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Li M, Zhang W, Zheng S, Guo J, He H, Ma Y, Huang Y, Feng Y, Ji C. A real-world study on the changing characteristics of measles antibodies in premature infants in China. Hum Vaccin Immunother 2024; 20:2338505. [PMID: 38599768 PMCID: PMC11008540 DOI: 10.1080/21645515.2024.2338505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/31/2024] [Indexed: 04/12/2024] Open
Abstract
The waning of maternal antibodies may cause infants to lose protection against measles before receiving measles-containing vaccine (MCV). The aim of this study is to investigate the changing characteristics and influencing factors of measles antibodies in preterm infants (PT), and to provide scientific basis for optimizing MCV vaccination strategy of the target population. Blood samples were collected from PT and full-term infants (FT) at the chronological age (CA) of 3, 6, and 12 months. Measles antibodies were quantitatively detected by enzyme-linked immunosorbent assay. Demographic and vaccination information were both collected. Kruskal-Wallis rank sum test was used to compare the measles antibodies among different gestation age (GA) groups, and multiple linear regression was performed to identify the correlative factors for the antibodies. Measles antibodies of PT decreased significantly with age increasing before MCV vaccination. The positive rates of antibodies of PT were 10.80% and 3.30% at the age of 3 and 6 months, respectively (p < .001). At 12 months, the measles antibodies and seropositive rate in the infants who received MCV vaccination increased sharply (p < .001). Regression analyzes showed that the younger the GA or the older the age, the lower the antibodies at 3 months(p < .001,p = .018); while the lower measles antibody levels at 3 months and older age predicted the lower antibodies at 6 months(p < .001, p = .029). PT were susceptible to measles due to the low level of maternally derived antibodies before MCV vaccination. More efforts should be considered to protect the vulnerable population during their early postnatal life.
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Affiliation(s)
- Mingyan Li
- Department of Child Health Care, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Weiwei Zhang
- Department of Child Health Care, Maternal and Child Health Hospital of Changxing, Huzhou, China
| | - Shuangshuang Zheng
- Department of Child Health Care, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Junxia Guo
- Department of Child Health Care, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Hanqing He
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yongjun Ma
- Department of Pediatrics, Maternal and Child Healthcare Hospital Department of Shangyu, Shaoxing, China
| | - Yan Huang
- Department of Immunization Program, Center for Disease Control and Prevention of Shangyu, Shaoxing, China
| | - Yan Feng
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Chai Ji
- Department of Child Health Care, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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Baumer-Mouradian SH, Hofstetter AM, O'Leary ST, Opel DJ. Vaccine Confidence as Critical to Pandemic Preparedness and Response. Pediatr Clin North Am 2024; 71:499-513. [PMID: 38754938 DOI: 10.1016/j.pcl.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Vaccine confidence is a belief that vaccines work, are safe, and are part of a trustworthy medical system. The COVID-19 pandemic exposed the fragility of the public's confidence in vaccines and the vaccine enterprise, limiting the public health impact of vaccination. In this review, we examine the critical nature of vaccine confidence to pandemic preparedness and response.
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Affiliation(s)
- Shannon H Baumer-Mouradian
- Department of Pediatrics, Medical College of Wisconsin, 9000 W. Wisconsin Avenue, Milwaukee, WI 53226, USA
| | - Annika M Hofstetter
- Department of Pediatrics, University of Washington School of Medicine and Center for Clinical and Translational Research, Seattle Children's Research Institute, M/S CURE-4, PO Box 5371, Seattle, WA 98145, USA
| | - Sean T O'Leary
- Department of Pediatrics and Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, 1890 North Revere Court, Aurora, CO 80045, USA
| | - Douglas J Opel
- Department of Pediatrics, University of Washington School of Medicine and Treuman Katz Center for Pediatric Bioethics and Palliative Care, Center for Clinical and Translational Research, Seattle Children's Research Institute, M/S: JMB-6; 1900 Ninth Avenue, Seattle, WA 98101, USA.
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Taffie W, Temesgen H, Ashebir W, Mekonen H. Measles second dose vaccine uptake and its associated factors among children aged 24-35 months in Northwest Ethiopia, 2022. Sci Rep 2024; 14:11059. [PMID: 38744908 PMCID: PMC11094091 DOI: 10.1038/s41598-024-61048-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 04/30/2024] [Indexed: 05/16/2024] Open
Abstract
Measles is a major public health problem in under-five children, leading to lifelong complications. Therefore, the study aimed to assess the magnitude of measles second-dose vaccine uptake and its determinants among children aged 24-35 months in Northwest Ethiopia. A community-based cross-sectional study was conducted among 418 children aged 24-35 months in Northwest Ethiopia between January 2022 and February 2022. A simple random sampling technique was used to access study subjects. A binary logistic regression model was employed. An adjusted odd ratio with a 95% confidence interval (CI) and a p-value < 0.05 was used to declare significant predictors of measles second dose vaccine uptake. The magnitude of the measles second dose vaccine uptake among children aged 24-35 months was 41.39%. Postnatal care visits (AOR: 4.78, CI 1.49, 15.34), child vaccination status of other scheduled vaccines (AOR: 3.88, CI 2.23, 6.73), awareness of the measles second dose vaccine and its schedule (AOR: 8.924, CI 5.27, 15.09), and distance from the vaccination center (AOR: 0.21, CI 0.06, 0.77) were significantly associated with measles second dose vaccine uptake. The uptake of measles second dose vaccine in the study area was low. Therefore, health workers and other partners should initiate awareness creation programs for mothers/caretaker to improve the uptake of measles second dose vaccine.
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Affiliation(s)
- Worku Taffie
- East Gojjam Zone, Shebel Berenta Woreda Health Office, Debre Markos, Ethiopia
| | - Habtamu Temesgen
- Department of Human Nutrition, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Wassachew Ashebir
- Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Habitamu Mekonen
- Department of Human Nutrition, College of Health Science, Debre Markos University, Debre Markos, Ethiopia.
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Dhalaria P, Kumar P, Verma A, Priyadarshini P, Kumar Singh A, Tripathi B, Taneja G. Exploring landscape of measles vaccination coverage: A step towards measles elimination goal in India. Vaccine 2024:S0264-410X(24)00511-5. [PMID: 38704248 DOI: 10.1016/j.vaccine.2024.04.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 04/23/2024] [Accepted: 04/23/2024] [Indexed: 05/06/2024]
Abstract
INTRODUCTION Measles remains a critical public health concern causing significant morbidity and mortality globally. Despite the success of measles vaccination programs, challenges persist, particularly in India. This study investigates dose-wise measles vaccination coverage and explores gaps in immunization focusing on zero-dose, one-dose, and two-dose coverage among children aged 24-35 months. DATA SOURCES AND METHODOLOGY The National Family Health Survey 2019-21 (NFHS-5) served as the data source and the study analyzed information from 43,864 children aged 24-35 months. Sociodemographic variables such as birth order, wealth quintile, gender, social group, religion, residence, mother education, delivery-related factors, and media exposure were considered. Statistical analysis involved weighted estimates, chi-square tests, and multivariate multinomial logistic regression. RESULTS The study revealed that challenges persist in achieving optimal measles vaccination coverage. Analysis by sociodemographic factors highlighted disparities in coverage, with variations in zero dose prevalence across states and districts. The percentage of zero-dose children was significantly higher, with 11.5% of children in India remaining to receive any measles vaccination. Factors influencing vaccine coverage include birth order, age, wealth quintile, social group, religion, residence, maternal education, place of delivery, media exposure, and mode of delivery. The findings from the spatial analysis show the clustering of zero-dose children is high in the northeastern states of India. DISCUSSION Measles zero-dose children pose a significant obstacle to achieving elimination goals. Spatial analysis identifies clusters of unvaccinated populations guiding targeted interventions. The study aligns with global initiatives such as the Immunization Agenda 2030 emphasizing equitable vaccine access and discusses how India can tailor its strategies to achieve the goal. Lessons from polio eradication efforts inform strategies for measles elimination, stressing the importance of high-quality data and surveillance. The study underscores the urgency of addressing last-mile measles vaccination gaps in India. Spatially targeted interventions informed by sociodemographic factors can enhance immunization coverage. Achieving measles elimination requires sustained efforts and leveraging lessons from successful vaccination campaigns. The study findings have the potential to contribute to informed decision-making, supporting India's roadmap for the measles and rubella elimination goal.
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Affiliation(s)
- Pritu Dhalaria
- Immunization Technical Support Unit, Ministry of Health & Family Welfare, Government of India, New Delhi 110070, India
| | - Pawan Kumar
- Immunization Division, Ministry of Health & Family Welfare, New Delhi 110011, India
| | - Ajay Verma
- Department of Economics, Banaras Hindu University, Varanasi, Uttar Pradesh 221005, India
| | - Pretty Priyadarshini
- Immunization Technical Support Unit, Ministry of Health & Family Welfare, Government of India, New Delhi 110070, India
| | - Ajeet Kumar Singh
- Immunization Technical Support Unit, Ministry of Health & Family Welfare, Government of India, New Delhi 110070, India.
| | | | - Gunjan Taneja
- Bill & Melinda Gates Foundation, New Delhi 110067, India
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Alemu TG, Tamir TT, Workneh BS, Mekonen EG, Ali MS, Zegeye AF, Wassie M, Kassie AT, Tekeba B, Gonete AT. Coverage and determinants of second-dose measles vaccination among under-five children in East Africa countries: a systematic review and meta-analysis. Front Public Health 2024; 12:1359572. [PMID: 38751581 PMCID: PMC11094336 DOI: 10.3389/fpubh.2024.1359572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/11/2024] [Indexed: 05/18/2024] Open
Abstract
Background One of the biggest breakthroughs of contemporary medicine is measles vaccination. It is essential for the total elimination of measles. Understanding the magnitude and determinants of effective second-dose measles vaccination coverage is a critical task. Accordingly, we set out to check the best available evidence of the pooled second-dose measles vaccination coverage among under-five children in East Africa. Method We searched electronic databases such as PubMed, Google Scholar, Cochrane, and others. Two reviewers separately carried out the search of the Joanna Briggs Institute, selection of studies, critical appraisal, and data extraction. A third party was involved in resolving the disagreement among the reviewers. Seven studies included in this study, four from Ethiopia, two from Kenya, and one from Tanzania were cross-sectional and published in English language, with publication dates before 29 November 2023. Articles lacking full-text, the intended outcome, and that are not qualitative studies were excluded from the analysis. The Microsoft Excel checklist was used to extract the data and then exported to STATA 11. In addition, I2, Funnel plots, and Egger's test were employed to measure heterogeneity and detect publication bias, respectively. A random effect model was used. Result The meta-analysis includes a total sample size of 4,962 children from seven articles. The pooled prevalence of second-dose measles vaccination among under-five children in East Africa was found to be 32.22% [95% CI; (18.82, 45.63)], and the significant factors were as follows: birth order (1.72; OR = 95% CI: 1.32, 2.23), information about measles-containing second-dose vaccine (MCV 2) (7.39; OR = 95% CI: 5.21, 10.50), mother's marital status (1.47; OR = 95% CI: 1.05, 2.07), complete immunization for other vaccines (2.17; OR = 95% CI: 1.49, 3.17), and distance of vaccination site (3.31; OR = 95% CI: 2.42, 4.53). Conclusion The current study found that pooled prevalence of second-dose measles vaccination coverage among under-five children was still very low. It was also observed that birth order, distance of the vaccination site, complete immunization for other vaccines, mother's marital status, and information about MCV were factors associated with second-dose measles vaccination. These factors imply that there is a need for countries and their partners to act urgently to secure political commitment, expand primary health service and health education, and increase vaccination coverage.
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Affiliation(s)
- Tewodros Getaneh Alemu
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Tarik Tamir
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Belayneh Shetie Workneh
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Enyew Getaneh Mekonen
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohammed Seid Ali
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alebachew Ferede Zegeye
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulugeta Wassie
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemneh Tadesse Kassie
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Berhan Tekeba
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Almaz Tefera Gonete
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Kostandova N, Mutembo S, Prosperi C, Mwansa FD, Nakazwe C, Namukoko H, Nachinga B, Chongwe G, Chilumba I, Matakala KH, Musukwa G, Hamahuwa M, Mufwambi W, Matoba J, Situtu K, Mutale I, Kong AC, Simulundu E, Ndubani P, Hasan AZ, Truelove SA, Winter AK, Carcelen AC, Lau B, Moss WJ, Wesolowski A. Who is missed in a community-based survey: Assessment and implications of biases due to incomplete sampling frame in a community-based serosurvey, Choma and Ndola Districts, Zambia, 2022. PLOS Glob Public Health 2024; 4:e0003072. [PMID: 38683820 PMCID: PMC11057754 DOI: 10.1371/journal.pgph.0003072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 03/10/2024] [Indexed: 05/02/2024]
Abstract
Community-based serological studies are increasingly relied upon to measure disease burden, identify population immunity gaps, and guide control and elimination strategies; however, there is little understanding of the potential for and impact of sampling biases on outcomes of interest. As part of efforts to quantify measles immunity gaps in Zambia, a community-based serological survey using stratified multi-stage cluster sampling approach was conducted in Ndola and Choma districts in May-June 2022, enrolling 1245 individuals. We carried out a follow-up study among individuals missed from the sampling frame of the serosurvey in July-August 2022, enrolling 672 individuals. We assessed the potential for and impact of biases in the community-based serosurvey by i) estimating differences in characteristics of households and individuals included and excluded (77% vs 23% of households) from the sampling frame of the serosurvey and ii) evaluating the magnitude these differences make on healthcare-seeking behavior, vaccination coverage, and measles seroprevalence. We found that missed households were 20% smaller and 25% less likely to have children. Missed individuals resided in less wealthy households, had different distributions of sex and occupation, and were more likely to seek care at health facilities. Despite these differences, simulating a survey in which missed households were included in the sampling frame resulted in less than a 5% estimated bias in these outcomes. Although community-based studies are upheld as the gold standard study design in assessing immunity gaps and underlying community health characteristics, these findings underscore the fact that sampling biases can impact the results of even well-conducted community-based surveys. Results from these studies should be interpreted in the context of the study methodology and challenges faced during implementation, which include shortcomings in establishing accurate and up-to-date sampling frames. Failure to account for these shortcomings may result in biased estimates and detrimental effects on decision-making.
