A new report by the World Health Organisation, WHO, has shown that no fewer than 10.3 million people were infected with measles in 2023.
The new estimates from the WHO and the U.S. Centres for Disease Control and Prevention, CDC, showed that the surge was a 20 per cent increase from 2022. The report further traced the surge on inadequate immunisation coverage globally.
Measles is preventable with two doses of measles vaccine; yet more than 22 million children missed their first dose of measles vaccine in 2023. Globally, an estimated 83 per cent of children received their first dose of measles vaccine last year, while only 74 per cent received the recommended second dose.
Coverage of 95 per cent or greater of two doses of measles vaccine is needed in each country and community to prevent outbreaks and protect populations from one of the world’s most contagious human viruses.
WHO Director-General, Dr Tedros Adhanom Ghebreyesus who spoke on the report, said: “Measles vaccine has saved more lives than any other vaccine in the past 50 years. To save even more lives and stop this deadly virus from harming the most vulnerable, we must invest in immunisation for every person, no matter where they live.
“The number of measles infections are rising around the globe, endangering lives and health,” CDC Director Mandy Cohen said. “The measles vaccine is our best protection against the virus, and we must continue to invest in efforts to increase access.”
As a result of global gaps in vaccination coverage, 57 countries experienced large or disruptive measles outbreaks in 2023, affecting all regions except the Americas, and representing a nearly 60 per cent increase from 36 countries in the previous year. The WHO African, Eastern Mediterranean, European, South-East Asia and Western Pacific regions experienced a substantial upsurge in cases. Nearly half of all large and disruptive outbreaks occurred in the African region.
The new data showed that an estimated 107,500 people, mostly children younger than 5 years of age, died due to measles in 2023.
“Although this is an 8 per cent decrease from the previous year, far too many children are still dying from this preventable disease. This slight reduction in deaths was mainly because the surge in cases occurred in countries and regions where children with measles are less likely to die, due to better nutritional status and access to health services.
Even when people survive measles, serious health effects can occur, some of which are lifelong. Infants and young children are at greatest risk of serious complications from the disease, which include blindness, pneumonia, and encephalitis (an infection causing brain swelling and potentially brain damage).
The report further showed that as measles cases surge and outbreaks increase, the world’s elimination goal, as laid out in Immunisation Agenda 2030, was under threat.
“Worldwide, 82 countries had achieved or maintained measles elimination at end of 2023. Just this week, Brazil was reverified as having eliminated measles, making the WHO Americas Region once again free of endemic measles. With the exception of the African Region, at least 1 country in all WHO regions has eliminated the disease.”
It further called for urgent and targeted efforts by countries and partners, particularly in the African and Eastern Mediterranean regions, and in fragile, conflict-affected and vulnerable settings to vaccinate all children fully with two doses of measles vaccine.
“This requires achieving and maintaining high-performing routine immunisation programmes and delivering high-quality, high-coverage campaigns when those programmes are not yet sufficient to protect every child.
It further noted that countries and global immunisation partners must also strengthen disease surveillance, including the Global Measles Rubella Laboratory Network (GMRLN) as strong disease surveillance is critical to optimising immunisation programmes and detecting and responding rapidly to measles outbreaks in order to mitigate their size and impact.
Experts decry shortage of trauma surgeons as NOHIL launches SMART Course
By Chioma Obinna
Orthopaedic experts
have raised the alarm
over the rising burden of disabilities caused by traffic accidents, lamenting that, despite the significant strides made in orthopaedic care, the number of trained trauma surgeons in Nigeria remains woefully insufficient.
To this end, the National Orthopedic Hospital, Igbobi, Lagos, NOHIL, is hosting the Surgical Management and Reconstruction Trauma, (SMART) course for surgeons across Nigeria and West Africa to enhance the skills and knowledge of healthcare professionals in trauma care.
Speaking at the opening ceremony of the 1st Nigerian SMART Course themed: Principles of Trauma Care and Soft Tissue Reconstruction”, in Lagos, the Medical Director of NOHIL, Dr Alimi Mustapha pointed out that the National Orthopedic Hospital currently has only about 30 orthopaedic surgeons to cater to the needs of a population of over 23 million people in Lagos alone.
