Surveillance of measles disease in Libya, 2018

Background: Measles surveillance program plays an essential role in determining disease prevalence data and outbreaks as well as monitoring the preventive activities toward measles elimination. This study illustrates epidemiological measles indicators through the national measles surveillance program in Libya in the year 2018. Materials and Methods: Annual measles surveillance report in 2018 was analyzed to figure out the spread of measles disease. Case-based surveillance is being implemented to notify suspected measles cases (skin rash and fever) through the measles surveillance system. The program depends on immediate notification of suspected measles cases and blood sample collection by official measles surveillance officers covered most health facilities in the country. National measles laboratory is the only official institute authorized to confirm measles cases. The characteristics such as the number of confirmed measles cases, deaths, age group, measles trends, and vaccination status were analyzed to find the indicators, as well as the incidence rate of measles cases was calculated nationwide. Results: Total number of measles cases was 1059 confirmed from 1852 suspected measles cases. Of confirmed cases, 339 were laboratory confirmation and 720 were epi-linked, with limited deaths (2 cases) were registered in the year. Seven outbreaks were detected in several locations. The age group of most cases (86%) was below 3 years of age group. Measles incidence was 152 per million which higher than previous years and comparable to many neighboring countries. The measles vaccine was not reached to 47% of suspected cases. Seasonality of measles was not in normal trend as it was continued high even in the summer month. Conclusion: A significant measles burden was shown through the measles surveillance system even though high measles vaccination coverage rate was officially documented. Supplementary immunization activities should be an essential action point to mitigate measles morbidity.