Immunization service delivery – immunization management prospective.
EPI Fact ShEEt - origin.searo.who.intorigin.searo.who.int/immunization/data/myanmar.pdf ·...
6
World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization and Vaccine Development South-East Asia Region Myanmar 2016 Immunization system highlights There is a comprehensive multi- year plan (cMYP) for immunization covering 2017-2021. A national committee on immunization practice (NCIP) fully functional. A national system to monitor adverse events following immunization (AEFI) exists. A national policy for health care waste management including waste from immunization activities exists. All 330 districts had updated routine immunization micro-plans to raise immunization coverage. 11% of vaccine costs financed by the government. Of the 330 Townships, 282 (85%) have ³80% coverage for DTP-Hib- HepB3, 147 (45%) have ³90% coverage for MCV1. Demographic Health Survey is ongoing in 2015-2016. Source: WHO/UNICEF joint reporting form (JRF) 2015 Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Table 1: Basic information 1 2015 Division/Province/State/Region 17 Township/District 330/69 City/Town 396 Village 67,285 Population density (per sq. km) 88 Population living in urban areas 33% Population using improved drinking-water sources 86% Population using improved sanitation 77% Total expenditure on health as % of GDP 1.8% Births attended by skilled health personnel 78% Neonates protected at birth against NT 87% Total population 50 402 517 Live births (LB) 1 023 892 Children <1 year 928 612 Children <5 years 4 536 499 Children <15 years 13 342 996 Pregnant women 1 012 556 Women of child bearing age (15-49 years) 13 135 291 Neonatal mortality rate 25.5 (per 1,000 LB) Infant mortality rate 39.8 (per 1,000 LB) Under-five mortality rate 50.5 (per 1,000 LB) Maternal mortality ratio 200 (per 100,000 LB) 1 SEAR annual EPI reporting form, 2015 and WHO, World Health Statistics 2015 Vaccine Age of administration BCG Births to 2 months DTP-Hib-HepB 2 months, 4 months, 6 months OPV 2 months, 4 months, 6 months IPV 4 months MR 9 months Measles 18 months TT During pregnancy (at first contact and 1 month later) Vitamin A 6-59 months EPI history EPI launched in 1978. OPV and Measles vaccines introduced in 1987. AD syringes introduced in 2002. Hepatitis B vaccine introduced in 2003. MCV2 introduced partially in 2008 and made available nationwide in 2012. Hib Pentavalent (DTP-Hib-HepB) vaccine introduced in 2012. MR vaccine introduced in 2015. IPV introduced in 2015. Type 2 component of OPV withdrawn on 29 Apr 2016 by switching from tOPV to bOPV. PCV introduced in July 2016. Table 2: Immunization schedule, 2015 Source: cMYP 2012–2016 and EPI/MOH Source: WHO/UNICEF joint reporting form (JRF) 2015
Transcript of EPI Fact ShEEt - origin.searo.who.intorigin.searo.who.int/immunization/data/myanmar.pdf ·...
National Health laboratory - National polio laboratory - National measles & rubella laboratory - National Japanese encephalitis laboratory
- Department of Medical Research
NSC OfficeRSOs Office
Rotavirus laboratory
World Health Organization• SEARO/FGL/IVD • 31 August 2016World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development
South-East Asia Region
Immunization andVaccine Development
South-East Asia Region
Myanmar 2016
Immunization system highlights
� There is a comprehensive multi-year plan (cMYP) for immunization covering 2017-2021.
� A national committee on immunization practice (NCIP) fully functional.
� A national system to monitor adverse events following immunization (AEFI) exists.
� A national policy for health care waste management including waste from immunization activities exists.
� All 330 districts had updated routine immunization micro-plans to raise immunization coverage.
� 11% of vaccine costs financed by the government.
� Of the 330 Townships, 282 (85%) have ³80% coverage for DTP-Hib-HepB3, 147 (45%) have ³90% coverage for MCV1.
� Demographic Health Survey is ongoing in 2015-2016.
Source: WHO/UNICEF joint reporting form (JRF) 2015
Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
Table 1: Basic information1 2015Division/Province/State/Region 17
Township/District 330/69
City/Town 396
Village 67,285
Population density (per sq. km) 88
Population living in urban areas 33%
Population using improved drinking-water sources
86%
Population using improved sanitation 77%
Total expenditure on health as % of GDP 1.8%
Births attended by skilled health personnel 78%
Neonates protected at birth against NT 87%
Total population 50 402 517
Live births (LB) 1 023 892
Children <1 year 928 612
Children <5 years 4 536 499
Children <15 years 13 342 996
Pregnant women 1 012 556
Women of child bearing age (15-49 years)
13 135 291
Neonatal mortality rate 25.5 (per 1,000 LB)
Infant mortality rate 39.8 (per 1,000 LB)
Under-five mortality rate 50.5 (per 1,000 LB)
Maternal mortality ratio 200 (per 100,000 LB)
1 SEAR annual EPI reporting form, 2015 and WHO, World Health Statistics 2015
Vaccine Age of administration
BCG Births to 2 months
DTP-Hib-HepB 2 months, 4 months, 6 months
OPV 2 months, 4 months, 6 months
IPV 4 months
MR 9 months
Measles 18 months
TT During pregnancy (at first contact and 1 month later)
Vitamin A 6-59 months
EPI history � EPI launched in 1978.
� OPV and Measles vaccines introduced in 1987.
� AD syringes introduced in 2002.
� Hepatitis B vaccine introduced in 2003.
� MCV2 introduced partially in 2008 and made available nationwide in 2012.
� Hib Pentavalent (DTP-Hib-HepB) vaccine introduced in 2012.
� MR vaccine introduced in 2015.
� IPV introduced in 2015.
� Type 2 component of OPV withdrawn on 29 Apr 2016 by switching from tOPV to bOPV.
� PCV introduced in July 2016.
Table 2: Immunization schedule, 2015
Source: cMYP 2012–2016 and EPI/MOHSource: WHO/UNICEF joint reporting form (JRF) 2015
E P I F a c t S h E E t
Figure 12: Confirmed (Lab and Epi linked) measles outbreak associated cases, by age, 2010–2015
Figure 10: Immunity against measles: Immunity profile by age in 2015*
Figure 13: Unimmunized confirmed (Lab and Epi linked) measles outbreak associated cases, by age, 2010–2015
Figure 14: Network of WHO supported surveillance medical officers and laboratories
Figure 11: Immunity against measles: Immunity profile by age in 2016*
*Modeled using MSP tool ver 2 based on coverage data up to 2015.