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Affiliation(s)
- Natalya Kostandova
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Simon Mutembo
- Department of International Health, International Vaccine Access Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Christine Prosperi
- Department of International Health, International Vaccine Access Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Francis Dien Mwansa
- Department of Immunizations, Ministry of Health, Government of the Republic of Zambia, Lusaka, Zambia
| | - Chola Nakazwe
- Information, Research and Dissemination, Zambia Statistics Agency, Lusaka, Zambia
| | - Harriet Namukoko
- Population and Social Statistics, Zambia Statistics Agency, Lusaka, Zambia
| | - Bertha Nachinga
- Information, Research and Dissemination, Zambia Statistics Agency, Lusaka, Zambia
| | | | - Innocent Chilumba
- Biomedial Sciences Department, Tropical Diseases Research Centre, Ndola, Zambia
| | | | | | - Mutinta Hamahuwa
- Clinical Research Laboratory Department, Macha Research Trust, Macha, Zambia
| | - Webster Mufwambi
- Administration, Tropical Diseases Research Centre, Ndola, Zambia
| | - Japhet Matoba
- Molecular Biology Department, Macha Research Trust, Macha, Zambia
| | - Kenny Situtu
- Tropical Diseases Research Centre, Ndola, Zambia
| | - Irene Mutale
- Tropical Diseases Research Centre, Ndola, Zambia
| | - Alex C. Kong
- Department of International Health, International Vaccine Access Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | | | | | - Alvira Z. Hasan
- Department of International Health, International Vaccine Access Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Shaun A. Truelove
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of International Health, International Vaccine Access Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Amy K. Winter
- Department of International Health, International Vaccine Access Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, Georgia, United States of America
| | - Andrea C. Carcelen
- Department of International Health, International Vaccine Access Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Bryan Lau
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - William J. Moss
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of International Health, International Vaccine Access Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Amy Wesolowski
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
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Packham A, Taylor AE, Karangwa MP, Sherry E, Muvunyi C, Green CA. Measles Vaccine Coverage and Disease Outbreaks: A Systematic Review of the Early Impact of COVID-19 in Low and Lower-Middle Income Countries. Int J Public Health 2024; 69:1606997. [PMID: 38725903 PMCID: PMC11079172 DOI: 10.3389/ijph.2024.1606997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/27/2024] [Indexed: 05/12/2024] Open
Abstract
Objectives: We aimed to evaluate changes to measles-containing vaccine (MCV) provision and subsequent measles disease cases in low- and lower-middle income countries (LICs, LMICs) in relation to the COVID-19 pandemic. Methods: A systematic search was conducted of MEDLINE, OVID EMBASE and PubMed records. Primary quantitative and qualitative research studies published from January 2020 were included if they reported on COVID-19 impact on MCV provision and/or measles outbreak rates within LICs and LMICs. Results: 45 studies were included. The change in MCV1 vaccination coverage in national and international regions ranged -13% to +44.4% from pre-COVID time periods. In local regions, the median MCV1 and overall EPI rate changed by -23.3% and -28.5% respectively. Median MCV2 rate was disproportionally impacted in local areas during COVID-interruption time-periods (-48.2%) with ongoing disruption in early-recovery time-periods (-17.7%). 8.9% of studies reported on vaccination status of confirmed measles cases; from these, 71%-91% had received no MCV dose. Conclusion: MCV vaccination coverage experienced ongoing disruption during the recovery periods after initial COVID-19 disruption. Vaccination in local area datasets notably experienced longer-term disruption compared to nationally reported figures.
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Affiliation(s)
- Alice Packham
- School of Chemical Engineering, College of Engineering and Physical Sciences, University of Birmingham, Birmingham, England, United Kingdom
- Department of Infectious Diseases and Tropical Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Alice E. Taylor
- School of Chemical Engineering, College of Engineering and Physical Sciences, University of Birmingham, Birmingham, England, United Kingdom
- Department of Infectious Diseases and Tropical Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | | | - Emma Sherry
- School of Chemical Engineering, College of Engineering and Physical Sciences, University of Birmingham, Birmingham, England, United Kingdom
- Department of Infectious Diseases and Tropical Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | | | - Christopher A. Green
- School of Chemical Engineering, College of Engineering and Physical Sciences, University of Birmingham, Birmingham, England, United Kingdom
- Department of Infectious Diseases and Tropical Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
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8
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Sanchez C, Dunning D. Intermediate science knowledge predicts overconfidence. Trends Cogn Sci 2024; 28:284-285. [PMID: 38030533 DOI: 10.1016/j.tics.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 11/15/2023] [Indexed: 12/01/2023]
Abstract
Lackner et al. found science overconfidence peaks at intermediate levels of knowledge. Those with intermediate knowledge also hold the most negative attitudes toward scientists. In doing so, they provide a novel measure of overconfidence that measures the tendency to give incorrect answers as opposed to answering, 'I don't know'.
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Affiliation(s)
- Carmen Sanchez
- University of Illinois at Urbana Champaign, Champaign, IL, USA.
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Khalid Z, Muhammad J, Ali H, Rana MS, Usman M, Alam MM, Ullah R, Ullah A, Umair M, Ahmad A, Salman M, Ikram A, Khan A, Bari A. Insights into measles virus: Serological surveillance and molecular characterization. J Infect Public Health 2024; 17:994-1000. [PMID: 38636313 DOI: 10.1016/j.jiph.2024.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 02/21/2024] [Accepted: 03/26/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Measles has been a significant public health concern in Pakistan, especially in the Khyber Pakhtunkhwa (KPK) province, where sporadic and silent epidemics continue to challenge existing control measures. This study aimed to estimate the prevalence and investigate the molecular epidemiology of the measles virus (MeV) in KPK and explore the vaccination status among the suspected individuals. METHODS A cross-sectional study was conducted between February and October 2021. A total of 336 suspected measles cases from the study population were analyzed for IgM antibodies using Enzyme-Linked Immunosorbent Assay (ELISA). Throat swabs were randomly collected from a subset of positive cases for molecular analysis. Phylogenetic analysis of MeV isolates was performed using the neighbor-joining method. The vaccination status of individuals was also recorded. RESULTS Among the suspected participants, 61.0% (205/336) were ELISA positive for IgM antibodies, with a higher prevalence in males (64.17%) compared to females (57.04%). The majority of cases (36.0%) were observed in infants and toddlers, consistent with previous reports. The majority of IgM-positive cases (71.7%) had not received any dose of measles vaccine, highlighting gaps in vaccine coverage and the need for improved immunization programs. Genetic analysis revealed that all MeV isolates belonged to the B3 genotype, with minor genetic variations from previously reported variants in the region. CONCLUSION This study provides valuable insights into the genetic epidemiology of the MeV in KPK, Pakistan. The high incidence of measles infection among unvaccinated individuals highlights the urgency of raising awareness about vaccine importance and strengthening routine immunization programs.
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Affiliation(s)
- Zainab Khalid
- Department of Microbiology, The University of Haripur, Haripur, KP 22610, Pakistan.
| | - Javed Muhammad
- Department of Microbiology, The University of Haripur, Haripur, KP 22610, Pakistan.
| | - Hina Ali
- Shanghai Key Laboratory for Molecular Engineering of Chiral Drugs, School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, 200240, China.
| | | | - Muhammad Usman
- National Institute of Health, Islamabad 45500, Pakistan.
| | | | - Riaz Ullah
- Department of Pharmacognosy, College of Pharmacy, King Saud University Riyadh, Saudi Arabia.
| | - Arif Ullah
- Department of Microbiology, The University of Haripur, Haripur, KP 22610, Pakistan.
| | - Massab Umair
- National Institute of Health, Islamabad 45500, Pakistan.
| | - Ashfaq Ahmad
- National Institute of Health, Islamabad 45500, Pakistan.
| | | | - Aamer Ikram
- National Institute of Health, Islamabad 45500, Pakistan.
| | - Amjad Khan
- Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, KP, Pakistan; The University of Kentucky, KY 40506, United States.
| | - Ahmed Bari
- Department of Pharmaceutical Chemistry, College of Pharmacy King Saud University, Riyadh, Saudi Arabia.
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10
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Kanan M, Abdulrahman S, Alshehri A, AlSuhaibani R, Alotaibi NM, Alsaleh A, Nasser B, Baowaydhan R, Alredaini I, Khalid T, Almukhtar F, Altoaimi N, Alhneshel A, Alanazi S, Algmaizi S. Factors Underlying Vaccine Hesitancy and Their Mitigations in Saudi Arabia: Protocol for a Systematic Review. JMIR Res Protoc 2024; 13:e54680. [PMID: 38517463 PMCID: PMC10998176 DOI: 10.2196/54680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Vaccine hesitancy is a growing concern in Saudi Arabia, impacting even well-educated parents. The decision-making process involves various factors such as accessibility, trustworthy information, and the influence of social networks, reflecting a complex interplay of emotional, cultural, social, spiritual, and political dimensions. OBJECTIVE This review seeks to evaluate the prevalence and trends of vaccine hesitancy, identify contributing factors, and explore potential solutions to enhance immunization rates. This review aligns with global concerns, as the World Health Organization has identified vaccine hesitancy as a top global health threat. METHODS Our systematic review will follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and PICOS (Population, Intervention, Comparison, Outcomes, and Study) criteria for comprehensive assessment. We will conduct a thorough search across various databases, encompassing a wide range of vaccines, and pay special attention to vaccination campaigns and refusals. Inclusion criteria involve descriptive, observational, and analytical studies focusing on factors influencing vaccine acceptance or hesitancy. The study will use the Crowe Critical Appraisal Tool for quality assessment and perform a narrative synthesis to summarize findings thematically. RESULTS This systematic review is expected to unveil the prevalence and trends of vaccine hesitancy in diverse populations in Saudi Arabia, shedding light on cultural, religious, and social factors contributing to hesitancy. It aims to assess the effectiveness of implemented strategies, enable regional and global comparisons, and provide implications for tailored vaccination policies. Additionally, the review may pinpoint research gaps, guiding future investigations to address and mitigate vaccine hesitancy effectively. CONCLUSIONS The findings are expected to have direct policy implications and guide interventions to strengthen vaccination programs and improve public health outcomes. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/54680.
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Affiliation(s)
- Mohammed Kanan
- Department of Clinical Pharmacy, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | | | - Renad AlSuhaibani
- Department of Medicine, Imam Mohammed Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Nawaf M Alotaibi
- Department of Clinical Pharmacy, Northern Border University, Rafha, Saudi Arabia
| | - Azhar Alsaleh
- Department of Nursing, Prince Saud Bin Jalawi Hospital, Alhasa, Saudi Arabia
| | - Bushra Nasser
- Department of Clinical Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Rana Baowaydhan
- Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Taif Khalid
- Department of Clinical Laboratory, Al-Jawf University, Al-Jawf, Saudi Arabia
| | - Fatima Almukhtar
- Department of Medicine, Ministry of Health, Dammam, Saudi Arabia
| | - Nourah Altoaimi
- Department of Pharmacy, Qassim University, Qassim, Saudi Arabia
| | - Almaha Alhneshel
- Department of Medicine, Suliman Alrajhi University, Qassim, Saudi Arabia
| | - Shouq Alanazi
- Department of Medicine, Northern Border University, Northern Borders, Arar, Saudi Arabia
| | - Shahad Algmaizi
- Department of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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11
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McKeever R, Sundstrom B, Rhodes ME, Ritter E, McKeever BW. "A Victim of Our Own Success:" Testing Jenny's First Sleepover's Dark Satire to Improve Attitudes Toward Childhood Vaccination. Health Commun 2024:1-9. [PMID: 38514995 DOI: 10.1080/10410236.2024.2330121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
The COVID-19 pandemic resulted in substantially lower uptake of childhood vaccinations in the U.S. As vaccination rates struggle to rebound, childhood vaccine hesitancy continues to grow. Addressing vaccine disinformation and increasing catch-up vaccination is an urgent public health priority. The purpose of this study was to evaluate the effectiveness of "Jenny's First Sleepover," a darkly humorous satirical book about childhood vaccinations, to influence attitudes of vaccine hesitant parents. This study implemented a randomized pretest - posttest experimental design using a web-based survey with one intervention and one control. "Jenny's First Sleepover" improved attitudes toward vaccination among vaccine hesitant parents. Negative emotions were an important mediator of attitudes toward vaccinations. Findings identify mechanisms that increase effectiveness of satirical approaches, including the presentation of novel information about serious vaccine-preventable diseases with a dark narrative twist. Health communicators may consider a darkly humorous satirical approach to improve attitudes toward childhood vaccination among vaccine hesitant parents.
