A measles outbreak in Madagascar has killed more than 1,200, with much of the island lacking the resources to combat the disease, according to NBC News.

Only 58 percent of the island’s residents have been vaccinated against the disease, according to the news outlet, and medical experts say vaccination rates must reach between 90 and 95 percent to safeguard against outbreaks. Unlike other outbreaks, such as a recent series in New York, that have their roots in misinformation and active resistance to the vaccine, Madagascar’s is largely driven by poverty and lack of resources, according to the news outlet.

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Although some parts of the island resist vaccinations for religious reasons or defer to more traditional health practitioners, many people who want to vaccinate their children or themselves cannot afford to see a doctor or only have access to an understaffed or underfunded health center, according to the news outlet.

Most victims of the outbreak, which began last September, have been children younger than 15. Children have been at particularly high risk because nearly half the children on the island are malnourished, which exacerbates measles, according to Dr. Dossou Vincent Sodjinou, an epidemiologist for the World Health Organization.

"The epidemic unfortunately continues to expand in size,” albeit at a slower pace than a month before, Sodjinou told NBC. More than 117,000 cases had been reported by Madagascar’s health ministry in all regions of the country, according to NBC.