Source: SEAR annual EPI reporting form
*Modeled using MSP tool ver 2 assuming the schedule and measles containing vaccine (MCV) coverage remain unchanged and no SIAs in 2016
Source: SEAR annual EPI reporting form ND = No data
Routine/sporadic cases Outbreak associated cases
Year No. of suspected
case
No. of death
No. of lab-confirmed
measles cases
No. of lab-confirmed
rubella cases
No. of suspected
outbreak
No. of Outbreak
Investigated
No. of case
No. of death
No. of measles
outbreak*
No. of confirmed
measles case*
No. of confirmed
rubella outbreak*
No. of confirmed
rubella cases*
2010 135 0 48 6 12 12 201 1 7 102 1 8
2011 1 605 3 879 87 38 38 895 3 36 873 2 22
2012 1 174 0 871 4 50 50 1 209 15 50 1 209 0 0
2013 253 0 55 15 15 15 964 26 12 945 1 9
2014 242 0 8 24 7 7 236 0 3 102 1 5
2015 242 0 6 34 1 1 13 0 0 0 0 0
Source: Monthly VPD Reporting to WHO/SEARO * Laboratory confirmed & epidemiologically- linked
Table 8: Suspected sporadic and Outbreak associated measles and rubella cases, 2010–2015
Table 9: Quality of field and laboratory surveillance for measles and rubella, 2012–2015
Year
No. o
f Sus
pect
ed M
easl
es
Case classification (number) Indicators
Measles Rubella
Disc
arde
d no
n-m
easl
es n
on-
rube
lla c
ases
Annu
al in
cide
nce
of
confi
rmed
Mea
sles
cas
es p
er
mill
ion
tota
l pop
ulat
ion
Annu
al in
cide
nce
of
confi
rmed
Rub
ella
cas
es p
er
mill
ion
tota
l pop
ulat
ion
Prop
ortio
n of
all
susp
ecte
d m
easl
es a
nd ru
bella
cas
es
that
hav
e ha
d an
ade
quat
e in
vest
igat
ion
initi
ated
with
in
48 h
ours
of n
otifi
catio
n
Disc
arde
d no
n-m
easl
es
non-
rube
lla in
cide
nce
per
100,
000
tota
l pop
ulat
ion
Prop
ortio
n of
sub
natio
nal
adm
inis
trativ
e un
its re
porti
ng
at le
ast t
wo
disc
arde
d no
n-m
easl
es n
on-r
ubel
la c
ases
pe
r 100
,000
tota
l pop
ulat
ion
Prop
ortio
n of
sub
-nat
iona
l su
rvei
llanc
e un
its re
porti
ng
to th
e na
tiona
l lev
el o
n tim
e
Lab-
confi
rmed
Epi-L
inke
d
Clin
ical
ly-c
onfir
med
Lab-
confi
rmed
Epi-L
inke
d
Target – – 80% 2 80% 80%
2012 2 349 1 125 908 24 20 0 170 33.37 0.34 ND 0.34 15 97
2013 1 217 111 2 8 20 3 183 16.24 0.37 ND 0.34 16 96
2014 479 25 96 0 28 3 327 1.94 0.48 46 0.57 19 92
2015 243 6 0 0 33 1 203 0.12 0.68 ND 0.42 ND ND
Source: SEAR Annual EPI Reporting Form ND=No data
Table 10: Performance of Laboratory Surveillance, 2012–2015
Year
% Serum specimen collected from
suspected measles cases
Total Serum Specimen
received in Laboratory
% serum specimens
tested
Specimen Positive for Measles IgM
Specimen Positive for Rubella IgM
% Results within 4 of
receipt
% Outbreak tested for
viral detection
Genotypes detected
No. % No. % Measles Rubella
2012 92 1 455 97 1 182 83 20 10 NA 100 D9 ND
2013 100 336 97 110 33 23 11 NA 100 ND ND
2014 95 282 100 24 9 29 11 52 100 ND ND
2015 100 244 100 6 3 34 14 93 100 ND ND
Source: SEAR Annual EPI Reporting Form ND=No data
For contact or feedback: Deputy Director (Expanded Programme on Immunization)Department of Public Health, Ministry of HealthNay Pyi Taw, Myanmar, Tel:+95 67420925Email:[email protected], www.moh.gov.mm
Immunization and Vaccine Development (IVD)WHO-SEARO, IP Estate, MG Marg, New Delhi 110002, IndiaTel: +91 11 23370804, Fax: +91 11 23370251Email: [email protected], www.searo.who.int/entity/immunization
0%10%20%30%40%50%60%70%80%90%
100%
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Perce
nt of
popu
lation
Age (in years)Protected by maternal antibodies Protected by routine vaccination with 1st doseProtected by routine vaccination with 2nd dose Protected by SIAsImmune due to past infection Susceptible
0%10%20%30%40%50%60%70%80%90%
100%
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Perce
nt of
popu
lation
Age (in years)Susceptible Immune due to past infectionProtected by SIAs Protected by routine vaccination with 2nd doseProtected by routine vaccination with 1st dose Protected by maternal antibodies
0
50
100
150
200
250
300
350
2010 2011 2012 2013 2014 2015
<1 year 1–4 years 5–9 years 10–14 years 15+ years
n=101 n=842 n=1208 n=945 n=102 n=0 n=33 n=420 n=558 n=871 n=102 n=0(33%) (50%) (46%) (92%) (100%) (0%)
0
50
100
150
200
250
300
350
2010 2011 2012 2013 2014 2015
<1 year 1–4 years 5–9 years 10–14 years 15+ years
E P I F a c t S h E E t
World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development
South-East Asia Region
Table 3: OPV supplementary immunization activities (SIA)
Figure 3: DTP-Hib-HepB3 coverage, 2015
Figure 5: Non-polio AFP rate by province, 2015 Table 6: MCV supplementary immunization activities
Figure 7: MCV1 & MCV2 coverage1 and measles cases2, 1980–2015
Figure 9: Sporadic and outbreak associated measles cases* by month and MR SIA coverage, 2010–2015
Figure 4: TT2+ coverage1 and NT cases2, 1980–2015