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Affiliation(s)
- Robert McKeever
- Department of Advertising and Public Relations, University of Alabama
| | | | | | | | - Brooke W McKeever
- Department of Advertising and Public Relations, University of Alabama
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12
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Addis M, Mekonnen W, Estifanos AS. Health system barriers to the first dose of measles immunization in Ethiopia: a qualitative study. BMC Public Health 2024; 24:665. [PMID: 38429806 PMCID: PMC10908078 DOI: 10.1186/s12889-024-18132-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/17/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Ethiopia has made considerable progress toward measles elimination. Despite ongoing efforts, the country remains among those with the highest number of children missing their initial dose of measles vaccine, and the disease continues to be a public health emergency. The barriers within the health system that hinder the first dose of measles immunization have not been thoroughly investigated. This study aims to identify these barriers within the Ethiopian context. METHODS Qualitative research, using purposive expert sampling to select key informants from health organizations in Addis Ababa, Ethiopia was employed. We conducted in-depth face-to-face interviews using a semi-structured interview guide. A thematic analysis based on the World Health Organization's health systems building blocks framework was conducted. RESULTS The study uncovered substantial health system barriers to the uptake of the first dose of the measles vaccine in Ethiopia. These barriers include; restricted availability of immunization services, vaccine stockouts, shortage of cold chain technologies, data inaccuracy resulting from deliberate data falsification or accidental manipulation of data, as well as data incompleteness. CONCLUSION Our research highlighted significant health system barriers to MCV1 immunization, contributing to unmet EPI targets in Ethiopia. Our results suggest that to accelerate the country towards measles elimination, there is an urgent need to improve the health systems components such as service delivery, information systems, as well as access to vaccine and cold chain technologies.
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Affiliation(s)
- Meron Addis
- Department of Reproductive, Family and Population Health, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Wubegzier Mekonnen
- Department of Reproductive, Family and Population Health, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abiy Seifu Estifanos
- Department of Reproductive, Family and Population Health, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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13
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Pinchon E, Henry S, Leon F, Fournier-Wirth C, Foulongne V, Cantaloube JF. Rapid Detection of Measles Virus Using Reverse Transcriptase/Recombinase Polymerase Amplification Coupled with CRISPR/Cas12a and a Lateral Flow Detection: A Proof-of-Concept Study. Diagnostics (Basel) 2024; 14:517. [PMID: 38472989 DOI: 10.3390/diagnostics14050517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/18/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024] Open
Abstract
The measles virus is highly contagious, and efforts to simplify its diagnosis are essential. A reverse transcriptase/recombinase polymerase amplification assay coupled with CRISPR/Cas12a and an immunochromatographic lateral flow detection (RT-RPA-CRISPR-LFD) was developed for the simple visual detection of measles virus. The assay was performed in less than 1 h at an optimal temperature of 42 °C. The detection limit of the assay was 31 copies of an RNA standard in the reaction tube. The diagnostic performances were evaluated on a panel of 27 measles virus RT-PCR-positive samples alongside 29 measles virus negative saliva samples. The sensitivity and specificity were 96% (95% CI, 81-99%) and 100% (95% CI, 88-100%), respectively, corresponding to an accuracy of 98% (95% CI, 94-100%; p < 0.0001). This method will open new perspectives in the development of the point-of-care testing diagnosis of measles.
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Affiliation(s)
- Elena Pinchon
- Pathogénèse et Contrôle des Infections Chroniques et Emergentes, Etablissement Français du Sang, Université de Montpellier, Inserm, 34184 Montpellier, France
| | - Steven Henry
- Pathogénèse et Contrôle des Infections Chroniques et Emergentes, Etablissement Français du Sang, Université de Montpellier, Inserm, 34184 Montpellier, France
| | - Fanny Leon
- Pathogénèse et Contrôle des Infections Chroniques et Emergentes, Etablissement Français du Sang, Université de Montpellier, Inserm, 34184 Montpellier, France
| | - Chantal Fournier-Wirth
- Pathogénèse et Contrôle des Infections Chroniques et Emergentes, Etablissement Français du Sang, Université de Montpellier, Inserm, 34184 Montpellier, France
| | - Vincent Foulongne
- Pathogénèse et Contrôle des Infections Chroniques et Emergentes, Etablissement Français du Sang, Université de Montpellier, Inserm, 34184 Montpellier, France
| | - Jean-François Cantaloube
- Pathogénèse et Contrôle des Infections Chroniques et Emergentes, Etablissement Français du Sang, Université de Montpellier, Inserm, 34184 Montpellier, France
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14
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Hirata K, Takahara A, Suzuki S, Murakami S, Kawaji K, Nishiyama A, Sasano M, Shoji-Ueno M, Usui E, Murayama K, Hayashi H, Oishi S, Kodama EN. Helical peptides with disordered regions for measles viruses provide new generalized insights into fusion inhibitors. iScience 2024; 27:108961. [PMID: 38333694 PMCID: PMC10850769 DOI: 10.1016/j.isci.2024.108961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/13/2023] [Accepted: 01/15/2024] [Indexed: 02/10/2024] Open
Abstract
Despite effective vaccines, measles virus (MeV) outbreaks occur sporadically. Therefore, developing anti-MeV agents remains important for suppressing MeV infections. We previously designed peptide-based MeV fusion inhibitors, M1 and M2, that target MeV class I fusion protein (F protein). Here, we developed a novel fusion inhibitor, MEK35, that exerts potent activity against M1/M2-resistant MeV variants. Comparing MEK35 to M1 derivatives revealed that combining disordered and helical elements was essential for overcoming M1/M2 resistance. Moreover, we propose a three-step antiviral process for peptide-based fusion inhibitors: (i) disordered peptides interact with F protein; (ii) the peptides adopt a partial helical conformation and bind to F protein through hydrophobic interactions; and (iii) subsequent interactions involving the disordered region of the peptides afford a peptide-F protein with a high-affinity peptide-F protein interaction. An M1-resistant substitution blocks the second step. These results should aid the development of novel viral fusion inhibitors targeting class I F protein.
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Affiliation(s)
- Kazushige Hirata
- Department of Infectious Diseases, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
- Department of Clinical Laboratory Medicine, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Aoi Takahara
- Graduate School of Pharmaceutical Sciences, Kyoto University, 46-29, Yoshida-Shimo-Adachi-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Satoshi Suzuki
- Department of Infectious Diseases, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Shumei Murakami
- Department of Intelligent Network for Infection Control, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
- Division of Infectious Diseases, International Research Institute of Disaster Science, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Kumi Kawaji
- Division of Infectious Diseases, International Research Institute of Disaster Science, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Akie Nishiyama
- Department of Infectious Diseases, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Mina Sasano
- Division of Infectious Diseases, International Research Institute of Disaster Science, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Mariko Shoji-Ueno
- Department of Infectious Diseases, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Emiko Usui
- Division of Infectious Diseases, International Research Institute of Disaster Science, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Kazutaka Murayama
- Division of Biomedical Measurements and Diagnostics, Graduate School of Biomedical Engineering, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Hironori Hayashi
- Department of Intelligent Network for Infection Control, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
- Division of Infectious Diseases, International Research Institute of Disaster Science, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Shinya Oishi
- Graduate School of Pharmaceutical Sciences, Kyoto University, 46-29, Yoshida-Shimo-Adachi-cho, Sakyo-ku, Kyoto 606-8501, Japan
- Department of Medicinal Chemistry, Kyoto Pharmaceutical University, 1, Misasagi-Shichono-cho, Yamashina-ku, Kyoto 607-8412, Japan
| | - Eiichi N. Kodama
- Department of Intelligent Network for Infection Control, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
- Division of Infectious Diseases, International Research Institute of Disaster Science, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
- Department of Infectious Diseases, Graduate School of Medicine and Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
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15
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Davila-Payan CS, Hill A, Kayembe L, Alexander JP, Lynch M, Pallas SW. Analysis of the yearly transition function in measles disease modeling. Stat Med 2024; 43:435-451. [PMID: 38100282 DOI: 10.1002/sim.9951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 10/03/2023] [Accepted: 10/16/2023] [Indexed: 12/17/2023]
Abstract
Globally, there were an estimated 9.8 million measles cases and 207 500 measles deaths in 2019. As the effort to eliminate measles around the world continues, modeling remains a valuable tool for public health decision-makers and program implementers. This study presents a novel approach to the use of a yearly transition function that formulates mathematically the vaccine schedules for different age groups while accounting for the effects of the age of vaccination, the timing of vaccination, and disease seasonality on the yearly number of measles cases in a country. The methodology presented adds to an existing modeling framework and expands its analysis, making its utilization more adjustable for the user and contributing to its conceptual clarity. This article also adjusts for the temporal interaction between vaccination and exposure to disease, applying adjustments to estimated yearly counts of cases and the number of vaccines administered that increase population immunity. These new model features provide the ability to forecast and compare the effects of different vaccination timing scenarios and seasonality of transmission on the expected disease incidence. Although the work presented is applied to the example of measles, it has potential relevance to modeling other vaccine-preventable diseases.
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Affiliation(s)
- C S Davila-Payan
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - A Hill
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - L Kayembe
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - J P Alexander
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - M Lynch
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - S W Pallas
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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16
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Conceição PB, San Pedro A, Praça HLF, dos Santos YT, Reis LNM, Gibson G. [Stratification of risk areas for measles transmission: a systematic reviewEstratificación de las zonas de riesgo de transmisión del sarampión: revisión sistemática]. Rev Panam Salud Publica 2024; 48:e1. [PMID: 38226153 PMCID: PMC10787521 DOI: 10.26633/rpsp.2024.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/17/2023] [Indexed: 01/17/2024] Open
Abstract
Objective To perform a systematic review of scientific publications addressing the use of stratification methods to define risk areas for measles transmission. Method Articles published in English, Portuguese, and Spanish in journals indexed in the SciELO, PubMed, and LILACS databases were selected. The search terms risk assessment AND measles were used without date limits. Editorials, opinion articles, individual-level observational studies, and publications that did not focus on the application of methods to stratify measles transmission risk areas were excluded. Year of publication, authorship, country where the study was performed, objective, geographic level of analysis, method used, indicators, and limitations were recorded in a data form. Results Thirteen articles published between 2011 and 2022 in nine countries from the six World Health Organization (WHO) regions were selected. Of these, 10 referred to the Measles Risk Assessment Tool developed by the WHO/Centers for Disease Control and Prevention. Only one study adapted the tool to the local context. The risk stratification indicators used in the selected studies focused on a combination of the following dimensions: population immunity, quality of surveillance systems, and epidemiologic status. The systematic output of data with adequate quality and coverage was a noteworthy aspect hindering risk stratification. Conclusion There seems to be limited dissemination of measles risk stratification strategies, especially at local levels. The need to train human resources to process and interpret risk analyses as part of the routine of surveillance services is emphasized.
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Affiliation(s)
- Paula Barbosa Conceição
- Universidade Federal do Rio de Janeiro (UFRJ)Instituto de Estudos em Saúde ColetivaRio de Janeiro (RJ)BrasilUniversidade Federal do Rio de Janeiro (UFRJ), Instituto de Estudos em Saúde Coletiva, Rio de Janeiro (RJ), Brasil.
| | - Alexandre San Pedro
- Universidade Federal do Rio de Janeiro (UFRJ)Instituto de Estudos em Saúde ColetivaRio de Janeiro (RJ)BrasilUniversidade Federal do Rio de Janeiro (UFRJ), Instituto de Estudos em Saúde Coletiva, Rio de Janeiro (RJ), Brasil.
| | - Heitor Levy Ferreira Praça
- Universidade Federal do Rio de Janeiro (UFRJ)Instituto de Estudos em Saúde ColetivaRio de Janeiro (RJ)BrasilUniversidade Federal do Rio de Janeiro (UFRJ), Instituto de Estudos em Saúde Coletiva, Rio de Janeiro (RJ), Brasil.
| | - Yasmin Toledo dos Santos
- Universidade Federal do Rio de Janeiro (UFRJ)Instituto de Estudos em Saúde ColetivaRio de Janeiro (RJ)BrasilUniversidade Federal do Rio de Janeiro (UFRJ), Instituto de Estudos em Saúde Coletiva, Rio de Janeiro (RJ), Brasil.
| | - Larissa Nunes Moreira Reis
- Universidade Federal do Rio de Janeiro (UFRJ)Instituto de Estudos em Saúde ColetivaRio de Janeiro (RJ)BrasilUniversidade Federal do Rio de Janeiro (UFRJ), Instituto de Estudos em Saúde Coletiva, Rio de Janeiro (RJ), Brasil.
| | - Gerusa Gibson
- Universidade Federal do Rio de Janeiro (UFRJ)Instituto de Estudos em Saúde ColetivaRio de Janeiro (RJ)BrasilUniversidade Federal do Rio de Janeiro (UFRJ), Instituto de Estudos em Saúde Coletiva, Rio de Janeiro (RJ), Brasil.
