were kind enough to answer I few questions I had about their involvement in the Measles Initiative.

Last summer, Blair and Cindy Packard served a 3-month mission for the Church of Jesus Christ of Latter-Day Saints in Mozambique working with the Measles Initiative. Prior to that service, they travelled to to southern Africa multiple times to found and organize Care for Life. Blair’s professional background is as a physical therapist, and Cindy worked as a midwife. They currently serve as in a volunteer 3-year capacity as mission presidents in Mozambique. You can learn more about the Packards here, here, and here. Thanks for joining us, President and Sister Packard!

1. Describe your daily activities with the Measles Initiative. Who were your partners?

Let me answer the last part of this question first, which will lead to what we actually did for our 3 months in Mozambique. The partners in the global measles and polio campaign are several, depending the nation in which the work is taking place. Worldwide partners include the American and International Red Cross and Red Crescent organizations, the Center for Disease Control, UNICEF and the World Health Organization. The Church of Jesus Christ of Latter-day Saints got involved about 3 years ago in the African phase of the work with an initial contribution of $3 million and the commitment to mobilize its members in each nation to assist primarily in social mobilization. This support from the Church has been renewed and is ongoing.

In each country a major partner is the local ministries of health or other ministries related to the health and social needs of their people. It was with this national ministry in Mozambique that we worked most closely. In fact, we were members of the national micro-planning committee which met weekly to plan and review every detail of the campaign. In these meetings we shared what the Church could do to assist in the campaign. This included donating prepared television and radio spots and purchasing airtime for these spots, developing posters and flyers for the campaign, developing ID badges for our volunteers and other workers, and contributing volunteer time by our Church members in a variety of ways.

Our work involved “social mobilization” which included getting the message out about the campaign and getting the populace to the immunization stations. Specific activities included the following:

• Contacted Olympic Gold Medalist Maria Matola from Mozambique and obtained her willingness to participate in promoting the campaign. While she was in the US for training we worked with her and the Church Media department to film and record TV and radio spots in Portuguese and English. These spots were later modified on site to meet local needs. We negotiated with local TV and radio stations to air the spots.
• Church Media provided two other radio spots that had been used in other campaigns successfully. These were translated to Portuguese and reproduced for use in Mozambique.
• In cooperation with the Ministry of Health we designed and produced 11,000 large campaign posters for use throughout Mozambique. These poster featured Maria Matola and our 6 year old daughter, Lindy, running together to “win the race against Measles and Polio.” The posters contained dates and other information about the campaign. The posters were distributed by the Ministry of Health and were a very visible part of the campaign.
• We organized a training program for all our Church members that was provided to each congregation. The program had two purposes – to educate our own members about these two diseases and their prevention and two encourage their participation as volunteers in encouraging their neighbors and others to have their children immunized.
• We organized over a thousand volunteer members to participate in various ways in the campaign. This included door knocking with campaign literature, distribution of fliers and posters, develop of small skits or theatre to dispel some of the myths of immunization, and organization of members who volunteered or were hired as workers at the immunization posts throughout Mozambique.

2. Describe your successes and why you think those efforts were successful. Are you aware of any data?

The overall success rate of the campaign in Mozambique was nearly 94% of the target population. The target population were children under 15 and these 9 million plus children represented 45% of the total population of Mozambique. Success goes directly to Dr. Mark Grabowsky’s approach. Dr. Grabowsky is from the Center for Disease Control (and was on loan to the American Red Cross during the campaign). It was he who first conceived of the initiative and a strategy that was based on “partial ownership of complete success instead of compete ownership of partial success.” It was an experienced group of global partners all working together with local ministries of health toward a goal of “complete success.” The logistical challenges in each nation are significant, but each group working together, contributed to the campaign success.

Another success that goes to the heart of the Church’s involvement relates to the approach taken. Initially a request came to the Church from the American Red Cross just for a financial contribution. That invitation was accepted. But it was Church president Gordon B. Hinckley’s foresight to involve members and contribute in ways more than just monetarily that made the biggest difference.

3. What were some of your major challenges?

Perhaps the biggest challenge from our perspective was just the coordination of such an effort. Bureaucracy always plays a part in such a large undertaking and did in many instances in the campaign in Mozambique. But, overall, there was a marvelous degree of cooperation and energy. It was particularly rewarding to observe at many of the immunization sites and ask some of the mothers who were bringing children why they were doing so. It was clear there was both an awareness of the diseases and a strong desire to see their children safe or provided with a better life than parents had. We saw one mother with Polio who used a hand crank scooter to pedal several kilometers and bring her small child to get immunized. We saw children carrying younger siblings on their backs and even young children coming by alone to get their immunizations. (See attached photos)

Initially we thought that getting the information out to more rural areas would be the biggest challenge. Contrary to that, the lowest success rates were in the largest metropolitan area in Maputo. Better organization by more rural units and public indifference in the cities were probably contributing factors to the challenge.