Figure 6: Adequate stool specimen collection percentage by province, 2015
Table 7: Districts with more than 95% MCV1 coverage
Figure 8: MCV1 coverage by province, 2015
Year Activity Target population (<5 years)
Date of 1st round Date of 2nd round 1st round coverage (%) 2nd round coverage (%)
2002-2003 NID 6 251 093 8-Dec-02 12-Jan-03 97 97
2003-2004 SNID 771 081 14-Dec-03 18-Jan-04 95 99
2005 SNID 321 850 9-Jan-05 20-Feb-05 99 100
2006 SNID 104 572 22-Jan-06 26-Feb-07 100 100
2006 SNID 2 037 606 3-Sep-06 1-Oct-06 97 97
2007 SNID 415 554 14-May-07 9-Jun-07 116 101
2007 SNID 2 416 960 4-Jul-07 3-Sep-07 102 99
2007 NID 7 207 399 3-Nov-07 2-Dec-07 98 98
2008 SNID 1 825 117 25-Feb-08 - 99 -
2009 NID 7 394 415 10-Jan-09 9-Feb-09 98 100
2010 SNID 2 229 394 3-Apr-10 1-May-10 98 100
2011 SNID 2 925 709 14-May-11 11-Jun-11 98 99
2012 SNID 281 026 22-Oct-12 22-Nov-12 99 101
2013 SNID 335 860 Mar-2013 Apr-2013 97 97
2015 SNID 367 972 5-Dec-15 - 97 -Source: WHO/UNICEF JRF
Indicator 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
AFP cases 410 413 511 472 414 418 457 404 389 336
Wild poliovirus confirmed cases 0 11 0 0 0 0 0 0 0 0
Compatible cases 0 8 0 0 0 0 0 0 0 0
AFP rate 2.13 2.10 2.55 2.33 2.02 2.02 2.21 1.91 1.82 2.36
Non-polio AFP rate1 2.12 1.98 2.55 2.33 2.02 2.02 2.21 1.91 1.82 2.34
Adequate stool specimen collection percentage2 95% 91% 95% 96% 94% 94% 97% 95% 96% 93%
Total stool samples collected 808 811 1,016 942 828 834 916 808 772 672
% NPEV isolation 16 11 11 7 14 14 14 11 13 13
% Timeliness of primary result reported3 100 100 100 100 91 92 93 94 94 95
Year Vaccine, geographic coverage, target group
Target Coverage Achieved
2007 M, nationwide, 9 months to 59 months 6 056 000 94%
2012 M, follow up, 9 months to 59 months 6 432 064 97%
2015 MR, 9 months to 15 years 13 958 963 94%
Year Number of districts %
2010 81 25
2011 81 25
2012 74 22
2013 86 26
2014 106 32
2015 63 19
1 Number of discarded AFP cases per 100,000 children under 15 years of age.2 Percent with 2 specimens, 24 hours apart and within 14 days of paralysis onset.3 2005 to 2007 result reported within 28 days and 2008 onwards result reported within 14 days of sample received at laboratory.
*Includes laboratory confirmed and epidemiologically linked casesSource: SEAR Monthly VPD reports
Source: WHO/UNICEF JRF
Source: WHO/UNICEF JRF
Table 4: AFP surveillance performance indicators, 2006–2015• Last polio case due to indigenous wild polio virus (WPV) was reported from Rakhine province in February 2000.• Last polio case due to imported wild polio virus (WPV) was reported from Rakhine province in May 2007.
Figure 1: National immunization coverage, 1980–2015 Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980–2015
Year Polio Diphtheria Pertussis Neonatal Tetanus (% of all Tetanus)
Measles Rubella Mumps Japanese Encephalitis
Congenital Rubella Syndrome
2006 0a 3 13 41 (18%) 735 0 0 0 ND
2007 11b 5 13 49 (19%) 1 088 2 ND 28 ND
2008 0 3 5 25 (17%) 333 5 ND 5 ND
2009 0 19 3 34 (15%) 217 13 ND 8 ND
2010 0c 4 0 19 (20%) 190 11 ND 18 ND
2011 0 7 5 32 (18%) 2 046 103 ND 20 ND
2012 0d 19 2 29 (39%) 2 175 21 ND 14 ND
2013 0 38 14 39 (53%) 1 010 23 ND 3 ND
2014 0 29 5 32 (44%) 122 30 ND 50 ND
2015 0e 87 5 30 (ND) 6 34 ND 113 ND
Table 5: Reported cases of vaccine preventable disease, 2006–2015
a Excludes one type 1 VDPV b Excludes four type 1 VDPV c Excludes one type 2 VDPV d Excludes one type 1 VDPV e Excludes two type 2 VDPVs
Source: WHO/UNICEF JRF ND=No data
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015BCG 9 45 95 90 88 76 93 93 87 86 86 86DTP3 4 16 88 84 82 73 90 84 84 75 75 75OPV3 3 88 84 88 86 90 90 87 76 76 76MCV1 68 82 84 84 88 88 84 86 86 86
0
20
40
60
80
100
% C
over
age
0
20
40
60
80
100
0
200
400
600
800
1000
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
Year
Diphtheria Cases Pertussis Cases DTP3 Coverage
26878 10238 7882
<70% 70%–79% 80%–89% > 90%
0
20
40
60
80
100
020406080
100120140
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearNT cases TT2 Coverage
<60% 60%–79% > No AFP80<1 1–1.99 > No non-polio AFP case2
21457 16386 7900
0
20
40
60
80
100
0
300
600
900
1200
1500
1800
2100
2400
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearMeasles Cases MCV1 Coverage MCV2 Coverage
<70% 70%–79% 80%–89% > 90
0
100
200
300
400
500
600
Jan-
10Ma
r-10
May-1
0Ju
l-10
Sep-
10No
v-10
Jan-
11Ma
r-11
May-1
1Ju
l-11
Sep-
11No
v-11
Jan-
12Ma
r-12
May-1
2Ju
l-12
Sep-
12No
v-12
Jan-
13Ma
r-13
May-1
3Ju
l-13
Sep-
13No
v-13
Jan-
14Ma
r-14
May-1
4Ju
l-14
Sep-
14No
v-14
Jan-
15Ma
r-15
May-1
5Ju
l-15
Sep-
15No
v-15
No. o
f cas
es
Sporadic measles Outbreak associated measles
M, follow up (97%) MR, catch up (94%)
Source: SEAR annual EPI reporting form, 2015 (administrative data)1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016
