Identifying high-risk areas for sporadic measles outbreaks: lessons from South Africa

To develop a model for identifying areas at high risk for sporadic measles outbreaks based on an analysis of factors associated with a national outbreak in South Africa between 2009 and 2011. Data on cases occurring before and during the national outbreak were obtained from the South African measles...

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Vydáno v:	Bulletin of the World Health Organization Ročník 91; číslo 3; s. 174 - 183
Hlavní autoři:	Sartorius, Benn, Cohen, C, Chirwa, T, Ntshoe, G, Puren, A, Hofman, K
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Genève Organisation mondiale de la santé 01.03.2013 World Health Organization The World Health Organization
Témata:	Babies Bayes Theorem Bayesian analysis Binomial distribution Biological and medical sciences Children & youth Comorbidity Disease Outbreaks Disease prevention Disease Susceptibility - epidemiology Epidemics Epidemiology General aspects Health Health information Health surveillance High risk HIV HIV Infections - epidemiology Human immunodeficiency virus Human viral diseases Humans Immune system Immunization Incidence Infants Infections Infectious diseases Information sources Information systems Laboratories Measles Measles - epidemiology Measles - prevention & control Measles - transmission Measles Vaccine - administration & dosage Measles Vaccine - supply & distribution Medical sciences Miscellaneous Models, Biological Outbreaks Poisson Distribution Population Density Population number Population Surveillance Probability Public health Public health. Hygiene Public health. Hygiene-occupational medicine Risk Risk Assessment Sick role South Africa South Africa - epidemiology Spatial Analysis Surveillance Surveillance systems Vaccination and vaccines Vaccines Viral diseases Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye South Africa Africa Infection Epidemic High risk Sporadic Viral disease Measles Tropical medicine Public health WHO
ISSN:	0042-9686, 1564-0604, 1564-0604
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Popis
Shrnutí:	To develop a model for identifying areas at high risk for sporadic measles outbreaks based on an analysis of factors associated with a national outbreak in South Africa between 2009 and 2011. Data on cases occurring before and during the national outbreak were obtained from the South African measles surveillance programme, and data on measles immunization and population size, from the District Health Information System. A Bayesian hierarchical Poisson model was used to investigate the association between the risk of measles in infants in a district and first-dose vaccination coverage, population density, background prevalence of human immunodeficiency virus (HIV) infection and expected failure of seroconversion. Model projections were used to identify emerging high-risk areas in 2012. A clear spatial pattern of high-risk areas was noted, with many interconnected (i.e. neighbouring) areas. An increased risk of measles outbreak was significantly associated with both the preceding build-up of a susceptible population and population density. The risk was also elevated when more than 20% of infants in a populous area had missed a first vaccine dose. The model was able to identify areas at high risk of experiencing a measles outbreak in 2012 and where additional preventive measures could be undertaken. The South African measles outbreak was associated with the build-up of a susceptible population (owing to poor vaccine coverage), high prevalence of HIV infection and high population density. The predictive model developed could be applied to other settings susceptible to sporadic outbreaks of measles and other vaccine-preventable diseases.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23
ISSN:	0042-9686 1564-0604 1564-0604
DOI:	10.2471/BLT.12.110726