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17
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Kurata T, Kaida Y, Kanbayashi D, Motomura K. Achieving measles elimination and emerging modified measles: Longitudinal measles epidemiology from 1982 to 2021 in Osaka Prefecture, Japan. Vaccine 2024; 42:271-286. [PMID: 38097458 DOI: 10.1016/j.vaccine.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/14/2023] [Accepted: 12/01/2023] [Indexed: 01/01/2024]
Abstract
BACKGROUND Measles is a contagious viral disease causing infant mortality in developing countries without vaccination programs. In Japan, measles vaccination was launched in 1978, surveillance commenced in 1981, and elimination was achieved in 2015. This was due to improved, legally required surveillance methods and vaccine programs. METHODS The data sets of sentinel (1982-2007) and notifiable (2008-2021) disease surveillance, as well as the vaccination coverage, detected genotypes, and seroepidemiology during the study period in Osaka Prefecture, were analyzed. Additionally, the trend under the current notifiable surveillance was compared before (2008-2014) and after (2015-2021) measles elimination. RESULTS Under sentinel surveillance, 51,107 cases were reported, predominantly infants aged 1-4 years (63.6 %). Under notifiable disease surveillance, the 781 patients were predominantly in their 20s-30s (43.7 %). From 2000, the age of the major susceptible group increased due to the rise in vaccination coverage, which exceeded 95% for the first dose in 1998 and 90% for the second dose in 2009. Consistent with these data, seroprevalence exceeded 95% in 2011. However, the geometric mean of the antibody titer showed a decreasing trend with a falling number of patients. Compared with before and after measles elimination, the number of modified measles cases increased from 10.1% to 48.2%. During the study period, 398 strains comprising eight genotypes were identified, and the dominant type changed over time. After measles elimination, genotypes B3 and D8, derived from imported cases, became predominant. CONCLUSIONS Improved vaccination coverage and surveillance reduced measles cases and increased herd immunity. However, the lack of a booster effect due to the low incidence of measles caused waning antibody titers despite high seroprevalence, which may contribute to the rising rate of vaccine failures causing modified measles. Careful monitoring of measles incidence and herd immunity are necessary for measles eradication.
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Affiliation(s)
- Takako Kurata
- Osaka Institute of Public Health, Division of Microbiology, Virology Section Nakamichi 1-3-3, Higashinari-ku, Osaka 537-0025, Japan.
| | - Yuko Kaida
- Fujiidera Public Health Center, Inspection Division, Fujiidera 1-8-36, Fujiidera-shi, Osaka 583-0024, Japan.
| | - Daiki Kanbayashi
- Osaka Institute of Public Health, Division of Microbiology, Virology Section Nakamichi 1-3-3, Higashinari-ku, Osaka 537-0025, Japan.
| | - Kazushi Motomura
- Osaka Institute of Public Health, Division of Public Health, Nakamichi 1-3-3, Higashinari-ku, Osaka 537-0025, Japan.
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Hoffman SA, Maldonado YA. Emerging and re-emerging pediatric viral diseases: a continuing global challenge. Pediatr Res 2024; 95:480-487. [PMID: 37940663 PMCID: PMC10837080 DOI: 10.1038/s41390-023-02878-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/08/2023] [Accepted: 10/19/2023] [Indexed: 11/10/2023]
Abstract
The twenty-first century has been marked by a surge in viral epidemics and pandemics, highlighting the global health challenge posed by emerging and re-emerging pediatric viral diseases. This review article explores the complex dynamics contributing to this challenge, including climate change, globalization, socio-economic interconnectedness, geopolitical tensions, vaccine hesitancy, misinformation, and disparities in access to healthcare resources. Understanding the interactions between the environment, socioeconomics, and health is crucial for effectively addressing current and future outbreaks. This scoping review focuses on emerging and re-emerging viral infectious diseases, with an emphasis on pediatric vulnerability. It highlights the urgent need for prevention, preparedness, and response efforts, particularly in resource-limited communities disproportionately affected by climate change and spillover events. Adopting a One Health/Planetary Health approach, which integrates human, animal, and ecosystem health, can enhance equity and resilience in global communities. IMPACT: We provide a scoping review of emerging and re-emerging viral threats to global pediatric populations This review provides an update on current pediatric viral threats in the context of the COVID-19 pandemic This review aims to sensitize clinicians, epidemiologists, public health practitioners, and policy stakeholders/decision-makers to the role these viral diseases have in persistent pediatric morbidity and mortality.
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Affiliation(s)
- Seth A Hoffman
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
| | - Yvonne A Maldonado
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
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Prieto Alvarado FE, Salas Suspes HP, Cortés Molano NP, Tavera PA. [Maintaining measles elimination status in Colombia during outbreak control, 2019Manutenção do status de eliminação do sarampo na Colômbia durante o controle de surtos, 2019]. Rev Panam Salud Publica 2023; 47:e165. [PMID: 38089106 PMCID: PMC10712572 DOI: 10.26633/rpsp.2023.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/10/2023] [Indexed: 03/08/2024] Open
Abstract
Objective Describe measles outbreaks caused by importation of multiple cases, and the corresponding control interventions. Methods Descriptive study of measles outbreaks caused by the importation of multiple cases to Colombia in 2018-2019. Case definitions, classification of source of infection, collection of biological specimens, searches for suspected cases, case identification, and contact tracing were employed. Vaccination records were obtained from vaccination cards or from the Colombian information system. Nationality was determined from records found in the public health surveillance system. The incident command system was used, and response teams and action plans were activated to control outbreaks. Results In March 2018, the first case of measles imported from Venezuela was confirmed. Measles incidence in 2018 was 0.2 cases per 100 000 population, and it was 0.3 per 100 000 in 2019. The case fatality rate in 2019 was 0.4%. A total of 214 cases were confirmed in the Venezuelan population (91% with no vaccination history); and 69 outbreaks with no epidemiological link were studied. The MVi/Hulu Langat.MYS/26.11[D8] lineage was identified. Endemic circulation was prevented through innovative interventions such as infection surveillance and control, immediate notification, prioritization of field visits, and transmission risk level criteria. Conclusions Colombia controlled measles outbreaks that resulted from imported cases, and it prevented endemic circulation, thereby maintaining certification of measles elimination in the country.
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Affiliation(s)
| | | | | | - Pilar Andrea Tavera
- Instituto Nacional de SaludBogotáColombiaInstituto Nacional de Salud, Bogotá, Colombia.
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Melis T, Mose A, Fikadu Y, Haile K, Habte A, Jofiro G. Predictors for low coverage of uptake of second dose of measles vaccine among children in sub-Saharan Africa, 2023: a systematic review and meta-analysis. J Pharm Policy Pract 2023; 17:2285507. [PMID: 38205190 PMCID: PMC10775641 DOI: 10.1080/20523211.2023.2285507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024] Open
Abstract
Background Measles became a public health important disease in sub-Saharan Africa. World Health Organization recommended measles-containing vaccine dose 2 (MCV2) through routine service delivery. This study aims to determine coverage of second-dose measles vaccination uptake and its predictors among children aged 24-35 months in sub-Saharan Africa. Methods and materials We conducted an extensive search of literature as indicated in the guideline of reporting systematic review and meta-analysis (PRISMA). The databases used were PubMed, Google Scholar, and HINARI literature. Results The overall uptake of the second dose of measles vaccine uptake was 41% (95% CI: 28.90-53.47). Caregiver's awareness of the importance of the second dose of measles (2.51, 95% CI 1.77, 3.25), educational status of mothers (1.30, 95% CI 1.16, 1.45), distance from vaccination site (1.22, 95% CI 1.12, 1.32), and attending four and above ANC visit (2.72, 95% CI 2.29, 3.15) were determinants for second dose measles vaccine uptake. Conclusion Coverage of the second dose of measles uptake in Sub-Saharan Africa was low (41%) which is lower than the recommendation from WHO. Therefore policymakers and stakeholders should increase mother's awareness. Also, special strategies should be developed for those who are far from the vaccination site. Abbreviation and acronyms ANC: Ante Natal Care; JBI: Joanna Briggs Institute; MCV1: Measles containing vaccine dose 1; MCV2: Measles containing vaccine dose 2; WHO: World Health Organization.
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Affiliation(s)
- Tamirat Melis
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Ayenew Mose
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Yohannes Fikadu
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Kassahun Haile
- Department of medical laboratory, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Aklilu Habte
- Department of Public Health, College of Medicine and Health Science, Wachamo University, Hosanna, Ethiopia
| | - Gemechu Jofiro
- Department of Nurse, College of Medicine and Health Science, Arsi University, Asela, Ethiopia
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Zahradeen SU, Muhammad ID, Adamou N, Rabiu A, Yusuf MA, Shuaibu SAD, Ibrahim G. Seroprevalence and risk factors for rubella infection in pregnant women attending a tertiary hospital in Kano-Nigeria. Pan Afr Med J 2023; 46:97. [PMID: 38405097 PMCID: PMC10891375 DOI: 10.11604/pamj.2023.46.97.39433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 10/09/2023] [Indexed: 02/27/2024] Open
Abstract
Introduction rubella is a leading cause of vaccine preventable birth defects especially in developing countries. Acquisition of infection with the rubella virus in early pregnancy exposes the fetus to a very high chance of developing congenital rubella syndrome. The neonate is born with multiple abnormalities with the triad of congenital cataract, deafness and cardiovascular abnormalities like ventricular septal defect or patent ductus arteriosus. Limited data exist on the seroprevalence of rubella antibodies in pregnant women in Nigeria. The aim of this study was to determine the seroprevalence of rubella antibodies in pregnant women attending antenatal clinic in Aminu Kano Teaching Hospital, Kano State. Methods the study was a cross-sectional study involving one hundred and sixty-three pregnant women attending antenatal clinic of Aminu Kano Teaching Hospital in Kano, Nigeria. Interviewer administered questionnaire was used to collect sociodemographic data and risk factors. Blood samples were taken from consenting pregnant women during antenatal care and samples were subjected to antibody testing (IgG and IgM). Descriptive analysis was done for sociodemographic data and seroprevalence of rubella. Chi-square tests were used to determine associations. Results one hundred and sixty-three pregnant women were recruited for the study. The participants´ age ranged from 18 to 41 years with mean age of 27.60±5.7 years. The overall rubella seroprevalence was found to be 68.7%. The seroprevalence of specific anti-Rubella virus IgM and IgG was found to be 58.4% and 37.3% respectively while prevalence of having both anti-Rubella virus IgG and IgM in the women was found to be 26.4%. Non-formal education and immunodeficiency was found to be associated with rubella infection (P-value of 0.018 and 0.001 respectively). Conclusion the study found a high prevalence of anti-Rubella virus immunoglobulins in asymptomatic pregnant women attending antenatal care in our facility with immunodeficiency and non-formal education found to be significant risk factors.
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Affiliation(s)
| | | | - Natalia Adamou
- Department of Obstetrics and Gynaecology, Bayero University, Kano, Nigeria
| | - Ayyuba Rabiu
- Department of Obstetrics and Gynaecology, Bayero University, Kano, Nigeria
| | | | | | - Garba Ibrahim
- Department of Obstetrics and Gynaecology, Bayero University, Kano, Nigeria
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Santacruz-Sanmartin E, Hincapié-Palacio D, Ochoa J, Buitrago S, Ospina M. Population measles seroprevalence: Heterogeneity by birth-year cohort. J Virus Erad 2023; 9:100352. [PMID: 38046787 PMCID: PMC10692715 DOI: 10.1016/j.jve.2023.100352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 09/26/2023] [Accepted: 10/03/2023] [Indexed: 12/05/2023] Open
Abstract
Objective This work sought to estimate population measles seroprevalence and heterogeneity in the antibody concentration distribution that could be explained by the birth-year cohort according to the opportunity of viral and vaccine exposure, applied to data from Medellín, Colombia. Methods Prevalence of IgG antibodies was analyzed for measles based on a population study with a random sample of 2098 individuals from 6 to 64 years of age. Finite mixture models were used to estimate global seroprevalence and that of three birth-year cohorts (I: born up to 1982; II: 1983-1994; III: born since 1995). Multiple linear regression permitted adjusting the concentration of antibodies by cohort, zone, and sex. Results Globally, seronegativity was 6.5% (95% CI 4.9- 8.6), seropositivity of 78.4% (95% CI 75.1-81.4), and equivocal of 15.1% (95% CI 12.5-18.1). Two components were found with skewed normal distribution, which reclassified those equivocal as seropositive. Differences were observed by cohort in the geometric mean of antibodies [Cohort I: 1704.6; II: 562.2; III: 802.1 milli-international units per milliliter (mIU/mL] and seronegativity (Cohort I: 4%; II:13.3%; III: 8.9%). Antibody concentration increased by 1.26 mIU/mL in residents in the rural area, while diminishing in individuals from cohort II (by 3.02 mIU/mL) and cohort III (by 2.14 mIU/mL). Conclusion The younger cohorts (II and III) had a lower antibody concentration (higher seronegativity), indicating the need to monitor periodically seroprevalence and an eventual reestablishment of the transmission in these groups with higher risk of infection.