1 Country official estimates, 1980-2015.2 WHO vaccine-preventable diseases: monitoring system 2016.
Source: WHO and UNICEF estimates of national immunization coverage, July 2016 revision
1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016
E P I F a c t S h E E t
World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development
South-East Asia Region
Table 3: OPV supplementary immunization activities (SIA)
Figure 3: DTP-Hib-HepB3 coverage, 2015
Figure 5: Non-polio AFP rate by province, 2015 Table 6: MCV supplementary immunization activities
Figure 7: MCV1 & MCV2 coverage1 and measles cases2, 1980–2015
Figure 9: Sporadic and outbreak associated measles cases* by month and MR SIA coverage, 2010–2015
Figure 4: TT2+ coverage1 and NT cases2, 1980–2015
Figure 6: Adequate stool specimen collection percentage by province, 2015
Table 7: Districts with more than 95% MCV1 coverage
Figure 8: MCV1 coverage by province, 2015
Year Activity Target population (<5 years)
Date of 1st round Date of 2nd round 1st round coverage (%) 2nd round coverage (%)
2002-2003 NID 6 251 093 8-Dec-02 12-Jan-03 97 97
2003-2004 SNID 771 081 14-Dec-03 18-Jan-04 95 99
2005 SNID 321 850 9-Jan-05 20-Feb-05 99 100
2006 SNID 104 572 22-Jan-06 26-Feb-07 100 100
2006 SNID 2 037 606 3-Sep-06 1-Oct-06 97 97
2007 SNID 415 554 14-May-07 9-Jun-07 116 101
2007 SNID 2 416 960 4-Jul-07 3-Sep-07 102 99
2007 NID 7 207 399 3-Nov-07 2-Dec-07 98 98
2008 SNID 1 825 117 25-Feb-08 - 99 -
2009 NID 7 394 415 10-Jan-09 9-Feb-09 98 100
2010 SNID 2 229 394 3-Apr-10 1-May-10 98 100
2011 SNID 2 925 709 14-May-11 11-Jun-11 98 99
2012 SNID 281 026 22-Oct-12 22-Nov-12 99 101
2013 SNID 335 860 Mar-2013 Apr-2013 97 97
2015 SNID 367 972 5-Dec-15 - 97 -Source: WHO/UNICEF JRF
Indicator 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
AFP cases 410 413 511 472 414 418 457 404 389 336
Wild poliovirus confirmed cases 0 11 0 0 0 0 0 0 0 0
Compatible cases 0 8 0 0 0 0 0 0 0 0
AFP rate 2.13 2.10 2.55 2.33 2.02 2.02 2.21 1.91 1.82 2.36
Non-polio AFP rate1 2.12 1.98 2.55 2.33 2.02 2.02 2.21 1.91 1.82 2.34
Adequate stool specimen collection percentage2 95% 91% 95% 96% 94% 94% 97% 95% 96% 93%
Total stool samples collected 808 811 1,016 942 828 834 916 808 772 672
% NPEV isolation 16 11 11 7 14 14 14 11 13 13
% Timeliness of primary result reported3 100 100 100 100 91 92 93 94 94 95
Year Vaccine, geographic coverage, target group
Target Coverage Achieved
2007 M, nationwide, 9 months to 59 months 6 056 000 94%
2012 M, follow up, 9 months to 59 months 6 432 064 97%
2015 MR, 9 months to 15 years 13 958 963 94%
Year Number of districts %
2010 81 25
2011 81 25
2012 74 22
2013 86 26
2014 106 32
2015 63 19
1 Number of discarded AFP cases per 100,000 children under 15 years of age.2 Percent with 2 specimens, 24 hours apart and within 14 days of paralysis onset.3 2005 to 2007 result reported within 28 days and 2008 onwards result reported within 14 days of sample received at laboratory.
*Includes laboratory confirmed and epidemiologically linked casesSource: SEAR Monthly VPD reports
Source: WHO/UNICEF JRF
Source: WHO/UNICEF JRF
Table 4: AFP surveillance performance indicators, 2006–2015• Last polio case due to indigenous wild polio virus (WPV) was reported from Rakhine province in February 2000.• Last polio case due to imported wild polio virus (WPV) was reported from Rakhine province in May 2007.
Figure 1: National immunization coverage, 1980–2015 Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980–2015
Year Polio Diphtheria Pertussis Neonatal Tetanus (% of all Tetanus)
Measles Rubella Mumps Japanese Encephalitis
Congenital Rubella Syndrome
2006 0a 3 13 41 (18%) 735 0 0 0 ND
2007 11b 5 13 49 (19%) 1 088 2 ND 28 ND
2008 0 3 5 25 (17%) 333 5 ND 5 ND
2009 0 19 3 34 (15%) 217 13 ND 8 ND
2010 0c 4 0 19 (20%) 190 11 ND 18 ND
2011 0 7 5 32 (18%) 2 046 103 ND 20 ND
2012 0d 19 2 29 (39%) 2 175 21 ND 14 ND
2013 0 38 14 39 (53%) 1 010 23 ND 3 ND
2014 0 29 5 32 (44%) 122 30 ND 50 ND
2015 0e 87 5 30 (ND) 6 34 ND 113 ND
Table 5: Reported cases of vaccine preventable disease, 2006–2015
a Excludes one type 1 VDPV b Excludes four type 1 VDPV c Excludes one type 2 VDPV d Excludes one type 1 VDPV e Excludes two type 2 VDPVs
Source: WHO/UNICEF JRF ND=No data
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015BCG 9 45 95 90 88 76 93 93 87 86 86 86DTP3 4 16 88 84 82 73 90 84 84 75 75 75OPV3 3 88 84 88 86 90 90 87 76 76 76MCV1 68 82 84 84 88 88 84 86 86 86
0
20
40
60
80
100
% C
over
age
0
20
40
60
80
100
0
200
400
600
800
1000
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
Year
Diphtheria Cases Pertussis Cases DTP3 Coverage
26878 10238 7882
<70% 70%–79% 80%–89% > 90%
0
20
40
60
80
100
020406080
100120140
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearNT cases TT2 Coverage
<60% 60%–79% > No AFP80<1 1–1.99 > No non-polio AFP case2
21457 16386 7900
0
20
40
60
80
100
0
300
600
900
1200
1500
1800
2100
2400
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearMeasles Cases MCV1 Coverage MCV2 Coverage
<70% 70%–79% 80%–89% > 90
0
100
200
300
400
500
600
Jan-
10Ma
r-10
May-1
0Ju
l-10
Sep-
10No
v-10
Jan-
11Ma
r-11
May-1
1Ju
l-11
Sep-
11No
v-11
Jan-
12Ma
r-12
May-1
2Ju
l-12
Sep-
12No
v-12
Jan-
13Ma
r-13
May-1
3Ju
l-13
Sep-
13No
v-13
Jan-
14Ma
r-14
May-1
4Ju
l-14
Sep-
14No
v-14
Jan-
15Ma
r-15
May-1
5Ju
l-15
Sep-
15No
v-15
No. o
f cas
es
Sporadic measles Outbreak associated measles
M, follow up (97%) MR, catch up (94%)
Source: SEAR annual EPI reporting form, 2015 (administrative data)1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016
