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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Veröffentlicht in:Bulletin of the World Health Organization Jg. 91; H. 3; S. 174 - 183
Hauptverfasser: Sartorius, Benn, Cohen, C, Chirwa, T, Ntshoe, G, Puren, A, Hofman, K
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Genève Organisation mondiale de la santé 01.03.2013
World Health Organization
The World Health Organization
Schlagworte:
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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Beschreibung
Zusammenfassung: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.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0042-9686
1564-0604
1564-0604
DOI:10.2471/BLT.12.110726