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Affiliation(s)
- Eduardo Santacruz-Sanmartin
- Epidemiology Research Group in “Héctor Abad Gómez” National Faculty of Public Health at University of Antioquia, St 62 # 52-59, Medellín, Colombia
| | - Doracelly Hincapié-Palacio
- Epidemiology Research Group in “Héctor Abad Gómez” National Faculty of Public Health at University of Antioquia, St 62 # 52-59, Medellín, Colombia
| | - Jesús Ochoa
- Epidemiology Research Group in “Héctor Abad Gómez” National Faculty of Public Health at University of Antioquia, St 62 # 52-59, Medellín, Colombia
| | - Seti Buitrago
- Departmental Laboratory of Public Health- the Sectional Secretariat of Health and Social Protection of Antioquia, St 72 A # 78 B 141, Third Floor, Medellín, Colombia
| | - Marta Ospina
- Departmental Laboratory of Public Health- the Sectional Secretariat of Health and Social Protection of Antioquia, St 72 A # 78 B 141, Third Floor, Medellín, Colombia
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Kanchanarat S, Nudee K, Chinviriyasit S, Chinviriyasit W. Mathematical analysis of pulse vaccination in controlling the dynamics of measles transmission. Infect Dis Model 2023; 8:964-979. [PMID: 37654518 PMCID: PMC10465959 DOI: 10.1016/j.idm.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 09/02/2023] Open
Abstract
Although the incidence of measles has been significantly reduced through vaccination, it remains an important public health problem. In this paper, a measles model with pulse vaccination is formulated to investigate the influential pulse vaccination on the period of time for the extinction of the disease. The threshold value of the formulated model, called the control reproduction number and denoted by R ∗ , is derived. It is found that the disease-free periodic solution of the model exists and is globally attractivity whenever R ∗ < 1 in the sense that measles is eliminated. If R ∗ > 1 , the positive solution of the model exists and is permanent which indicates the disease persists in the community. Theoretical conditions for disease eradication under various constraints are given. The effect of pulse vaccination is explored using data from Thailand. The results obtained can guide policymakers in deciding on the optimal scheduling in order to achieve the strategic plan of measles elimination by vaccination.
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Affiliation(s)
- Siwaphorn Kanchanarat
- Department of Mathematics, Faculty of Science, King Mongkut's University of Technology Thonburi, Bangkok, Thailand
| | - Kadkanok Nudee
- Department of Mathematics, Faculty of Science, King Mongkut's University of Technology Thonburi, Bangkok, Thailand
- Faculty of Science and Technology Suratthani Rajabhat University, Surat Thani, Thailand
| | - Settapat Chinviriyasit
- Department of Mathematics, Faculty of Science, King Mongkut's University of Technology Thonburi, Bangkok, Thailand
| | - Wirawan Chinviriyasit
- Department of Mathematics, Faculty of Science, King Mongkut's University of Technology Thonburi, Bangkok, Thailand
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Kumar SS, Hartner AM, Chandran A, Gaythorpe KAM, Li X. Evaluating effective measles vaccine coverage in the Malaysian population accounting for between-dose correlation and vaccine efficacy. BMC Public Health 2023; 23:2351. [PMID: 38017415 PMCID: PMC10683193 DOI: 10.1186/s12889-023-17082-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/27/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Malaysia introduced the two dose measles-mumps-rubella (MMR) vaccine in 2004 as part of its measles elimination strategy. However, despite high historical coverage of MCV1 and MCV2, Malaysia continues to report high measles incidence. This study suggests a novel indicator for investigating population immunity against measles in the Malaysian population. METHODS We define effective vaccine coverage (EVC) of measles as the proportion of a population vaccinated with measles-containing vaccine (MCV) and effectively protected against measles infection. A quantitative evaluation of EVC throughout the life course of Malaysian birth cohorts was conducted accounting for both vaccine efficacy (VE) and between-dose correlation (BdC). Measles vaccination coverage was sourced from WHO-UNICEF estimates of Malaysia's routine immunisation coverage and supplementary immunisation activities (SIAs). United Nations World population estimates and projections (UNWPP) provided birth cohort sizes stratified by age and year. A step wise joint Bernoulli distribution was used to proportionate the Malaysian population born between 1982, the first year of Malaysia's measles vaccination programme, and 2021, into individuals who received zero dose, one dose and multiple doses of MCV. VE estimates by age and doses received are then adopted to derive EVC. A sensitivity analysis was conducted using 1000 random combinations of BdC and VE parameters. RESULTS This study suggests that no birth cohort in the Malaysian population has achieved > 95% population immunity (EVC) conferred through measles vaccination since the measles immunisation programme began in Malaysia. CONCLUSION The persistence of measles in Malaysia is due to pockets of insufficient vaccination coverage against measles in the population. Monitoring BdC through immunisation surveillance systems may allow for the identification of susceptible subpopulations (primarily zero-dose MCV individuals) and increase the coverage of individuals who are vaccinated with multiple doses of MCV. This study provides a tool for assessment of national-level population immunity of measles conferred through vaccination and does not consider subnational heterogeneity or vaccine waning. This tool can be readily applied to other regions and vaccine-preventable diseases.
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Affiliation(s)
- Shurendar Selva Kumar
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, W2 1NY, UK.
| | - Anna-Maria Hartner
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, W2 1NY, UK
- Centre for Artificial Intelligence in Public Health Research, Robert Koch Institute, Wildau, Germany
| | | | - Katy A M Gaythorpe
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, W2 1NY, UK
| | - Xiang Li
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, W2 1NY, UK.
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Alruqaie N, Al Qadrah B, Almansour S, Alghamdi E, Alharbi M. A Measles Outbreak in Riyadh in 2023: Clinical and Epidemiological Characteristics. Cureus 2023; 15:e48171. [PMID: 38046773 PMCID: PMC10693316 DOI: 10.7759/cureus.48171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 12/05/2023] Open
Abstract
Background Measles is a highly contagious viral disease that has recently made headlines due to outbreaks in several parts of the world. The disease can cause serious health complications, especially in young children, which has led to concerns about vaccination rates and public health policies. This study aims to investigate and describe the epidemiology, clinical characteristics, and outcomes of measles infection among children in Riyadh. Methodology We conducted a descriptive cross-sectional study among all pediatric patients with confirmed measles infection at a tertiary hospital from January 15, 2023, to March 15, 2023. We collected data including demographic characteristics, clinical presentations, and clinical outcomes. Results A total of 63 confirmed measles cases were reported. Most patients were under four years of age (82.7%), and 85.7% were unvaccinated. Adenovirus was the most common viral coinfection (12.7%). The most common complication was pneumonia (58.7%). Chest X-ray findings reported a localized right parenchymal infiltrate in 19% of patients and a patchy bilateral infiltrate in 15.9% of patients. In addition, 88.9% required hospital admission secondary to dehydration (47.6%) and hypoxia (41.3%). Among admitted patients, 17.5% were admitted to the pediatric intensive care unit (PICU), 9.5% were admitted due to respiratory failure, and 6.3% due to septic shock. Children under one year of age had a higher risk for PICU admission (p < 0.05). The mortality rate was 1.6%. Conclusions Measles is a serious disease that causes significant health effects and incurs high financial costs for public health systems. Vaccination remains the most effective way to prevent measles outbreaks and reduce their impact on individuals and communities.
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Affiliation(s)
- Nourah Alruqaie
- Pediatric Infectious Diseases, King Abdulaziz Medical City, Riyadh, SAU
| | | | | | - Eman Alghamdi
- Public Health, King Abdulaziz Medical City, Riyadh, SAU
| | - Musaed Alharbi
- Pediatric Infectious Diseases, King Abdulaziz Medical City, Riyadh, SAU
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Krishna Susarla S, Jahagirdar R, Ghosh Uttam K, Srikanth Bhatt S, Prashanth S, Rajapantula V, Satish M, Rajashakar BC, Sandhya G, Rajendra L, Prasad Sahoo D, Kumar Kanakasapapathy A. Immunogenicity and safety of Mebella™ vaccine developed by Human Biologicals Institute in a Phase II/III, randomized, multicentric, non-inferiority study. Vaccine 2023; 41:6558-6564. [PMID: 37659893 DOI: 10.1016/j.vaccine.2023.08.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 08/11/2023] [Accepted: 08/24/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND The goal of 'Measles and Rubella Strategic Framework 2021-2030' is to make "A world free from measles and rubella". To be a part of this journey, Human Biologicals Institute has developed Mebella™ vaccine, which is a lyophilized Measles and Rubella (Live) vaccine. A randomized, single blind, comparative, multicenter Phase II/III trial was conducted to compare the immunogenicity and safety of Mebella™ vaccine with MR-VAC® vaccine in healthy subjects. METHODS A total of 888 subjects were enrolled in four age groups (222 subjects in each group) of 18 years to 49 years; 2 years to below 18 years; 12 months to below 24 months; and 9 months to below 12 months of age. The subjects were randomized in 2:1 ratio to receive single dose of either Mebella™ vaccine of Human Biologicals Institute or MR-VAC® vaccine. Immunogenicity was assessed at 42 days after the vaccination and was compared between the vaccine arms in each group. Safety was also assessed and compared between the vaccine arms during the study period. RESULTS A total of 875 subjects completed the study out of 888 enrolled subjects. The seroprotection rates, seroconversion rates, and geometric mean titres for both Measles and Rubella components of Mebella™ vaccine were found to be comparable and non-inferior to the MR-VAC® vaccine after 42 days of vaccination. Injection site pain was the most common local adverse event reported whereas fever was the only systemic adverse event reported in both the vaccine arms. No serious adverse event was reported. CONCLUSION It was concluded from the study results that the test vaccine, Mebella™, was immunogenic and well tolerated and was non-inferior to the comparator vaccine, MR-VAC®, when administered to healthy subjects of 9 months to 49 years of age. Clinical Trial Registry of India Identifier: CTRI/2020/07/026930.
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Affiliation(s)
- Sai Krishna Susarla
- Human Biologicals Institute (A Division of Indian Immunologicals Limited), Hyderabad, Telangana, India.
| | - Rahul Jahagirdar
- Department of Pediatrics, Bharati Vidyapeeth (Deemed to be University) Medical College & Hospital, Pune, Maharashtra, India
| | - Kheya Ghosh Uttam
- Department of Pediatric Medicine, Institute of Child Health, Kolkata, West Bengal, India
| | - S Srikanth Bhatt
- Department of Pediatrics, Gandhi Medical College and Hospital, Secunderabad, Telangana, India
| | - S Prashanth
- Department of Pediatrics, Cheluvamba Hospital, Mysore Medical College and Research Institute, Mysore, Karnataka, India
| | - Vasudev Rajapantula
- Department of Medicine, King George Hospital, Visakhapatnam, Andhra Pradesh, India
| | - M Satish
- Human Biologicals Institute (A Division of Indian Immunologicals Limited), Hyderabad, Telangana, India
| | - B C Rajashakar
- Human Biologicals Institute (A Division of Indian Immunologicals Limited), Hyderabad, Telangana, India
| | - G Sandhya
- Human Biologicals Institute (A Division of Indian Immunologicals Limited), Hyderabad, Telangana, India
| | - L Rajendra
- Human Biologicals Institute (A Division of Indian Immunologicals Limited), Hyderabad, Telangana, India
| | - Devi Prasad Sahoo
- Human Biologicals Institute (A Division of Indian Immunologicals Limited), Hyderabad, Telangana, India
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Mengistu ST, Achila OO, Tewelde AT, Hamida ME, Tekle F, Michae I, Said M, Fsahatsion D, Abai H, Mulugeta R, Tsegai T, Woldu LG, Werke WY. Epidemiology of confirmed measles virus cases, surveillance, incidence, and associated factors in Eritrea: 18-year retrospective analysis. Front Public Health 2023; 11:1218317. [PMID: 37780421 PMCID: PMC10533993 DOI: 10.3389/fpubh.2023.1218317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Background Despite the outstanding measles vaccine coverage (MVC) in Eritrea, sporadic outbreaks are not uncommon. Therefore, understanding the incidence of laboratory-confirmed measles virus cases, related factors, and spatial inequalities in testing and surveillance remains crucial. In this analysis, we evaluated the incidence and spatiotemporal distribution of measles in Eritrea. An evaluation of the factors associated with measles vaccination and IgM positive (+) febrile rash was also undertaken. Methods A retrospective (period: 2002-2020) study was carried out by abstracting data from the integrated disease surveillance and response database (IDSR). Data was analyzed using descriptive statistics and binary logistic regression. Spatial variability and distribution of confirmed cases was evaluated using ArcGIS Pro version 3.0.1. Results In total, 9,111 suspected cases, 2,767 [1,431 (51.7%) females] were serologically tested. The median (IQR) age, minimum-maximum age were 7 years (IQR: 4-14 years) and 1 month-97 years, respectively. Among the 608(21.9%) laboratory-confirmed cases, 534 (87.8%) were unvaccinated and 53 (9.92%) were < 1 year old. The crude incidence rate for MV was 14/100,000 persons. The age-specific positivity rate per 100,000 suspected cases tested was 21.5 with individuals >30 years presenting with the highest rates (69.9/100,000). Higher odds (OR) of MV test positivity was associated with age at onset - higher in the following age-bands [10-14 years: OR = 1.6 (95%CI, 1.1-2.2, value of p = 0.005); 15-29 years: OR = 7.0 (95%CI, 5.3-9.2, value of p = 0.005); and > =30 years: OR = 16.7 (95%CI, 11.7-24) p < 0.001]. Other associations included: Address - higher in Anseba (OR = 2.3, 95%CI: 1.7-3.1, value of p<0.001); Debub (OR = 2.7, 95%CI: 1.9-3.9, value of p < 0.001); Gash-Barka (OR = 15.4, 95%CI: 10.9-21.7, value of p < 0.001); Northern Red Sea (OR = 11.8, 95%CI: 8.5-16.2, value of p < 0.001); and Southern Red Sea (OR = 14.4, 95%CI: 8.2-25.2, value of p < 0.001). Further, test positivity was higher in health centers (OR = 2.5, 95%CI: 1.9-3.4, value of p < 0.001) and hospitals (OR = 6.8, 95%CI: 5.1-9.1, value of p < 0.001). Additional factors included vaccination status - higher in the unvaccinated (OR = 14.7, 95%CI: 11.4-19.1, value of p < 0.001); and year of onset of rash - (higher >2015: OR = 1.4, 95%CI: 1.1-1.7, value of p<0.001). Uptake of measles vaccine associated with a similar complement of factors. Conclusion In large part, efforts to eliminate measles in Eritrea are hindered by disparities in vaccine coverage, under-surveillance, and low vaccination rates in neighboring countries. Enhanced surveillance and regional micro planning targeting hard-to-reach areas can be an effective strategy to improve measles elimination efforts in Eritrea.
