Measles testing falls short amid kit shortage, obscuring true scale of outbreak

Testing for measles in Bangladesh remains significantly below capacity due to a shortage of diagnostic kits, raising concerns that the true extent of the outbreak is not being accurately captured.

At present, measles testing is conducted solely at the laboratory of the Institute of Public Health at Mohakhali, Dhaka, the only government facility in the country equipped for such testing.

According to its Director, Md Mominur Rahman, the institute has the capacity to test 300 to 400 samples every day, yet is currently processing only around 120 due to limited supplies.

“We simply do not have enough kits to conduct more tests,” he said.

Officials at the institute on Sunday confirmed that the testing kits are supplied by the World Health Organization (WHO), with each kit capable of analysing samples from 90 patients. As of Sunday noon, only three kits remained in stock. Later in the evening, WHO delivered 60 additional kits, while more supplies are awaiting clearance at Hazrat Shahjalal International Airport due to administrative delays.

Despite repeated assurances from Health Minister Sardar Sakhawat Hossain and senior officials at the Directorate General of Health Services (DGHS) that adequate measures are being taken to contain the outbreak, experts argue that insufficient attention has been given to diagnostic capacity—an essential component of disease control.

Public health expert Abu Jamil Faisel described the situation as a clear failure of preparedness. “It is inconceivable that testing is being limited due to a lack of kits. This reflects negligence and a lack of seriousness. Without adequate testing, we cannot understand the true scale of the situation,” he said, calling for exemplary punishment of the people responsible for this situation.

On average, around 300 suspected measles samples are being sent daily from across the country to the Institute of Public Health. Samples are typically collected from nasal secretions or throat swabs. Data from the institute show that between 11 and 18 April, 965 samples were tested, of which 641, approximately 66.4 per cent, returned positive results.

However, not all submitted samples are being processed. Professor Mahbubul Haque, Director of the Bangladesh Shishu Hospital and Institute, said that 316 children had been admitted with measles-related illness this year. Of the 266 samples sent for testing, results have been received for only 135, with 76 confirmed positive cases. The remaining results are still pending.

In Barguna, one of the hardest-hit districts, uncertainty persists over testing outcomes. According to Rezwanur Rahman, Superintendent of Barguna Sadar Hospital, 104 samples were sent for testing, with 28 confirmed cases. However, the total number of processed samples remains unclear, as the hospital has not been informed.

Mominur Rahman, Director of the Institute of Public Health at Mohakhali, noted that the institute operates four laboratories—including those dedicated to polio and measles, food safety, public health, and general diagnostics. He conceded that no prior planning had anticipated the need for large-scale measles testing. Consequently, sufficient kits were neither procured nor stockpiled.

Officials added that WHO has pledged to supply an additional 100 kits next week, which may partially alleviate the shortage.

According to the Integrated Control Room of the DGHS, between 15 March and 19 April, a total of 23,606 suspected measles cases were identified nationwide. Of these, 3,044 have been laboratory-confirmed. Experts caution that the actual number may be significantly higher due to limited testing.

As of Sunday, 181 deaths have been reported among patients exhibiting measles-like symptoms, while 36 deaths have been confirmed as caused by measles.

A countrywide measles-rubella vaccination campaign begins today, Monday, targeting all children aged between six months and five years.

Professor Md Zahid Raihan, Additional Director General (administration) at the DGHS, said that approximately 18 million children will be vaccinated during the campaign, which will run from 20 April to 20 May.

According to the Expanded Programme on Immunisation (EPI), vaccination will be conducted not only at routine centres but also at nurseries, kindergartens, ebtedayee madrasahs, maktabs, orphanages, and childcare facilities. Children outside the formal education system will be reached through community-based vaccination centres.

During the campaign, permanent vaccination centres will operate in every upazila health complex, pourashava, and city corporation hospital, as well as in each ward of city corporations. These centres will remain open daily, except on government holidays, between 8:00 am and 4:00 pm, while routine immunisation services will continue alongside the campaign.

Special arrangements will also be made to reach high-risk and hard-to-access child populations, including those accompanying mothers in markets, factories, and rice mills; children of nomadic communities; street children; hospital children; children living in prisons with their mothers; and those residing in brothels and slum areas.