Peer-reviewed article
Resurgence of measles in Bosnia and Herzegovina amid declining vaccination coverage.
Anes Jogunčić, Asaf Salčinović, Aida Pošković-Bajraktarević, Agnesa Porović-Hodžić, Anisa Bajramović et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001Sarajevo Canton in Bosnia and Herzegovina experienced large measles outbreaks in 2019 and 2024, with 869 and 4505 cases respectively. Children aged 1-4 years were most affected, and the vast majority of cases were unvaccinated or had unknown vaccination status. The 2024 outbreak was significantly larger and longer than 2019, with one death reported each year. The study shows that declining vaccination coverage directly contributed to increased measles transmission.
Key points
- Total of 869 measles cases in 2019 and 4505 cases in 2024 in Sarajevo Canton
- Children aged 1-4 years comprised 42.1% of all cases
- 92.3% of 2019 cases and 87.7% of 2024 cases were unvaccinated
- 2024 outbreak had a higher and longer peak (416 vs 91 cases) than 2019
- One death reported in each outbreak year
Limitations
The study uses publicly available data without individual-level patient details, so it cannot fully characterize transmission patterns, identify specific barriers to vaccination uptake, or assess outcomes beyond case counts and deaths. The analysis is descriptive and retrospective, limiting causal inference about factors contributing to the resurgence.
Abstract
BACKGROUND: Sarajevo Canton reported large measles outbreaks in 2019 and 2024, highlighting the impact of the persistent gaps in immunisation coverage. AIM: To analyse 2 measles outbreaks in Sarajevo Canton in Bosnia and Herzegovina, identify populations at risk and assess the impact of vaccination coverage on disease transmission. METHODS: We collected publicly available weekly case counts data for 45 weeks from the Public Health Institute of Sarajevo Canton and examined the vaccination coverage for 5 years to assess the impact of immunisation on outbreak dynamics. We conducted descriptive analyses using RStudio version 2024 and evaluated the differences between outbreaks using Mann-Whitney U test. P < 0.05 was considered statistically significant. RESULTS: A total of 869 cases were reported in 2019 and 4505 in 2024, and children aged 1-4 years were mostly affected (42.1%). Most of the cases were either unvaccinated or had unknown vaccination status; 92.3% of cases in 2019 were unvaccinated, and 87.7% in 2024 were unvaccinated, while 9.9% had unknown vaccination status. The 2024 outbreak had a higher and longer peak (416 vs 91 cases) occurence than 2019, and one death was reported in each year. CONCLUSION: The declining vaccination coverage in Sarajevo Canton contributed to increased measles incidence. Strengthening mandatory immunisation, targeted catch-up campaigns and public communication are essential to achieve herd immunity, prevent future outbreaks and progress towards Universal Health Coverage.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
Problem
Measles outbreaks occurring among children in a population with declining vaccination coverage
- Intervention
- vaccination coverage (immunisation)
- Population
- Children in Sarajevo Canton, Bosnia and Herzegovina, particularly those aged 1-4 years
Key finding
Measles cases increased substantially from 869 in 2019 to 4505 in 2024