1 Country official estimates, 1980-2015.2 WHO vaccine-preventable diseases: monitoring system 2016.
Source: WHO and UNICEF estimates of national immunization coverage, July 2016 revision
1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016
E P I F a c t S h E E t
World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development
South-East Asia Region
Table 3: OPV supplementary immunization activities (SIA)
Figure 3: DTP-Hib-HepB3 coverage, 2015
Figure 5: Non-polio AFP rate by province, 2015 Table 6: MCV supplementary immunization activities
Figure 7: MCV1 & MCV2 coverage1 and measles cases2, 1980–2015
Figure 9: Sporadic and outbreak associated measles cases* by month and MR SIA coverage, 2010–2015
Figure 4: TT2+ coverage1 and NT cases2, 1980–2015
Figure 6: Adequate stool specimen collection percentage by province, 2015
Table 7: Districts with more than 95% MCV1 coverage
Figure 8: MCV1 coverage by province, 2015
Year Activity Target population (<5 years)
Date of 1st round Date of 2nd round 1st round coverage (%) 2nd round coverage (%)
2002-2003 NID 6 251 093 8-Dec-02 12-Jan-03 97 97
2003-2004 SNID 771 081 14-Dec-03 18-Jan-04 95 99
2005 SNID 321 850 9-Jan-05 20-Feb-05 99 100
2006 SNID 104 572 22-Jan-06 26-Feb-07 100 100
2006 SNID 2 037 606 3-Sep-06 1-Oct-06 97 97
2007 SNID 415 554 14-May-07 9-Jun-07 116 101
2007 SNID 2 416 960 4-Jul-07 3-Sep-07 102 99
2007 NID 7 207 399 3-Nov-07 2-Dec-07 98 98
2008 SNID 1 825 117 25-Feb-08 - 99 -
2009 NID 7 394 415 10-Jan-09 9-Feb-09 98 100
2010 SNID 2 229 394 3-Apr-10 1-May-10 98 100
2011 SNID 2 925 709 14-May-11 11-Jun-11 98 99
2012 SNID 281 026 22-Oct-12 22-Nov-12 99 101
2013 SNID 335 860 Mar-2013 Apr-2013 97 97
2015 SNID 367 972 5-Dec-15 - 97 -Source: WHO/UNICEF JRF
Indicator 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
AFP cases 410 413 511 472 414 418 457 404 389 336
Wild poliovirus confirmed cases 0 11 0 0 0 0 0 0 0 0
Compatible cases 0 8 0 0 0 0 0 0 0 0
AFP rate 2.13 2.10 2.55 2.33 2.02 2.02 2.21 1.91 1.82 2.36
Non-polio AFP rate1 2.12 1.98 2.55 2.33 2.02 2.02 2.21 1.91 1.82 2.34
Adequate stool specimen collection percentage2 95% 91% 95% 96% 94% 94% 97% 95% 96% 93%
Total stool samples collected 808 811 1,016 942 828 834 916 808 772 672
% NPEV isolation 16 11 11 7 14 14 14 11 13 13
% Timeliness of primary result reported3 100 100 100 100 91 92 93 94 94 95
Year Vaccine, geographic coverage, target group
Target Coverage Achieved
2007 M, nationwide, 9 months to 59 months 6 056 000 94%
2012 M, follow up, 9 months to 59 months 6 432 064 97%
2015 MR, 9 months to 15 years 13 958 963 94%
Year Number of districts %
2010 81 25
2011 81 25
2012 74 22
2013 86 26
2014 106 32
2015 63 19
1 Number of discarded AFP cases per 100,000 children under 15 years of age.2 Percent with 2 specimens, 24 hours apart and within 14 days of paralysis onset.3 2005 to 2007 result reported within 28 days and 2008 onwards result reported within 14 days of sample received at laboratory.
*Includes laboratory confirmed and epidemiologically linked casesSource: SEAR Monthly VPD reports
Source: WHO/UNICEF JRF
Source: WHO/UNICEF JRF
Table 4: AFP surveillance performance indicators, 2006–2015• Last polio case due to indigenous wild polio virus (WPV) was reported from Rakhine province in February 2000.• Last polio case due to imported wild polio virus (WPV) was reported from Rakhine province in May 2007.
Figure 1: National immunization coverage, 1980–2015 Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980–2015
Year Polio Diphtheria Pertussis Neonatal Tetanus (% of all Tetanus)
Measles Rubella Mumps Japanese Encephalitis
Congenital Rubella Syndrome
2006 0a 3 13 41 (18%) 735 0 0 0 ND
2007 11b 5 13 49 (19%) 1 088 2 ND 28 ND
2008 0 3 5 25 (17%) 333 5 ND 5 ND
2009 0 19 3 34 (15%) 217 13 ND 8 ND
2010 0c 4 0 19 (20%) 190 11 ND 18 ND
2011 0 7 5 32 (18%) 2 046 103 ND 20 ND
2012 0d 19 2 29 (39%) 2 175 21 ND 14 ND
2013 0 38 14 39 (53%) 1 010 23 ND 3 ND
2014 0 29 5 32 (44%) 122 30 ND 50 ND
2015 0e 87 5 30 (ND) 6 34 ND 113 ND
Table 5: Reported cases of vaccine preventable disease, 2006–2015
a Excludes one type 1 VDPV b Excludes four type 1 VDPV c Excludes one type 2 VDPV d Excludes one type 1 VDPV e Excludes two type 2 VDPVs
Source: WHO/UNICEF JRF ND=No data
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015BCG 9 45 95 90 88 76 93 93 87 86 86 86DTP3 4 16 88 84 82 73 90 84 84 75 75 75OPV3 3 88 84 88 86 90 90 87 76 76 76MCV1 68 82 84 84 88 88 84 86 86 86
0
20
40
60
80
100
% C
over
age
0
20
40
60
80
100
0
200
400
600
800
1000
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
Year
Diphtheria Cases Pertussis Cases DTP3 Coverage
26878 10238 7882
<70% 70%–79% 80%–89% > 90%
0
20
40
60
80
100
020406080
100120140
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearNT cases TT2 Coverage
<60% 60%–79% > No AFP80<1 1–1.99 > No non-polio AFP case2
21457 16386 7900
0
20
40
60
80
100
0
300
600
900
1200
1500
1800
2100
2400
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015%
Cov
erag
e
No. o
f cas
es
YearMeasles Cases MCV1 Coverage MCV2 Coverage
<70% 70%–79% 80%–89% > 90
0
100
200
300
400
500
600
Jan-
10Ma
r-10
May-1
0Ju
l-10
Sep-
10No
v-10
Jan-
11Ma
r-11
May-1
1Ju
l-11
Sep-
11No
v-11
Jan-
12Ma
r-12
May-1
2Ju
l-12
Sep-
12No
v-12
Jan-
13Ma
r-13
May-1
3Ju
l-13
Sep-
13No
v-13
Jan-
14Ma
r-14
May-1
4Ju
l-14
Sep-
14No
v-14
Jan-
15Ma
r-15
May-1
5Ju
l-15
Sep-
15No
v-15
No. o
f cas
es
Sporadic measles Outbreak associated measles
M, follow up (97%) MR, catch up (94%)
Source: SEAR annual EPI reporting form, 2015 (administrative data)1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016
