Importance d’un schéma de vaccination a deux doses dans la lutte contre la rougeole (cas de la zone de santé de Manika)

Objectif: Pour contribuer a la reduction de la morbide mortalite liee a la rougeole, nous avons menes une etude descriptive transversale, au cours de laquelle nous avons analyses,, l’importance de la seconde vaccination, face aux resurgences de l’epidemie de la rougeole dans la zone de sante de Manika, district de Kolwezi, province du Katanga, en Republique democratique du Congo, au cours de la periode allant de janvier a decembre 2011 . Methodologie et resultats: ressort de notre travail que, parmi les enfants enquetes, 46,8% etaient non vaccines, et parmi eux 38% avaient presente la rougeole, l’Odds ratio est de 6,34 avec un intervalle de confiance de [4,26 ; 9,43], d’ou une difference statistiquement significative qui se degage entre la survenue de la rougeole et le statut de zero dose. Pour ce qui est des enfants qui ont recu une dose, on deduit que la vaccination est un facteur (OR = 0,45 IC95% [0,16 ; 0,87]). Quant aux enfants ayant recu deux doses, il est a note que la deuxieme vaccination etait apparu comme un facteur protecteur, offrant a l’enfant moins de chance a developper la rougeole (OR = 0,03 IC95% [0,01 ; 0,07]). Conclusion et application des resultats: Actuellement, il est admis qu’avec une seule dose de vaccination contre la rougeole, il est peu probable de reduire la morbidite et la mortalite liee a la rougeole dans la Zone de sante Manika, car environ 20,3% d’enfants vaccines d’une seule dose, ont developpe la maladie. La seconde vaccination des enfants demeure un enjeu majeur pour un meilleur controle, et elimination de la rougeole, dans notre pays. Mots cles: epidemie rougeole Manika : importance du schema a deux doses English Abstract Objective: To contribute to the reduction of the morbid mortality related to measles, we conducted a descriptive transversal study, during which we analyzed, the importance of the second vaccination, in the face of resurgences of the measles epidemic in the Manika Health Zone, Kolwezi District, Katanga Province, Democratic Republic of the Congo, during the period January to December 2011. Methodology and results: Our work shows that among the children surveyed, 46.8% were unvaccinated, and among them 38% had measles, the odds ratio was 6.34 with a confidence interval of [4.26; 9.43], resulting in a statistically significant difference between the occurrence of measles and zero dose status. For children who received a dose, it is deduced that vaccination is a protective factor because its odds ratio is 0.45 (> to 1) and its confidence interval is [0.16; 0.87]. As for the children who received two doses, it was noted that the second vaccination is also a protective factor, giving the child less chance to develop measles, because his odds ratio was 0.03 with a confidence interval of [0.01; 0.07]. Conclusion and application of results: Currently, it is recognized that with a single measles vaccination dose, it is unlikely to reduce measles-related morbidity and mortality in the Manika Health Zone, as about 20.3% of children vaccinated against measles are affected by measles. A single dose, developed the disease. The second vaccination of children remains a major challenge for better control and elimination of measles in our country Keywords: Manika measles epidemic: importance of the two-dose regime