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Affiliation(s)
| | - Oliver Okoth Achila
- Unit of Clinical Laboratory Sciences, Orotta College of Medicine and Health Sciences, Asmara, Eritrea
| | | | | | - Freweini Tekle
- Serology Department, National Health Laboratory, Asmara, Eritrea
| | - Issaias Michae
- Serology Department, National Health Laboratory, Asmara, Eritrea
| | - Mensura Said
- Serology Department, National Health Laboratory, Asmara, Eritrea
| | - Dawit Fsahatsion
- Serology Department, National Health Laboratory, Asmara, Eritrea
| | - Haimanot Abai
- Serology Department, National Health Laboratory, Asmara, Eritrea
| | - Rahel Mulugeta
- Serology Department, National Health Laboratory, Asmara, Eritrea
| | - Tsigehana Tsegai
- Serology Department, National Health Laboratory, Asmara, Eritrea
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Masresha BG, Hatcher C, Lebo E, Tanifum P, Bwaka AM, Minta AA, Antoni S, Grant GB, Perry RT, O’Connor P. Progress Toward Measles Elimination - African Region, 2017-2021. MMWR Morb Mortal Wkly Rep 2023; 72:985-991. [PMID: 37676836 PMCID: PMC10495184 DOI: 10.15585/mmwr.mm7236a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
Worldwide, measles remains a major cause of disease and death; the highest incidence is in the World Health Organization African Region (AFR). In 2011, the 46 AFR member states established a goal of regional measles elimination by 2020; this report describes progress during 2017-2021. Regional coverage with a first dose of measles-containing vaccine (MCV) decreased from 70% in 2017 to 68% in 2021, and the number of countries with ≥95% coverage decreased from six (13%) to two (4%). The number of countries providing a second MCV dose increased from 27 (57%) to 38 (81%), and second-dose coverage increased from 25% to 41%. Approximately 341 million persons were vaccinated in supplementary immunization activities, and an estimated 4.5 million deaths were averted by vaccination. However, the number of countries meeting measles surveillance performance indicators declined from 26 (62%) to nine (22%). Measles incidence increased from 69.2 per 1 million population in 2017 to 81.9 in 2021. The number of estimated annual measles cases and deaths increased 22% and 8%, respectively. By December 2021, no country in AFR had received verification of measles elimination. To achieve a renewed regional goal of measles elimination in at least 80% of countries by 2030, intensified efforts are needed to recover and surpass levels of surveillance performance and coverage with 2 MCV doses achieved before the COVID-19 pandemic.
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Naranjo D, Kimball E, Nelson J, Samore M, Alder SC, Stroupe K, Evans CT, Weaver FM, Ray C, Kale I, Galyean PO, Zickmund S. Differences in perceptions and acceptance of COVID-19 vaccination between vaccine hesitant and non-hesitant persons. PLoS One 2023; 18:e0290540. [PMID: 37682878 PMCID: PMC10490972 DOI: 10.1371/journal.pone.0290540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/10/2023] [Indexed: 09/10/2023] Open
Abstract
Acceptance of the COVID-19 vaccination becomes more critical as new variants continue to evolve and the United States (US) attempts to move from pandemic response to management and control. COVID-19 stands out in the unique way it has polarized patients and generated sustained vaccine hesitancy over time. We sought to understand differences in perceptions and acceptance of COVID-19 vaccination between vaccine hesitant and non-hesitant patients, with the goal of informing communication and implementation strategies to increase uptake of COVID-19 vaccines in Veteran and non-Veteran communities. This qualitative study used interview data from focus groups conducted by the Department of Veterans Affairs (VA) and the University of Utah; all focus groups were conducted using the same script March-July 2021. Groups included forty-six United States Veterans receiving care at 28 VA facilities across the country and 166 non-Veterans across Utah for a total of 36 one-hour focus groups. We identified perceptions and attitudes toward COVID-19 vaccination through qualitative analysis of focus group participant remarks, grouping connections with identified themes within domains developed based on the questions asked in the focus group guide. Responses suggest participant attitudes toward the COVID-19 vaccine were shaped primarily by vaccine attitude changes over time, impacted by perceived vaccine benefits, risks, differing sources of vaccine information and political ideology. Veterans appeared more polarized, being either largely non-hesitant, or hesitant, whereas non-Veterans had a wider range of hesitancy, with more participants identifying minor doubts and concerns about receiving the vaccine, or simply being altogether unsure about receiving it. Development of COVID-19 vaccine communication strategies in Veteran and non-Veteran communities should anticipate incongruous sources of information and explicitly target community differences in perceptions of risks and benefits associated with the vaccine to generate candid discussions and repair individuals' trust. We believe this could accelerate vaccine acceptance over time.
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Affiliation(s)
- Diana Naranjo
- Informatics, Decision-Enhancement and Analytic Sciences Center (IDEAS), VA Salt Lake City Health Care System, Salt Lake City, Utah, United States of America
- Department of Internal Medicine, Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Elisabeth Kimball
- Department of Internal Medicine, Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Jeanette Nelson
- Center for Business, Health, and Prosperity, David Eccles School of Business, University of Utah, Salt Lake City, Utah, United States of America
| | - Matthew Samore
- Informatics, Decision-Enhancement and Analytic Sciences Center (IDEAS), VA Salt Lake City Health Care System, Salt Lake City, Utah, United States of America
- Department of Internal Medicine, Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Stephen C. Alder
- Department of Internal Medicine, Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
- Center for Business, Health, and Prosperity, David Eccles School of Business, University of Utah, Salt Lake City, Utah, United States of America
| | - Kevin Stroupe
- Center of Innovation for Complex Chronic Healthcare (CINCCH) Edward Hines Health Care System, Hines, Illinois, United States of America
| | - Charlesnika T. Evans
- Center of Innovation for Complex Chronic Healthcare (CINCCH) Edward Hines Health Care System, Hines, Illinois, United States of America
- Department of Preventive Medicine (Epidemiology), Northwestern University, Chicago, Illinois, United States of America
| | - Frances M. Weaver
- Center of Innovation for Complex Chronic Healthcare (CINCCH) Edward Hines Health Care System, Hines, Illinois, United States of America
| | - Cara Ray
- Center of Innovation for Complex Chronic Healthcare (CINCCH) Edward Hines Health Care System, Hines, Illinois, United States of America
| | - Ibuola Kale
- Center of Innovation for Complex Chronic Healthcare (CINCCH) Edward Hines Health Care System, Hines, Illinois, United States of America
| | - Patrick O. Galyean
- Informatics, Decision-Enhancement and Analytic Sciences Center (IDEAS), VA Salt Lake City Health Care System, Salt Lake City, Utah, United States of America
- Department of Internal Medicine, Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Susan Zickmund
- Informatics, Decision-Enhancement and Analytic Sciences Center (IDEAS), VA Salt Lake City Health Care System, Salt Lake City, Utah, United States of America
- Department of Internal Medicine, Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
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Franconeri L, Antona D, Cauchemez S, Lévy-Bruhl D, Paireau J. Two-dose measles vaccine effectiveness remains high over time: A French observational study, 2017-2019. Vaccine 2023; 41:5797-5804. [PMID: 37586955 DOI: 10.1016/j.vaccine.2023.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND From 2008 to 2019, France has experienced a resurgence of measles epidemics. Surveillance data have shown that the proportion of cases vaccinated with two doses of measles-containing vaccine (MCV) increased with age, raising concerns about the duration of vaccine protection. Our objectives were to investigate age-stratified vaccine effectiveness (VE) for the second dose of MCV (MCV2) and to quantify protection levels over time. METHODS We analyzed data on measles cases aged 2-31 years, reported via mandatory notification to the French measles surveillance system from October 2017 to September 2019. We estimated an age-stratified VE for MCV2 using the screening method, which compares the vaccination status of cases with that of the general population. We improved this method by accounting for natural immunity, exploring four scenarios with four possible levels of natural immunity in the population. In addition, we quantified the decay rate of protection over time, by fitting an exponential decay model among individuals vaccinated in early life. RESULTS In the baseline analysis (absence of natural immunity), VE estimates were high in all age groups and decreased with age, from 99.6 % (95 % confidence interval: 99.3-99.8) in 2-5 years old to 91.4 % (85.1-95.0) in 26-31 years old. Accounting for natural immunity increased VE in the older age group to 93.2-99.2 % depending on the scenario. We estimated that VE was slowly decreasing over time, with an exponential decay rate of 0.0022/year (0.0017-0.0028), leading to VE of 96.7 % (96.0-97.4) 16 years after MCV2 vaccination. This decline was most compatible with scenario 2, a scenario of 4.4 % naturally immunized, non-vaccinated individuals in the 26-31 years old. CONCLUSION Our study confirms the continued high effectiveness of two doses of MCV with only slight degradation, decades after immunization. These findings support the importance of achieving a very high vaccination coverage with 2 doses of MCV.
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Affiliation(s)
- Léa Franconeri
- Direction des Maladies Infectieuses, Santé publique France, 94415 Saint Maurice, France.
| | - Denise Antona
- Direction des Maladies Infectieuses, Santé publique France, 94415 Saint Maurice, France
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, CNRS UMR 2000, 75015 Paris, France
| | - Daniel Lévy-Bruhl
- Direction des Maladies Infectieuses, Santé publique France, 94415 Saint Maurice, France
| | - Juliette Paireau
- Direction des Maladies Infectieuses, Santé publique France, 94415 Saint Maurice, France; Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, CNRS UMR 2000, 75015 Paris, France
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Chen J, Zhang W, Wang Y, Yang W. Determinants of measles persistence in Beijing, China: A modelling study. Epidemiol Infect 2023; 151:e144. [PMID: 37605994 PMCID: PMC10540187 DOI: 10.1017/s0950268823001322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 07/10/2023] [Accepted: 08/15/2023] [Indexed: 08/23/2023] Open
Abstract
In Beijing, the capital of China, routine measles mass vaccination has been in place for decades with high coverage; and since the 2000s, catch-up vaccination programmes have been implemented for migrant workers coming to the city. However, measles epidemics in Beijing persisted. Here, we explored the contributing factors of persistent measles transmission in Beijing using an epidemic model in conjunction with a particle filter. Model inputs included data on birth, death, migration, and vaccination. We formulated a series of hypotheses covering the impact of migrant influx, early waning of maternal immunity, and increased mixing among infants; we compared the plausibility of the hypotheses based on model fit to age-grouped, weekly measles incidence data from January 2005 to December 2014, and out-of-fit prediction during 2015-2019. Our best models showed close agreement with the data, and the out-of-fit prediction generally captured the trend of measles incidence from 2015 to 2019. We found that large influx of migrants with considerably higher susceptibility likely contributed to the persistent measles transmission in Beijing. Our findings suggest that stronger catch-up vaccination programmes for migrants may help eliminate measles transmission in Beijing.
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Affiliation(s)
- Jianjiu Chen
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Yong Wang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Wan Yang
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA
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Jia Y, Xu Q, Zhu Y, Li C, Qi C, She K, Liu T, Zhang Y, Li X. Estimation of the relationship between meteorological factors and measles using spatiotemporal Bayesian model in Shandong Province, China. BMC Public Health 2023; 23:1422. [PMID: 37491220 PMCID: PMC10369697 DOI: 10.1186/s12889-023-16350-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/19/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Measles-containing vaccine (MCV) has been effective in controlling the spread of measles. Some countries have declared measles elimination. But recently years, the number of cases worldwide has increased, posing a challenge to the global goal of measles eradication. This study estimated the relationship between meteorological factors and measles using spatiotemporal Bayesian model, aiming to provide scientific evidence for public health policy to eliminate measles. METHODS Descriptive statistical analysis was performed on monthly data of measles and meteorological variables in 136 counties of Shandong Province from 2009 to 2017. Spatiotemporal Bayesian model was used to estimate the effects of meteorological factors on measles, and to evaluate measles risk areas at county level. Case population was divided into multiple subgroups according to gender, age and occupation. The effects of meteorological factors on measles in subgroups were compared. RESULTS Specific meteorological conditions increased the risk of measles, including lower relative humidity, temperature, and atmospheric pressure; higher wind velocity, sunshine duration, and diurnal temperature variation. Taking lowest value (Q1) as reference, RR (95%CI) for higher temperatures (Q2-Q4) were 0.79 (0.69-0.91), 0.54 (0.44-0.65), and 0.48 (0.38-0.61), respectively; RR (95%CI) for higher relative humidity (Q2-Q4) were 0.76 (0.66-0.88), 0.56 (0.47-0.67), and 0.49 (0.38-0.63), respectively; RR (95%CI) for higher wind velocity (Q2-Q4) were 1.43 (1.25-1.64), 1.85 (1.57-2.18), 2.00 (1.59-2.52), respectively. 22 medium-to-high risk counties were identified, mainly in northwestern, southwestern and central Shandong Province. The trend was basically same in the effects of meteorological factors on measles in subgroups, but the magnitude of the effects was different. CONCLUSIONS Meteorological factors have an important impact on measles. It is crucial to integrate these factors into public health policies for measles prevention and control in China.
