Daniel A. Kertesz,1
Kandjoura Touré,2 Adama Berthé,2 Youssouf Konaté,3
andFlabou Bougoudogo4
1Bureaudel'OrganisationMondialedela
Santé, 2Divisiondel'Epidémiologie
and 3CentreNationald'Immunisation,
DirectionNationaldelaSantéPublique,and 4InstitutNationaldelaRechercheenSantéPublique,Bamako,Mali
There arean estimated 234,000 casesof
measles and 13,851measles-related deaths per yearin Mali. In 1998and 1999, 548,309 childrenaged 959 months werevaccinated
against measles duringmass campaigns in urban
centers across Mali. Afterthe first campaign, measlesincidence decreased by 95%in districts
encompassing vaccinatedurban centers and by
41% in nonvaccinated districts.There was no shiftin the proportion ofcases by age group
in vaccinated centers. Measlesin vaccinated districts
afterthe campaign was likelyrelated to
persistent transmissionin age groups not
targeted for vaccination andamong children living innonvaccinated districts. The secondcampaign (1999)
did notchange the incidence ofmeasles in
vaccinated comparedwith nonvaccinated centers. Urbanmass measles vaccination probablydid not affect
overallmeasles transmission in Mali.Mass
vaccination of allchildren in Mali, targeting
a larger age group,will be necessary toreach
measles control objectives.
ALL INFORMATION, DATA, AND
MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION
PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS
OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR
LEGAL ADVICE. THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND
COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH
YOUR HEALTH CARE PROVIDER.
"A foolish faith in authority is the worst enemy of truth."
-- Albert Einstein, letter to a friend, 1901
"I know of no safe depository of the ultimate powers of the society but the people themselves, and if we think them not enlightened enough to exercise control with a wholesome discretion, the remedy is not to take it from them, but to inform their discretion by education."
-- Thomas Jefferson, letter to William C. Jarvis, September 28, 1820
"What's the point of vaccination if it doesn't protect you from the unvaccinated?"
-- Sandy Gottstein
"Who gets to decide what the greater good is and how many will be sacrificed to it?"