1 Country official estimates, 1980-2015.2 WHO vaccine-preventable diseases: monitoring system 2016.
Source: WHO and UNICEF estimates of national immunization coverage, July 2016 revision
1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016
National Health laboratory - National polio laboratory - National measles & rubella laboratory - National Japanese encephalitis laboratory
- Department of Medical Research
NSC OfficeRSOs Office
Rotavirus laboratory
World Health Organization• SEARO/FGL/IVD • 31 August 2016World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development
South-East Asia Region
Immunization andVaccine Development
South-East Asia Region
Myanmar 2016
Immunization system highlights
� There is a comprehensive multi-year plan (cMYP) for immunization covering 2017-2021.
� A national committee on immunization practice (NCIP) fully functional.
� A national system to monitor adverse events following immunization (AEFI) exists.
� A national policy for health care waste management including waste from immunization activities exists.
� All 330 districts had updated routine immunization micro-plans to raise immunization coverage.
� 11% of vaccine costs financed by the government.
� Of the 330 Townships, 282 (85%) have ³80% coverage for DTP-Hib-HepB3, 147 (45%) have ³90% coverage for MCV1.
� Demographic Health Survey is ongoing in 2015-2016.
Source: WHO/UNICEF joint reporting form (JRF) 2015
Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
Table 1: Basic information1 2015Division/Province/State/Region 17
Township/District 330/69
City/Town 396
Village 67,285
Population density (per sq. km) 88
Population living in urban areas 33%
Population using improved drinking-water sources
86%
Population using improved sanitation 77%
Total expenditure on health as % of GDP 1.8%
Births attended by skilled health personnel 78%
Neonates protected at birth against NT 87%
Total population 50 402 517
Live births (LB) 1 023 892
Children <1 year 928 612
Children <5 years 4 536 499
Children <15 years 13 342 996
Pregnant women 1 012 556
Women of child bearing age (15-49 years)
13 135 291
Neonatal mortality rate 25.5 (per 1,000 LB)
Infant mortality rate 39.8 (per 1,000 LB)
Under-five mortality rate 50.5 (per 1,000 LB)
Maternal mortality ratio 200 (per 100,000 LB)
1 SEAR annual EPI reporting form, 2015 and WHO, World Health Statistics 2015
Vaccine Age of administration
BCG Births to 2 months
DTP-Hib-HepB 2 months, 4 months, 6 months
OPV 2 months, 4 months, 6 months
IPV 4 months
MR 9 months
Measles 18 months
TT During pregnancy (at first contact and 1 month later)
Vitamin A 6-59 months
EPI history � EPI launched in 1978.
� OPV and Measles vaccines introduced in 1987.
� AD syringes introduced in 2002.
� Hepatitis B vaccine introduced in 2003.
� MCV2 introduced partially in 2008 and made available nationwide in 2012.
� Hib Pentavalent (DTP-Hib-HepB) vaccine introduced in 2012.
� MR vaccine introduced in 2015.
� IPV introduced in 2015.
� Type 2 component of OPV withdrawn on 29 Apr 2016 by switching from tOPV to bOPV.
� PCV introduced in July 2016.
Table 2: Immunization schedule, 2015
Source: cMYP 2012–2016 and EPI/MOHSource: WHO/UNICEF joint reporting form (JRF) 2015
E P I F a c t S h E E t
Figure 12: Confirmed (Lab and Epi linked) measles outbreak associated cases, by age, 2010–2015
Figure 10: Immunity against measles: Immunity profile by age in 2015*
Figure 13: Unimmunized confirmed (Lab and Epi linked) measles outbreak associated cases, by age, 2010–2015
Figure 14: Network of WHO supported surveillance medical officers and laboratories
Figure 11: Immunity against measles: Immunity profile by age in 2016*
*Modeled using MSP tool ver 2 based on coverage data up to 2015.