This ratio, he emphasised, is grossly inadequate, leading to an overwhelming burden on healthcare professionals and delaying critical care for trauma patients.
“One of the key challenges faced in trauma care is the limited availability of advanced medical equipment. While basic equipment for managing orthopaedic deformities is available, more specialised tools like image intensifiers-which are crucial for precise surgeries-are not universally accessible.
“An image intensifier, for instance, can cost up to N170 million, and managing these devices properly requires both expertise and consistent maintenance.”
Represented by the Head, of Clinical Services, Dr. Lawal Wakeel Olayide, he added that although vendors are present to showcase available equipment, there is still a significant need for more specialised tools to ensure high-quality trauma care across the country.
He said the SMART course is particularly focused on the long-term effects of traffic accidents, which often result in debilitating injuries. These injuries, if not properly managed, can lead to permanent disability, affecting the quality of life for many Nigerians. “
One of the main goals of this program is to bridge the knowledge gap in trauma care, especially in rural and underserved areas where access to specialized care is limited,” he said.
Stating that the initiative is critical in addressing the pressing need for skilled orthopaedic surgeons and improving trauma care across the country, he highlighted that trauma care is currently concentrated in major urban centres, leaving many in rural areas without adequate treatment.
The course aims to address this gap by training more surgeons who can provide specialised care even in remote regions.
Speaking, a paediatric orthopaedic surgeon from the University of California, San Francisco. Dr. Sanjeev Sabharwal, who has worked extensively in both India and the United States, spoke about the importance of context in medical education and practice.
Stating that the SMART course is being led by international faculty members, he emphasized that while countries like Nigeria face similar challenges to those in India, there are significant opportunities for cross-learning.
Sabharwal noted that one of the main objectives of the course is to adapt global best practices to local contexts.
“In countries like Nigeria, where resources are limited, the key is to find cost-effective solutions that work within the local context. This includes learning how to make the best use of limited resources and ensuring that treatments are accessible to the broader population.”
He also stressed the importance of building local expertise in trauma care so that low-resource settings can deliver high-quality services without relying on expensive foreign interventions.
On his part, a Consultant Paediatric orthopaedics, and trauma surgeon at the National Orthopedic Hospital, Dr. Emeka Izuagba emphasised the wider societal benefits of improved trauma care.
“Trauma is the leading cause of morbidity and mortality, particularly among young adults who are the backbone of our workforce. When trauma cases are not properly treated, individuals may become unable to work, which in turn exacerbates poverty and strains the healthcare system.”
Izuagba also highlighted the growing trend of Nigerians seeking treatment abroad due to a perceived lack of advanced care within the country, a phenomenon often referred to as “Japa”.
He expressed optimism that by improving local capacity through courses like the SMART programme, more Nigerians would be able to receive the treatment they need without having to travel abroad.
He further noted that one of the key challenges in trauma care in Nigeria is the prevalence of traditional bone healers who often lack formal medical training and may unintentionally cause further harm by attempting to treat complex injuries.
Izuagba regretted that many patients in Nigeria first seek treatment from traditional healers before coming to hospitals, which can lead to complications such as infection, poor healing, and even the loss of limbs.
“We’ve tried to collaborate with traditional healers in the past to help them recognize life-threatening injuries and refer them promptly, but there has been resistance.”
He pointed out that while traditional healers are here to stay, there is a need for better regulation and education to ensure that they are working within the limits of their expertise and referring patients to hospitals when necessary.
He stressed the need for government support in the form of basic health insurance for trauma cases as it would go a long way in making treatment more affordable and reducing the burden on patients.
He said the SMART course is a promising initiative, but one step in the long journey towards improving trauma care in Nigeria.
The SMART course is part of a broader effort to address the gaps in trauma care and orthopaedic practice in Nigeria.
For lasting change, there needs to be a focus on local manufacturing and industry partnerships to ensure that medical equipment is accessible, affordable, and maintainable.
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