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Affiliation(s)
- Yan Jia
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Qing Xu
- Institute of Immunization and Preventive Management, Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Yuchen Zhu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Chunyu Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Chang Qi
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Kaili She
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Tingxuan Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Ying Zhang
- Faculty of Medicine and Health, School of Public Health, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Xiujun Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
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Levin A, Burgess C, Shendale S, Morgan W, Cw Hutubessy R, Jit M. Cost-effectiveness of measles and rubella elimination in low-income and middle-income countries. BMJ Glob Health 2023; 8:e011526. [PMID: 37429697 PMCID: PMC10335502 DOI: 10.1136/bmjgh-2022-011526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/10/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Since 2000, the incidence of measles and rubella has declined as measles-rubella (MR) vaccine coverage increased due to intensified routine immunisation (RI) and supplementary immunisation activities (SIAs). The World Health Assembly commissioned a feasibility assessment of eliminating measles and rubella. The objective of this paper is to present the findings of cost-effectiveness analysis (CEA) of ramping up MR vaccination with a goal of eliminating transmission in every country. METHODS We used projections of impact of routine and SIAs during 2018-2047 for four scenarios of ramping up MR vaccination. These were combined with economic parameters to estimate costs and disability-adjusted life years averted under each scenario. Data from the literature were used for estimating the cost of increasing routine coverage, timing of SIAs and introduction of rubella vaccine in countries. RESULTS The CEA showed that all three scenarios with ramping up coverage above the current trend were more cost-effective in most countries than the 2018 trend for both measles and rubella. When the measles and rubella scenarios were compared with each other, the most cost-effective scenario was likely to be the most accelerated one. Even though this scenario is costlier, it averts more cases and deaths and substantially reduces the cost of treatment. CONCLUSIONS The Intensified Investment scenario is likely the most cost-effective of the vaccination scenarios evaluated for reaching both measles and rubella disease elimination. Some data gaps on costs of increasing coverage were identified and future efforts should focus on filling these gaps.
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Affiliation(s)
- Ann Levin
- Levin & Morgan LLC, Bethesda, Maryland, USA
| | | | | | | | | | - Mark Jit
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Sakamoto K, Konami M, Kameda S, Satoh Y, Wakimoto H, Kitagawa Y, Gotoh B, Jiang DP, Hotta H, Itoh M. Suppression of viral RNA polymerase activity is necessary for persistent infection during the transformation of measles virus into SSPE virus. PLoS Pathog 2023; 19:e1011528. [PMID: 37494386 PMCID: PMC10406308 DOI: 10.1371/journal.ppat.1011528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 08/07/2023] [Accepted: 07/03/2023] [Indexed: 07/28/2023] Open
Abstract
Subacute sclerosing panencephalitis (SSPE) is a fatal neurodegenerative disease caused by measles virus (MV), which typically develops 7 to 10 years after acute measles. During the incubation period, MV establishes a persistent infection in the brain and accumulates mutations that generate neuropathogenic SSPE virus. The neuropathogenicity is closely associated with enhanced propagation mediated by cell-to-cell fusion in the brain, which is principally regulated by hyperfusogenic mutations of the viral F protein. The molecular mechanisms underlying establishment and maintenance of persistent infection are unclear because it is impractical to isolate viruses before the appearance of clinical signs. In this study, we found that the L and P proteins, components of viral RNA-dependent RNA polymerase (RdRp), of an SSPE virus Kobe-1 strain did not promote but rather attenuated viral neuropathogenicity. Viral RdRp activity corresponded to F protein expression; the suppression of RdRp activity in the Kobe-1 strain because of mutations in the L and P proteins led to restriction of the F protein level, thereby reducing cell-to-cell fusion mediated propagation in neuronal cells and decreasing neuropathogenicity. Therefore, the L and P proteins of Kobe-1 did not contribute to progression of SSPE. Three mutations in the L protein strongly suppressed RdRp activity. Recombinant MV harboring the three mutations limited viral spread in neuronal cells while preventing the release of infectious progeny particles; these changes could support persistent infection by enabling host immune escape and preventing host cell lysis. Therefore, the suppression of RdRp activity is necessary for the persistent infection of the parental MV on the way to transform into Kobe-1 SSPE virus. Because mutations in the genome of an SSPE virus reflect the process of SSPE development, mutation analysis will provide insight into the mechanisms underlying persistent infection.
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Affiliation(s)
- Kento Sakamoto
- Department of Microbiology, Faculty of Bio-Science, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan
| | - Miho Konami
- Department of Microbiology, Faculty of Bio-Science, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan
| | - Shinra Kameda
- Department of Microbiology, Faculty of Bio-Science, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan
| | - Yuto Satoh
- Department of Microbiology, Faculty of Bio-Science, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan
| | - Hiroshi Wakimoto
- Department of Microbiology, Faculty of Bio-Science, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan
| | - Yoshinori Kitagawa
- Division of Microbiology and Infectious Diseases, Department of Pathology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Bin Gotoh
- Division of Microbiology and Infectious Diseases, Department of Pathology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Da-Peng Jiang
- Graduate School of Medicine, Kobe University, Kobe, Hyogo, Japan
| | - Hak Hotta
- Graduate School of Medicine, Kobe University, Kobe, Hyogo, Japan
| | - Masae Itoh
- Department of Microbiology, Faculty of Bio-Science, Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan
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Haslund MM, Sørensen JK, Graff Stensballe L. Genetics and measles, mumps and rubella vaccine response in childhood and adolescence-A systematic review. Scand J Immunol 2023; 97:e13266. [PMID: 38157324 DOI: 10.1111/sji.13266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/20/2023] [Accepted: 03/14/2023] [Indexed: 04/03/2023]
Abstract
Measles, mumps and rubella (MMR) are contagious infectious diseases that can be prevented by immunization. However, MMR infections can occur in previously immunized individuals. The vaccine response is, among other factors, influenced by the combined effects of many genes. This systematic review investigates the genetic influence on measles, mumps and rubella antibody responses after childhood vaccination. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), systematic literature searches were conducted in the medical databases PubMed, EMBASE and PsycINFO. Search strings were adjusted for each database. Citations were included if they measured and compared the immune response with immunogenetics after vaccination with a vaccine containing one or more of the following components: measles, mumps and/or rubella, MMR. The measure of vaccine response studied was antibodies after vaccination. Forty-eight articles were included in the final analysis. The results suggest that genetic determinants, including host genes, and single nucleotide polymorphisms in immune-related genes influence the MMR antibody responses after vaccination. Specifically, replicated associations were found between HLA, CD46, RARB, IRF9, EIF2AK2, cytokine genes and MMR vaccine-induced humoral immune responses. This knowledge can be useful in understanding and predicting immune responses and may have implications for future vaccine strategies.
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Affiliation(s)
- Marie Mykløy Haslund
- The Child and Adolescent Clinic, The Juliane Marie Center, The Danish National University Hospital "Rigshospitalet", 9-Blegdamsvej, DK-2100, Copenhagen East, Denmark
| | - Jesper Kiehn Sørensen
- The Child and Adolescent Clinic, The Juliane Marie Center, The Danish National University Hospital "Rigshospitalet", 9-Blegdamsvej, DK-2100, Copenhagen East, Denmark
| | - Lone Graff Stensballe
- The Child and Adolescent Clinic, The Juliane Marie Center, The Danish National University Hospital "Rigshospitalet", 9-Blegdamsvej, DK-2100, Copenhagen East, Denmark
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Lutz CS, Hasan AZ, Bolotin S, Crowcroft NS, Cutts FT, Joh E, Loisate S, Moss WJ, Osman S, Hayford K. Comparison of measles IgG enzyme immunoassays (EIA) versus plaque reduction neutralization test (PRNT) for measuring measles serostatus: a systematic review of head-to-head analyses of measles IgG EIA and PRNT. BMC Infect Dis 2023; 23:367. [PMID: 37259032 PMCID: PMC10231861 DOI: 10.1186/s12879-023-08199-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 03/26/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND As countries move towards or achieve measles elimination status, serosurveillance is an important public health tool. However, a major challenge of serosurveillance is finding a feasible, accurate, cost-effective, and high throughput assay to measure measles antibody concentrations and estimate susceptibility in a population. We conducted a systematic review to assess, characterize, and - to the extent possible - quantify the performance of measles IgG enzyme-linked assays (EIAs) compared to the gold standard, plaque reduction neutralization tests (PRNT). METHODS We followed the PRISMA statement for a systematic literature search and methods for conducting and reporting systematic reviews and meta-analyses recommended by the Cochrane Screening and Diagnostic Tests Methods Group. We identified studies through PubMed and Embase electronic databases and included serologic studies detecting measles virus IgG antibodies among participants of any age from the same source population that reported an index (any EIA or multiple bead-based assays, MBA) and reference test (PRNT) using sera, whole blood, or plasma. Measures of diagnostic accuracy with 95% confidence intervals (CI) were abstracted for each study result, where reported. RESULTS We identified 550 unique publications and identified 36 eligible studies for analysis. We classified studies as high, medium, or low quality; results from high quality studies are reported. Because most high quality studies used the Siemens Enzygnost EIA kit, we generate individual and pooled diagnostic accuracy estimates for this assay separately. Median sensitivity of the Enzygnost EIA was 92.1% [IQR = 82.3, 95.7]; median specificity was 96.9 [93.0, 100.0]. Pooled sensitivity and specificity from studies using the Enzygnost kit were 91.6 (95%CI: 80.7,96.6) and 96.0 (95%CI: 90.9,98.3), respectively. The sensitivity of all other EIA kits across high quality studies ranged from 0% to 98.9% with median (IQR) = 90.6 [86.6, 95.2]; specificity ranged from 58.8% to 100.0% with median (IQR) = 100.0 [88.7, 100.0]. CONCLUSIONS Evidence on the diagnostic accuracy of currently available measles IgG EIAs is variable, insufficient, and may not be fit for purpose for serosurveillance goals. Additional studies evaluating the diagnostic accuracy of measles EIAs, including MBAs, should be conducted among diverse populations and settings (e.g., vaccination status, elimination/endemic status, age groups).
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Affiliation(s)
- Chelsea S Lutz
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alvira Z Hasan
- International Vaccine Access Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shelly Bolotin
- Centre for Vaccine Preventable Diseases, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Public Health Ontario, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Natasha S Crowcroft
- Centre for Vaccine Preventable Diseases, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Immunisation, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Felicity T Cutts
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - Eugene Joh
- Public Health Ontario, Toronto, ON, Canada
| | - Stacie Loisate
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - William J Moss
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
- International Vaccine Access Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Kyla Hayford
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
- Pfizer Vaccines, Inc., New York City, NY, USA.
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Peart Akindele NA, Katamoni LD, Brockhurst J, Ghimire S, Suwanmanee S, Pieterse L, Metcalf Pate KA, Bunyan E, Bannister R, Cihlar T, Porter DP, Griffin DE. Effect of remdesivir post-exposure prophylaxis and treatment on pathogenesis of measles in rhesus macaques. Sci Rep 2023; 13:6463. [PMID: 37081035 PMCID: PMC10116456 DOI: 10.1038/s41598-023-33572-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/14/2023] [Indexed: 04/22/2023] Open
Abstract
Measles is a systemic disease initiated in the respiratory tract with widespread measles virus (MeV) infection of lymphoid tissue. Mortality can be substantial, but no licensed antiviral therapy is available. We evaluated both post-exposure prophylaxis and treatment with remdesivir, a broad-spectrum antiviral, using a well-characterized rhesus macaque model of measles. Animals were treated with intravenous remdesivir for 12 days beginning either 3 days after intratracheal infection (post-exposure prophylaxis, PEP) or 11 days after infection at the onset of disease (late treatment, LT). As PEP, remdesivir lowered levels of viral RNA in peripheral blood mononuclear cells, but RNA rebounded at the end of the treatment period and infectious virus was continuously recoverable. MeV RNA was cleared more rapidly from lymphoid tissue, was variably detected in the respiratory tract, and not detected in urine. PEP did not improve clinical disease nor lymphopenia and reduced the antibody response to infection. In contrast, LT had little effect on levels of viral RNA or the antibody response but also did not decrease clinical disease. Therefore, remdesivir transiently suppressed expression of viral RNA and limited dissemination when provided as PEP, but virus was not cleared and resumed replication without improvement in the clinical disease parameters evaluated.