Source: SEAR annual EPI reporting form
*Modeled using MSP tool ver 2 assuming the schedule and measles containing vaccine (MCV) coverage remain unchanged and no SIAs in 2016
Source: SEAR annual EPI reporting form ND = No data
Routine/sporadic cases Outbreak associated cases
Year No. of suspected
case
No. of death
No. of lab-confirmed
measles cases
No. of lab-confirmed
rubella cases
No. of suspected
outbreak
No. of Outbreak
Investigated
No. of case
No. of death
No. of measles
outbreak*
No. of confirmed
measles case*
No. of confirmed
rubella outbreak*
No. of confirmed
rubella cases*
2010 135 0 48 6 12 12 201 1 7 102 1 8
2011 1 605 3 879 87 38 38 895 3 36 873 2 22
2012 1 174 0 871 4 50 50 1 209 15 50 1 209 0 0
2013 253 0 55 15 15 15 964 26 12 945 1 9
2014 242 0 8 24 7 7 236 0 3 102 1 5
2015 242 0 6 34 1 1 13 0 0 0 0 0
Source: Monthly VPD Reporting to WHO/SEARO * Laboratory confirmed & epidemiologically- linked
Table 8: Suspected sporadic and Outbreak associated measles and rubella cases, 2010–2015
Table 9: Quality of field and laboratory surveillance for measles and rubella, 2012–2015
Year
No. o
f Sus
pect
ed M
easl
es
Case classification (number) Indicators
Measles Rubella
Disc
arde
d no
n-m
easl
es n
on-
rube
lla c
ases
Annu
al in
cide
nce
of
confi
rmed
Mea
sles
cas
es p
er
mill
ion
tota
l pop
ulat
ion
Annu
al in
cide
nce
of
confi
rmed
Rub
ella
cas
es p
er
mill
ion
tota
l pop
ulat
ion
Prop
ortio
n of
all
susp
ecte
d m
easl
es a
nd ru
bella
cas
es
that
hav
e ha
d an
ade
quat
e in
vest
igat
ion
initi
ated
with
in
48 h
ours
of n
otifi
catio
n
Disc
arde
d no
n-m
easl
es
non-
rube
lla in
cide
nce
per
100,
000
tota
l pop
ulat
ion
Prop
ortio
n of
sub
natio
nal
adm
inis
trativ
e un
its re
porti
ng
at le
ast t
wo
disc
arde
d no
n-m
easl
es n
on-r
ubel
la c
ases
pe
r 100
,000
tota
l pop
ulat
ion
Prop
ortio
n of
sub
-nat
iona
l su
rvei
llanc
e un
its re
porti
ng
to th
e na
tiona
l lev
el o
n tim
e
Lab-
confi
rmed
Epi-L
inke
d
Clin
ical
ly-c
onfir
med
Lab-
confi
rmed
Epi-L
inke
d
Target – – 80% 2 80% 80%
2012 2 349 1 125 908 24 20 0 170 33.37 0.34 ND 0.34 15 97
2013 1 217 111 2 8 20 3 183 16.24 0.37 ND 0.34 16 96
2014 479 25 96 0 28 3 327 1.94 0.48 46 0.57 19 92
2015 243 6 0 0 33 1 203 0.12 0.68 ND 0.42 ND ND
Source: SEAR Annual EPI Reporting Form ND=No data
Table 10: Performance of Laboratory Surveillance, 2012–2015
Year
% Serum specimen collected from
suspected measles cases
Total Serum Specimen
received in Laboratory
% serum specimens
tested
Specimen Positive for Measles IgM
Specimen Positive for Rubella IgM
% Results within 4 of
receipt
% Outbreak tested for
viral detection
Genotypes detected
No. % No. % Measles Rubella
2012 92 1 455 97 1 182 83 20 10 NA 100 D9 ND
2013 100 336 97 110 33 23 11 NA 100 ND ND
2014 95 282 100 24 9 29 11 52 100 ND ND
2015 100 244 100 6 3 34 14 93 100 ND ND
Source: SEAR Annual EPI Reporting Form ND=No data
For contact or feedback: Deputy Director (Expanded Programme on Immunization)Department of Public Health, Ministry of HealthNay Pyi Taw, Myanmar, Tel:+95 67420925Email:[email protected], www.moh.gov.mm
Immunization and Vaccine Development (IVD)WHO-SEARO, IP Estate, MG Marg, New Delhi 110002, IndiaTel: +91 11 23370804, Fax: +91 11 23370251Email: [email protected], www.searo.who.int/entity/immunization
0%10%20%30%40%50%60%70%80%90%
100%
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Perce
nt of
popu
lation
Age (in years)Protected by maternal antibodies Protected by routine vaccination with 1st doseProtected by routine vaccination with 2nd dose Protected by SIAsImmune due to past infection Susceptible
0%10%20%30%40%50%60%70%80%90%
100%
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Perce
nt of
popu
lation
Age (in years)Susceptible Immune due to past infectionProtected by SIAs Protected by routine vaccination with 2nd doseProtected by routine vaccination with 1st dose Protected by maternal antibodies
0
50
100
150
200
250
300
350
2010 2011 2012 2013 2014 2015
<1 year 1–4 years 5–9 years 10–14 years 15+ years
n=101 n=842 n=1208 n=945 n=102 n=0 n=33 n=420 n=558 n=871 n=102 n=0(33%) (50%) (46%) (92%) (100%) (0%)
0
50
100
150
200
250
300
350
2010 2011 2012 2013 2014 2015
<1 year 1–4 years 5–9 years 10–14 years 15+ years
National Health laboratory - National polio laboratory - National measles & rubella laboratory - National Japanese encephalitis laboratory
- Department of Medical Research
NSC OfficeRSOs Office
Rotavirus laboratory
World Health Organization• SEARO/FGL/IVD • 31 August 2016World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development
South-East Asia Region
Immunization andVaccine Development
South-East Asia Region
Myanmar 2016
Immunization system highlights
� There is a comprehensive multi-year plan (cMYP) for immunization covering 2017-2021.
� A national committee on immunization practice (NCIP) fully functional.
� A national system to monitor adverse events following immunization (AEFI) exists.
� A national policy for health care waste management including waste from immunization activities exists.
� All 330 districts had updated routine immunization micro-plans to raise immunization coverage.
� 11% of vaccine costs financed by the government.
� Of the 330 Townships, 282 (85%) have ³80% coverage for DTP-Hib-HepB3, 147 (45%) have ³90% coverage for MCV1.
� Demographic Health Survey is ongoing in 2015-2016.
Source: WHO/UNICEF joint reporting form (JRF) 2015
Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
Table 1: Basic information1 2015Division/Province/State/Region 17
Township/District 330/69
City/Town 396
Village 67,285
Population density (per sq. km) 88
Population living in urban areas 33%
Population using improved drinking-water sources
86%
Population using improved sanitation 77%
Total expenditure on health as % of GDP 1.8%
Births attended by skilled health personnel 78%
Neonates protected at birth against NT 87%
Total population 50 402 517
Live births (LB) 1 023 892
Children <1 year 928 612
Children <5 years 4 536 499
Children <15 years 13 342 996
Pregnant women 1 012 556
Women of child bearing age (15-49 years)
13 135 291
Neonatal mortality rate 25.5 (per 1,000 LB)
Infant mortality rate 39.8 (per 1,000 LB)
Under-five mortality rate 50.5 (per 1,000 LB)
Maternal mortality ratio 200 (per 100,000 LB)
1 SEAR annual EPI reporting form, 2015 and WHO, World Health Statistics 2015
Vaccine Age of administration
BCG Births to 2 months
DTP-Hib-HepB 2 months, 4 months, 6 months
OPV 2 months, 4 months, 6 months
IPV 4 months
MR 9 months
Measles 18 months
TT During pregnancy (at first contact and 1 month later)
Vitamin A 6-59 months
EPI history � EPI launched in 1978.
� OPV and Measles vaccines introduced in 1987.
� AD syringes introduced in 2002.
� Hepatitis B vaccine introduced in 2003.
� MCV2 introduced partially in 2008 and made available nationwide in 2012.
