{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T18:03:57Z","timestamp":1789581837604,"version":"build-2803163510"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lesotho, a lower middle-income country in southern Africa, has historically had relatively high routine immunization coverage over the last three decades. Since 1996, the country has been implementing measles elimination strategies. This manuscript evaluates Lesotho\u2019s performance, from 2011 to 2025, against the World Health Organization\u2019s criteria for measles and rubella elimination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective review of Lesotho\u2019s immunization and surveillance data during 2011\u20132025. This included Lesotho\u2019s annual WHO\/UNICEF Estimates of National Immunization Coverage (WUENIC) for routine measles-containing vaccine (MCV) doses; performance in the periodic measles rubella vaccination campaigns and case-based surveillance; and the trends of measles and rubella incidences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During 2011\u20132025, MCV1 coverage generally remained\u2009\u226590% but failed to reach the 95% elimination target. MCV2 coverage reached 80% in 2011 and 2012 before declining in subsequent years. Lesotho has mostly attained the targets for surveillance performance according to the two principal performance indicators \u2013 non-measles febrile rash illness rate and the proportion of districts that report a minimum of one suspected case. From 2011 to 2015, measles incidence stayed below one per 1 million population in Lesotho. However rubella incidence ranged between 33.4 in 2012 to 142.3 in 2014, and declined significantly after MR introduction in 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Lesotho has made significant progress in measles and rubella elimination efforts. To sustain the gains made, the country should work to strengthen vaccination in the second year of life, reinforce demand generation during preventive campaigns, address population denominator inaccuracies that hinder accurate coverage tracking, and systematically document measles and rubella virus genotypes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0358555","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:36:55Z","timestamp":1789580215000},"page":"e0358555","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Progress towards measles and rubella elimination in Lesotho, 2011\u20132025"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4008-5999","authenticated-orcid":true,"given":"Yankuba","family":"Singhateh","sequence":"first","affiliation":[{"name":"World Health Organization","place":["Harare, Zimbabwe"],"department":["Vaccine Preventable Disease Program, East and Southern Africa Inter-Country Support Team"]},{"name":"Ministry of Health","place":["Banjul, The Gambia"],"department":["Epidemiology and Disease Control Unit, Directorate of Public Health Services"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tshepiso Mechele","family":"Matoko","sequence":"additional","affiliation":[{"name":"Ministry of Health","place":["Maseru, Lesotho"],"department":["National Immunisation Program"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mannini","family":"Shaabe","sequence":"additional","affiliation":[{"name":"World Health Organization Lesotho Country Office","place":["Maseru, Lesotho"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selloane Amelia","family":"Maepe","sequence":"additional","affiliation":[{"name":"Independent Consultant","place":["Maseru, Lesotho"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis Dumobong Ngmenasong","family":"Abobo","sequence":"additional","affiliation":[{"name":"World Health Organization Lesotho Country Office","place":["Maseru, Lesotho"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Waithera","family":"Wanyoike","sequence":"additional","affiliation":[{"name":"World Health Organization","place":["Harare, Zimbabwe"],"department":["Vaccine Preventable Disease Program, East and Southern Africa Inter-Country Support Team"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"pone.0358555.ref001","unstructured":"Lesotho Population. 2026 [cited February 8 2006]. 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Wkly Epidemiol Rec. 2018;93(41):544\u201352."}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0358555","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:37:03Z","timestamp":1789580223000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0358555"}},"subtitle":[],"editor":[{"given":"Omar Enzo","family":"Santangelo","sequence":"first","affiliation":[{"name":"Regional Health Care and Social Agency of Lodi","place":["ITALY"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,9,16]]},"references-count":27,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,16]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0358555","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,16]]}}}