Abstract：
In 2012 the World Health Organization (WHO) aimed to eliminate measles in five regions by 2020. This retrospective descriptive study reviewed measles surveillance data in South Africa for the period 2015-2020 to document the epidemiology of measles and the progress made towards meeting the 2020 measles elimination goal.A total of 22,578 specimens were tested over the period 2015-2020 yielding 401 (1.8%) confirmed measles cases, 321 (1.4%) compatible and 21,856 (96.8%) discarded cases. The most affected age group was 0-4 year olds. At the provincial level, South Africa achieved adequate surveillance, defined as more than two cases of febrile rash notified annually per 100 000 popoulation, except for KwaZulu-Natal and Limpopo in 2020, probably due to COVID-19 lockdown restrictions. Of confirmed cases, only 26% were vaccinated, 3% were too young to receive vaccines, 5% were not vaccinated, and 65% had unknown vaccination status. Measles vaccine effectiveness amongst 1-4 year olds was 80%. Using the standard case definition, South Africa achieved the measles elimination target of less than one case per one million nationally in years 2015, 2016 and 2020. The years 2017 to 2019 had incidence rates exceeding one per million nationally. Using a narrow case definition, that excluded positive rubella cases, improved the indicators with only the year 2017 having an incidence rate of more than one per million.South Africa displays intermittent measles outbreaks approximately six-yearly interspersed by inter-epidemic periods in which the country meets measles elimination targets. Intense effort is needed to increase the vaccine coverage to avoid periodic outbreaks. Enhanced molecular testing of each case will be required as measles incidence declines regionally.
摘要：
2012年，世界卫生组织（WHO）的目标是到2020年在五个地区消除麻疹。这项回顾性描述性研究审查了南非2015-2020年期间的麻疹监测数据，以记录麻疹的流行病学以及在实现2020年消除麻疹目标方面取得的进展。在2015-2020年期间，共检测了22,578个标本，产生了401例（1.8％）确诊的麻疹病例，321例（1.4%）兼容，21,856例（96.8%）丢弃。受影响最大的年龄组是0-4岁。在省一级,南非实现了充分的监测，定义为每年每100000次戒毒通知两次以上的发热皮疹病例，除了2020年的夸祖鲁-纳塔尔省和林波波省，可能是由于COVID-19封锁限制。在确诊病例中，只有26%的人接种了疫苗，3%的人年龄太小，无法接种疫苗。5%没有接种疫苗，65%的疫苗接种状态未知.麻疹疫苗在1-4岁儿童中的有效性为80%。使用标准案例定义，南非在2015年、2016年和2020年实现了全国每百万病例不到1例的麻疹消除目标。2017年至2019年，全国发病率超过百万分之一。使用窄大小写定义，排除了风疹阳性病例，改善了指标，只有2017年的发病率超过百万分之一。南非每年约有六年发生间歇性麻疹疫情，并在该国达到消除麻疹目标的疫情期间穿插。需要加大努力来增加疫苗覆盖率，以避免定期爆发。随着地区麻疹发病率下降，将需要对每种病例进行加强分子检测。