Unfortunately, I was not able to attach some of the accompanying photos. I will figure it out soon!

Posted in Global Health and Mormonism, Guest Bloggers, Measles | Leave a Comment »

Q&A: Measles Vaccination Campaigns

Posted by chads on November 28, 2006

For an explanation of the Q&A series, look here.

Q: How effective are mass measles vaccination campaigns?

Methods: A PubMed search was done using the words “measles immunization campaigns.” 169 Articles were found. Of those, 15 were thought to be applicable.

A: Measles vaccination campaigns can reduce measles cases by as much as 90%, and eradication of the disease is a possibility with effective, comprehensive campaigns.

A September, 2005 Lancet article reported on 19 African countries that had completed measles immunization activities in children aged 9 months to 14 months between 2000 and June, 2003. 82·1 million children were targeted for vaccination in 12 countries and follow-up immunization in seven countries, reaching an average of 97% of the targeted population. The average decline in the number of reported measles cases was 91%. They also estimated the percentage decline in annual measles deaths to be around 20% (90 043 of 454 000).

There were several limitations to this study. First, measles cases were defined based on a clinical criteria (an illness characterised by rash, fever, and cough, coryza, or conjunctivitis), or “any illness that a clinician suspected to be measles.” Diagnosis (and, therefore, reporting) of measles cases, then, depended on the clinicians’ training, as well as possible discrepancies in the very definition of measles. Number of deaths averted were also estimated based on the percentage of measles deaths from prior years.

A 2003 article in the Journal of Infectious Diseases reported 39% decrease in measles cases in Uganda. However, only children aged 6 months to 5 years were targeted.

A report by the CDC estimated that cases of measles fell from 8,762 to 2,574 (about 70%) in 2002 after a mass immunization campaign in Afghanistan. An estimated 82% of the targeted 6 months-12 years population was reached.

Complications of vaccinations are rare, but have been reported and discussed in Brazil, where meningitis was reported, and Afghanistan, where abscesses formed. Reports also stress the importance of immunizing all of the 9-month to 15 year-old age group, using sterile needles, having the necessary infrastructure in place, as well as considering the impact that the campaign has on the underlying health system.

Posted in Measles, Q&A | Leave a Comment »

Measles

Posted by chads on November 11, 2006

I have been a practicing physician for over 3 years in the United States and I have never seen a case of measles. My wife’s grandfather remembers “red measles” (as opposed to “German measles,” or rubella) going through “the whole family and the whole town.” Measles was a part of life; 90% of children had measles before they were 15 until a vaccine was licensed in the US in 1963.

Measles is now a disease of the poor. Virtually unheard of in countries like the US (fewer than a few hundred cases a year), it continues to kill thousands of children in developing countries despite the fact that it is easily preventable. Estimates in 2004 put 454,000 children dying of measles in 2004. That number has been steadily declining since 1999, likely due to mass immunization campaigns.

Measles is caused by a virus, and transmitted by respiratory secretions. Approximately 2 weeks after contracting the virus, the child gradually develops a fever, followed by the “3 C’s”: cough, coryza (runny nose), and conjunctivitis (red eyes). A characteristic rash then develops. Most recover without further problems. Complications that can lead to death include dehydration due to diarrhea, pneumonia (infection of the lungs), and encephalitis. (Manson’s Tropical Diseases) The mortality rate (percentage of those who get the disease and die from it) ranges from 0.1% to 25%, due to malnutrition and vitamin deficiencies.

Posted in Measles | 3 Comments »

LDS Church and the Measles Initiative

Posted by chads on November 2, 2006

This is the first of a number of articles exploring Mormonism and Global Health.
In 2003, the LDS Chruch donated 3 million dollars to the Red Cross to support the Measles Initiative . According to the initiative’s website, it “is a long-term commitment and partnership among leaders in public health and supports the goal of reducing measles deaths globally by 90% by 2010 compared to 2000 estimates. Measles Initiative partners include the American Red Cross, UN Foundation, CDC, World Health Organization, and UNICEF.” Evidently the Church is the primary supporter of the initiative. The Church has also called missionaries to serve in Madagascar, Ivory Coast, Kenya, Mozambique, Nigeria, Benin and Tanzania, where they serve social mobilization roles. In the coming days, I will post a Global Health Topics article on measles, followed by a Q&A post answering the question “how effective are measles vaccination campaigns”? I will also have an invited blogger couple who will share their experiences as Mormon missionaries working with the Measles Initiative.

Posted in Global Health and Mormonism, Measles | Leave a Comment »