� Hib Pentavalent (DTP-Hib-HepB) vaccine introduced in 2012.
� MR vaccine introduced in 2015.
� IPV introduced in 2015.
� Type 2 component of OPV withdrawn on 29 Apr 2016 by switching from tOPV to bOPV.
� PCV introduced in July 2016.
Table 2: Immunization schedule, 2015
Source: cMYP 2012–2016 and EPI/MOHSource: WHO/UNICEF joint reporting form (JRF) 2015
E P I F a c t S h E E t
Figure 12: Confirmed (Lab and Epi linked) measles outbreak associated cases, by age, 2010–2015
Figure 10: Immunity against measles: Immunity profile by age in 2015*
Figure 13: Unimmunized confirmed (Lab and Epi linked) measles outbreak associated cases, by age, 2010–2015
Figure 14: Network of WHO supported surveillance medical officers and laboratories
Figure 11: Immunity against measles: Immunity profile by age in 2016*
*Modeled using MSP tool ver 2 based on coverage data up to 2015.
Source: SEAR annual EPI reporting form
*Modeled using MSP tool ver 2 assuming the schedule and measles containing vaccine (MCV) coverage remain unchanged and no SIAs in 2016
Source: SEAR annual EPI reporting form ND = No data
Routine/sporadic cases Outbreak associated cases
Year No. of suspected
case
No. of death
No. of lab-confirmed
measles cases
No. of lab-confirmed
rubella cases
No. of suspected
outbreak
No. of Outbreak
Investigated
No. of case
No. of death
No. of measles
outbreak*
No. of confirmed
measles case*
No. of confirmed
rubella outbreak*
No. of confirmed
rubella cases*
2010 135 0 48 6 12 12 201 1 7 102 1 8
2011 1 605 3 879 87 38 38 895 3 36 873 2 22
2012 1 174 0 871 4 50 50 1 209 15 50 1 209 0 0
2013 253 0 55 15 15 15 964 26 12 945 1 9
2014 242 0 8 24 7 7 236 0 3 102 1 5
2015 242 0 6 34 1 1 13 0 0 0 0 0
Source: Monthly VPD Reporting to WHO/SEARO * Laboratory confirmed & epidemiologically- linked
Table 8: Suspected sporadic and Outbreak associated measles and rubella cases, 2010–2015
Table 9: Quality of field and laboratory surveillance for measles and rubella, 2012–2015
Year
No. o
f Sus
pect
ed M
easl
es
Case classification (number) Indicators
Measles Rubella
Disc
arde
d no
n-m
easl
es n
on-
rube
lla c
ases
Annu
al in
cide
nce
of
confi
rmed
Mea
sles
cas
es p
er
mill
ion
tota
l pop
ulat
ion
Annu
al in
cide
nce
of
confi
rmed
Rub
ella
cas
es p
er
mill
ion
tota
l pop
ulat
ion
Prop
ortio
n of
all
susp
ecte
d m
easl
es a
nd ru
bella
cas
es
that
hav
e ha
d an
ade
quat
e in
vest
igat
ion
initi
ated
with
in
48 h
ours
of n
otifi
catio
n
Disc
arde
d no
n-m
easl
es
non-
rube
lla in
cide
nce
per
100,
000
tota
l pop
ulat
ion
Prop
ortio
n of
sub
natio
nal
adm
inis
trativ
e un
its re
porti
ng
at le
ast t
wo
disc
arde
d no
n-m
easl
es n
on-r
ubel
la c
ases
pe
r 100
,000
tota
l pop
ulat
ion
Prop
ortio
n of
sub
-nat
iona
l su
rvei
llanc
e un
its re
porti
ng
to th
e na
tiona
l lev
el o
n tim
e
Lab-
confi
rmed
Epi-L
inke
d
Clin
ical
ly-c
onfir
med
Lab-
confi
rmed
Epi-L
inke
dTarget – – 80% 2 80% 80%
2012 2 349 1 125 908 24 20 0 170 33.37 0.34 ND 0.34 15 97
2013 1 217 111 2 8 20 3 183 16.24 0.37 ND 0.34 16 96
2014 479 25 96 0 28 3 327 1.94 0.48 46 0.57 19 92
2015 243 6 0 0 33 1 203 0.12 0.68 ND 0.42 ND ND
Source: SEAR Annual EPI Reporting Form ND=No data
Table 10: Performance of Laboratory Surveillance, 2012–2015
Year
% Serum specimen collected from
suspected measles cases
Total Serum Specimen
received in Laboratory
% serum specimens
tested
Specimen Positive for Measles IgM
Specimen Positive for Rubella IgM
% Results within 4 of
receipt
% Outbreak tested for
viral detection
Genotypes detected
No. % No. % Measles Rubella
2012 92 1 455 97 1 182 83 20 10 NA 100 D9 ND
2013 100 336 97 110 33 23 11 NA 100 ND ND
2014 95 282 100 24 9 29 11 52 100 ND ND
2015 100 244 100 6 3 34 14 93 100 ND ND
Source: SEAR Annual EPI Reporting Form ND=No data
For contact or feedback: Deputy Director (Expanded Programme on Immunization)Department of Public Health, Ministry of HealthNay Pyi Taw, Myanmar, Tel:+95 67420925Email:[email protected], www.moh.gov.mm
Immunization and Vaccine Development (IVD)WHO-SEARO, IP Estate, MG Marg, New Delhi 110002, IndiaTel: +91 11 23370804, Fax: +91 11 23370251Email: [email protected], www.searo.who.int/entity/immunization
0%10%20%30%40%50%60%70%80%90%
100%
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Perce
nt of
popu
lation
Age (in years)Protected by maternal antibodies Protected by routine vaccination with 1st doseProtected by routine vaccination with 2nd dose Protected by SIAsImmune due to past infection Susceptible
0%10%20%30%40%50%60%70%80%90%
100%
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Perce
nt of
popu
lation
Age (in years)Susceptible Immune due to past infectionProtected by SIAs Protected by routine vaccination with 2nd doseProtected by routine vaccination with 1st dose Protected by maternal antibodies
0
50
100
150
200
250
300
350
2010 2011 2012 2013 2014 2015
<1 year 1–4 years 5–9 years 10–14 years 15+ years
n=101 n=842 n=1208 n=945 n=102 n=0 n=33 n=420 n=558 n=871 n=102 n=0(33%) (50%) (46%) (92%) (100%) (0%)
0
50
100
150
200
250
300
350
2010 2011 2012 2013 2014 2015
<1 year 1–4 years 5–9 years 10–14 years 15+ years
