Role of oral-fluid based measles diagnostic methods for measles global elimination

Abstract

Measles eradication is biologically feasible. There is an availability of a safe, effective and inexpensive vaccine; a proven elimination strategy; high Local demand; and an effective global partnership and initiative to support vaccination. Measles eradication is a cost-effective scenario and a good investment to avoid expensive epidemics and save those children die due to measles. Laboratory investigations are indispensable to monitor the progress of measles elimination. This role will require the development of more sensitive diagnostic methods suitable for diagnosis and surveillance, genetic analysis of measles strains and a technology which is transferable worldwide. Measles diagnosis relies increasingly on serological tests. The practical utility of oral-fluid methods (antibody and genetic) in evaluating and refining measles immunization programs would, additionally, provide support for a global surveillance initiative. The utility of in a population survey, in a vaccine sero-conversion study and application in molecular epidemiological use is demonstrated in this review. It is to be hoped that this review will assist in the wider uptake and acceptance of methodology in both developed and developing country situation. More research needed for further evaluation of a recently developed point-of-care test for measles diagnosis: detection of measles-specific IgM antibodies and viral nucleic acid for wider use oral-fluid methodology. There is a strong case and imperative for the promotion of methods by World Health Organization in its global program of control/eradication of measles over the coming decade.

Keywords: Measles elimination, Oral-fluid test methods, Laboratory diagnosis

Core tip: Laboratory investigations play a critical role in monitoring the success of measles elimination strategies. The role requires the development of more sensitive diagnostic which is transferable worldwide. Measles diagnosis relies increasingly on serological tests. Promotion of the use of oral fluid as viral diagnostic alternative to serum may be of advantage in communities where reliable age-specific notification and vaccination data are unavailable or in groups that are ‘‘hard to reach’’. This review will assist in the wider uptake and acceptance of oral-fluid methodology in both developed and developing country situation for global measles elimination.