Evaluation of measles elimination strategies in Dongola, Sudan: a surveillance and immunization converge analysis, 2018–2021
Published in Public Health
Behind the Paper: Tackling Measles in Dongola, Sudan — What Surveillance and Immunization Data Revealed
By Alhaj Saad Mohamed Ahmed Ali
Our research began with a fundamental question: Why do measles outbreaks still occur, even in areas where vaccination activities are regularly implemented?
We chose Dongola locality in Northern State, Sudan, as a case study to explore the interaction between immunization efforts and measles surveillance from 2018 to 2021.
Sudan has a long-standing Expanded Programme on Immunization (EPI), supplemented by periodic campaigns. Despite these efforts, sporadic measles outbreaks continued to be reported. This prompted us to examine available data more closely to understand where additional opportunities for strengthening measles control might exist.
Why Dongola?
Dongola is relatively well-resourced compared to other localities, with regular immunization activities and a functioning disease surveillance system. However, the recurrence of measles cases suggested there was value in taking a closer look at how routine immunization and surveillance data align—and how they could be used together to inform elimination strategies.
We used a convergence analysis approach, integrating data from both the immunization program and the national disease surveillance system. Our aim was not to critique existing efforts, but to identify areas where coordination and information use could be further enhanced
What Did We Find?
Our analysis yielded several key observations:
- In some years, measles cases were reported despite high administrative coverage rates, highlighting the importance of continuous follow-up to reach all target populations, particularly children who may not be fully vaccinated
- We noted the presence of “zero-dose” children—those who had not received their first dose of measles vaccine—indicating potential gaps in access or follow-up.
- Supplementary Immunization Activities (SIAs) were conducted periodically, and there may be opportunities to further align these with surveillance findings to ensure they reach the most at-risk populations.
- The sensitivity of the surveillance system appeared to vary slightly over the years, a natural challenge in many contexts, reinforcing the need for ongoing capacity building and support at the facility level.
Why This Matters
Measles remains a key indicator of immunization system performance. While great progress has been made, identifying and reaching unreached children is essential for achieving elimination goals.
This study underscores the value of using available data in a complementary way—not only to monitor progress, but also to inform targeted interventions and planning.
Behind the Numbers
At the heart of this study are the frontline health workers and surveillance officers who continue to carry out essential work under often challenging conditions. Their dedication to recording, reporting, and serving their communities forms the foundation of public health action. This research would not have been possible without their commitment.
Looking Ahead
We hope that this analysis contributes to ongoing efforts to strengthen the use of data in immunization and surveillance systems. By promoting integrated, data-driven decision-making, we believe we can take important steps toward measles elimination in Sudan and similar settings.
Read the full article here: https://doi.org/10.1186/s12982-025-00558-x
I am Alhaj Saad Mohamed Ahmed
Ali, a researcher in public health and
epidemiology. My work focuses on
disease outbreaks, health management in disasters, wars, and health emergencies.
Currently, I am working on infectious
diseases surveillance and assessing the
health needs of communities affected
by disasters and conflicts. I am keen on
advancing knowledge in these areas
through research and collaboration with
fellow researchers.
Follow the Topic
-
Discover Public Health
This is an open access journal publishing research from all fields relevant to public health.
Related Collections
With Collections, you can get published faster and increase your visibility.
Digital Frontiers in Public Health: Data-driven Solutions and Technologies for Efficiency, Effectiveness, and Equity
In recent years, the landscape of public health has been transformed by unprecedented access to high-quality data, advances in data storage and processing, and a growing willingness to share information across jurisdictions. The global response to the COVID-19 pandemic exemplified how coordinated data use and technological innovation can accelerate decision-making, enhance surveillance, and save lives. These developments mark a new era in which the application of modern data analytics in evidence-driven public health practices is not only possible but essential.
Building on this momentum, contemporary innovations are contributing to significant improvements in the three Es of public health: efficiency, effectiveness, and equity. Improved efficiency enables resources to be allocated and managed in a manner that generates the maximum attainable outputs; enhanced effectiveness ensures that public health policies, interventions, and practices achieve the expected health outcomes; and strengthened equity promotes fair access to healthcare and public health services across all populations. Together, these dimensions reflect the evolving priorities and capabilities of modern public health systems.
This Collection, “Digital Frontiers in Public Health: Data-driven Solutions and Technologies for Efficiency, Effectiveness, and Equity,” invites contributions that explore these themes through empirical studies, methodological advancements, case studies, and policy analyses. We seek manuscripts that highlight innovative data applications, cross-sector collaborations, digital health initiatives, and strategies that enhance equity through technology and data integration, as well as collaborative public health practices.
Topics of interest include, but are not limited to:
- Applications of novel data linkage and analytics methods in public health
- The role of participation and co-creation in addressing public health issues
- Digital and technological innovations in public health
- Complete or partial assessments of triple Es in public health
- Economic evaluations of public health interventions
By showcasing diverse approaches from around the world, this Collection aims to provide a comprehensive overview of how data-driven innovations are reshaping public health practice today, and in the future. Researchers, practitioners, and policymakers are encouraged to share their insights and experiences to contribute to this critical dialogue on the future of public health.
This Collection supports and amplifies research related to SDG 3.
Keywords: digital applications; data sharing; data infrastructure; economic evaluations; health equity; public health; policy analysis; health informatics
Publishing Model: Open Access
Deadline: Sep 30, 2026
Pediatric Noncommunicable Diseases: Policy, Practice, and Public Health
Non-Communicable Diseases (NCDs) such as diabetes, asthma, congenital heart conditions, and childhood cancers are increasingly recognized as significant contributors to morbidity and mortality among children and adolescents. Despite their growing impact, pediatric NCDs are often underrepresented in health policies and global health agendas, which traditionally focus on infectious diseases or adult populations.
According to the World Health Organization (WHO) and UNICEF, NCDs are responsible for approximately 20% of all deaths among adolescents aged 10–19 globally. Moreover, over 50% of disability-adjusted life years (DALYs) in this age group are attributed to NCDs, with mental health conditions such as depression, anxiety, and conduct disorders being the leading contributors. The burden is not only medical but also social and economic. Children with chronic conditions often face stigma, reduced educational opportunities, and long-term health complications. Additionally, 70% of premature adult deaths from NCDs are linked to behaviors that begin in childhood and adolescence, such as poor diet, physical inactivity, and exposure to tobacco and alcohol.
Despite this, pediatric NCDs remain under-prioritized in global health strategies. Addressing them requires a life-course approach that includes early prevention, integrated care, and supportive environments. Strengthening health systems to respond to pediatric NCDs is essential for achieving universal health coverage and sustainable development goals.
This Collection supports and amplifies research related to SDG 3.
Keywords: Pediatric Non-Communicable Diseases, Child and Adolescent Health, Chronic Illness in Children, Mental Health, Early-Life Risk Factors, Global Health and NCDs
Publishing Model: Open Access
Deadline: Jul 31, 2026
Please sign in or register for FREE
If you are a registered user on Research Communities by Springer Nature, please sign in