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Affiliation(s)
- Nadine A Peart Akindele
- Division of Pediatric Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, 21218, USA
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Rm E5636, Baltimore, MD, 21205, USA
- United States Food and Drug Administration, Silver Spring, MD, 20993, USA
| | - Laharika Dasharath Katamoni
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Rm E5636, Baltimore, MD, 21205, USA
- Zanvyl Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD, 21205, USA
- BioCheck, Inc., South San Francisco, CA, 94080, USA
| | - Jacqueline Brockhurst
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Rm E5636, Baltimore, MD, 21205, USA
- Department of Molecular and Comparative Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, 21218, USA
| | - Shristi Ghimire
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Rm E5636, Baltimore, MD, 21205, USA
| | - San Suwanmanee
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Rm E5636, Baltimore, MD, 21205, USA
- Department of Epidemiology, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Lisa Pieterse
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Rm E5636, Baltimore, MD, 21205, USA
| | - Kelly A Metcalf Pate
- Department of Molecular and Comparative Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, 21218, USA
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | | | | | - Tomas Cihlar
- Gilead Sciences Inc., Foster City, CA, 94404, USA
| | | | - Diane E Griffin
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Rm E5636, Baltimore, MD, 21205, USA.
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Sbarra AN, Mosser JF, Jit M, Ferrari M, Ramshaw RE, O'Connor P, Krause LK, Rogowski ELB, Portnoy A. Estimating national-level measles case-fatality ratios in low-income and middle-income countries: an updated systematic review and modelling study. Lancet Glob Health 2023; 11:e516-e524. [PMID: 36925172 PMCID: PMC10030458 DOI: 10.1016/s2214-109x(23)00043-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/05/2023] [Accepted: 01/12/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND To understand the current measles mortality burden, and to mitigate the future burden, it is crucial to have robust estimates of measles case fatalities. Estimates of measles case-fatality ratios (CFRs) that are specific to age, location, and time are essential to capture variations in underlying population-level factors, such as vaccination coverage and measles incidence, which contribute to increases or decreases in CFRs. In this study, we updated estimates of measles CFRs by expanding upon previous systematic reviews and implementing a meta-regression model. Our objective was to use all information available to estimate measles CFRs in low-income and middle-income countries (LMICs) by country, age, and year. METHODS For this systematic review and meta-regression modelling study, we searched PubMed on Dec 31, 2020 for all available primary data published from Jan 1, 1980 to Dec 31, 2020, on measles cases and fatalities occurring up to Dec 31, 2019 in LMICs. We included studies that previous systematic reviews had included or which contained primary data on measles cases and deaths from hospital-based, community-based, or surveillance-based reports, including outbreak investigations. We excluded studies that were not in humans, or reported only data that were only non-primary, or on restricted populations (eg, people living with HIV), or on long-term measles mortality (eg, death from subacute sclerosing panencephalitis), and studies that did not include country-level data or relevant information on measles cases and deaths, or were for a high-income country. We extracted summary data on measles cases and measles deaths from studies that fitted our inclusion and exclusion criteria. Using these data and a suite of covariates related to measles CFRs, we implemented a Bayesian meta-regression model to produce estimates of measles CFRs from 1990 to 2019 by location and age group. This study was not registered with PROSPERO or otherwise. FINDINGS We identified 2705 records, of which 208 sources contained information on both measles cases and measles deaths in LMICS and were included in the review. Between 1990 and 2019, CFRs substantially decreased in both community-based and hospital-based settings, with consistent patterns across age groups. For people aged 0-34 years, we estimated a mean CFR for 2019 of 1·32% (95% uncertainty interval [UI] 1·28-1·36) among community-based settings and 5·35% (5·08-5·64) among hospital-based settings. We estimated the 2019 CFR in community-based settings to be 3·03% (UI 2·89-3·16) for those younger than 1 year, 1·63% (1·58-1·68) for age 1-4 years, 0·84% (0·80-0·87) for age 5-9 years, and 0·67% (0·64-0·70) for age 10-14 years. INTERPRETATION Although CFRs have declined between 1990 and 2019, there are still large heterogeneities across locations and ages. One limitation of this systematic review is that we were unable to assess measles CFR among particular populations, such as refugees and internally displaced people. Our updated methodological framework and estimates could be used to evaluate the effect of measles control and vaccination programmes on reducing the preventable measles mortality burden. FUNDING Bill & Melinda Gates Foundation; Gavi, the Vaccine Alliance; and the US National Institutes of Health.
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Affiliation(s)
- Alyssa N Sbarra
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
| | - Jonathan F Mosser
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA
| | - Mark Jit
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Matthew Ferrari
- Department of Biology, The Pennsylvania State University, University Park, PA, USA
| | - Rebecca E Ramshaw
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Patrick O'Connor
- Department of Immunization, Vaccines, and Biologicals, WHO, Geneva, Switzerland
| | - L Kendall Krause
- Global Development Division, Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Emma L B Rogowski
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Allison Portnoy
- Center for Health Decision Science, Harvard T H Chan School of Public Health, Boston, MA, USA
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Sheriff AA, Zakariah A, Dapaa S, Odikro MA, Issahaku RG, Bandoh D, Noora CL, Gebru GN, Kenu E. Ghana’s progress towards measles elimination: Surveillance data analysis, Greater Accra Region, 2015 – 2019. Front Trop Dis 2023. [DOI: 10.3389/fitd.2023.1071486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
IntroductionAlthough measles is targeted for global elimination by 2020, an estimated 869,770 measles cases and 207,500 deaths occurred in 2019. Ghana adopted the World Health Organization measles elimination strategies, however, evidence of a systematic, comprehensive analysis of data tracking progress towards elimination is sparse. We analyzed measles data to describe its epidemiology, surveillance, and vaccination coverage performances in the Greater Accra Region.MethodsWe reviewed and conducted a descriptive analysis of measles surveillance, laboratory, and vaccination data for 2015 to 2019 obtained from the regional health directorate and National public health reference laboratory. Case patients’ demographic and clinical variables were analyzed into frequencies, proportions, and rates. We used WHO measles elimination performance targets; at least one suspected measles case reported per 100,000 population, 80% of suspected measles cases investigated with adequate blood samples, measles incidence <1/1,000,000 population, 95% routine vaccination coverage and during SIAs as benchmarks.ResultsOf 930 suspected measles cases reported, 605(65.1%) were tested. Males accounted for 356(58.8%); 141(23.3%), 342(56.5%), and 122(20.2%), were children <1, 1–4, and ≥5 years old respectively. Of those tested, 10(1.65%) were measles IgM confirmed, of which 7(70.0%) had received at least one dose of measles vaccine. Annualized measles reporting rate ranged from 1.8 to 6.4 per 100,000 population from 2015 to 2019. District specimen collection rate was 100%, and measles incidence was between 0 – 0.6 per million population in the period 2015–2019. Measles vaccination coverage increased from 73.5% in 2016 to 102% in 2019 with 75% of districts achieving 95% coverage in 2019.ConclusionThe measles case-based surveillance system and vaccination program in the Greater Accra region showed an increasing level of performance towards Ghana’s elimination status. However, performance in laboratory testing of blood specimens was suboptimal. Authorities of Ghana’s health system should strengthen laboratory capacity for prompt diagnosis of measles.
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Statler VA, Fox T, Ardura MI. Spotting a potential threat: Measles among pediatric solid organ transplantation recipients. Pediatr Transplant 2023; 27:e14502. [PMID: 36919399 DOI: 10.1111/petr.14502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 02/10/2023] [Accepted: 02/27/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Low-vaccination rates worldwide have led to the re-emergence of vaccine-preventable infections, including measles. Immunocompromised patients, including pediatric solid organ transplant (SOT) recipients, are at risk for measles because of suboptimal vaccination, reduced or waning vaccine immunity, lifelong immunosuppression, and global re-emergence of measles. OBJECTIVES To review published cases of measles in pediatric SOT recipients to heighten awareness of its clinical manifestations, summarize diagnostic and treatment strategies, and identify opportunities to optimize prevention. METHODS We conducted a literature review of published natural measles infections in SOT recipients ≤21 years of age, summarizing management and outcomes. We describe measles epidemiology, recommended diagnostics, treatment, and highlight prevention strategies. RESULTS There are seven published reports of measles infection in 12 pediatric SOT recipients, the majority of whom were unvaccinated or incompletely vaccinated. Subjects had atypical or severe clinical presentations, including lack of rash and complications, most frequently with encephalitis and pneumonitis, resulting in 33% mortality. Updated recommendations on testing and vaccination are provided. Treatment options beyond supportive care and vitamin A are limited, with no approved antivirals. CONCLUSION While measles is infrequently reported in pediatric SOT recipients, morbidity and mortality remain significant. A high index of suspicion is warranted in susceptible SOT recipients with clinically compatible illness or exposure. Providers must recognize this risk, educate families, and be aware of both classic and atypical presentations of measles to rapidly identify, isolate, and diagnose measles in pediatric SOT recipients. Continued efforts to optimize measles vaccination both pre- and post-SOT are warranted.
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Affiliation(s)
- Victoria A Statler
- Department of Pediatrics, Pediatric Infectious Diseases, Norton Children's and University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Thomas Fox
- Department of Pediatrics, Division of Infectious Disease, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Monica I Ardura
- Department of Pediatrics, Infectious Diseases & Host Defense, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA
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Sako S, Gilano G, Hailegebreal S. Determinants of childhood vaccination among children aged 12-23 months in Ethiopia: a community-based cross-sectional study. BMJ Open 2023; 13:e069278. [PMID: 36889833 PMCID: PMC10008449 DOI: 10.1136/bmjopen-2022-069278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Abstract
OBJECTIVE Childhood vaccination is a cost-effective, essential service to reach a larger population globally. Due to unclear reasons, new emergence and resurgence of vaccine-preventable diseases increase. Thus, the aim of this study is to identify prevalence and determinants of childhood vaccination in Ethiopia. DESIGN Community-based cross-sectional study. SETTING We used data from 2019 Ethiopia Mini Demographic and Health Survey. The survey included all the nine regional states and two city administrations of Ethiopia. PARTICIPANTS A weighted sample of 1008 children 12-23 months of age was included in the analysis. MAIN OUTCOME MEASURES A multilevel proportional odds model was fitted to identify determinants of childhood vaccination status. In the final model, variables with a p value of less than 5% and an adjusted OR (AOR) with a 95% CI were reported. RESULT The full childhood vaccination coverage of Ethiopia was 39.09% (95% CI: 36.06%-42.28%). Mothers who attended primary (AOR=2.16; 95% CI: 1.43-3.26), secondary (AOR=2.02; 95% CI: 1.07-3.79) and higher education (AOR=2.67; 95% CI: 1.25-5.71); being in union (AOR=2.21; 95% CI: 1.06-4.58); kept vaccination cards (AOR=26.18; 95% CI: 15.75-43.53); children receiving vitamin A1 (AOR=4.14; 95% CI: 2.9-5.9); living in Afar (AOR=0.14; 95% CI: 0.04-0.45), Somali (AOR=0.19; 95% CI: 0.06-0.60), Gambela (AOR=0.22; 95% CI: 0.06-0.77), Harari (AOR=0.14; 95% CI: 0.04-0.52) and Dire Dawa (AOR=0.23; 95% CI: 0.06-0.79) regions; and rural residents (AOR=0.53; 95% CI: 0.30-0.93) were factors significantly associated with childhood vaccination. CONCLUSION The full childhood vaccination coverage in Ethiopia was low and remained unchanged since 2016. The study identified that both the individual-level and community-level factors affected the vaccination status. Accordingly, public health interventions targeted to these identified factors can increase childhood full vaccination status.
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Affiliation(s)
- Sewunet Sako
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Girma Gilano
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Samuel Hailegebreal
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Jacenko S, Blough S, Grant G, Tohme R, McFarland J, Hatcher C, Goodson JL, Papania M, Pella DG, Li X, Yee SL. Lessons learnt from the applying the Centers for Disease Control and Prevention (CDC) evaluation framework to the measles incident management system response, USA, 2020-2021. BMJ Glob Health 2023; 8:bmjgh-2023-011861. [PMID: 36918218 PMCID: PMC10016298 DOI: 10.1136/bmjgh-2023-011861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 02/08/2023] [Indexed: 03/16/2023] Open
Abstract
The functionality and performance of public health programmes at all levels of government play a critical role in preventing, detecting, mitigating and responding to public health threats, including infectious disease outbreaks. Multiple and concurrent outbreaks in recent years, such as COVID-19, Ebola and Zika, have highlighted the importance of documenting lessons learnt from public health responses of national and global agencies. In February 2020, the US Centers for Disease Control and Prevention (CDC) Center for Global Health (CGH) activated the Measles Incident Management System (MIMS) to accelerate the ability to detect, mitigate and respond to measles outbreaks globally and advance progress towards regional measles elimination goals. The activation was triggered by a global resurgence in reported measles cases during 2018-2019 and supported emergency response activities conducted by partner organisations and countries. MIMS leadership decided early in the response to form an evaluation team to design and implement an evaluation approach for producing real-time data to document progress of response activities and inform timely decision-making. In this manuscript, we describe how establishing an evaluation unit within MIMS, and engaging MIMS leadership and subject matter experts in the evaluation activities, was critical to monitor progress and document lessons learnt to inform decision making. We also explain the CDC's Framework for Evaluation in Public Health Practice applied to evaluate the dynamic events throughout the MIMS response. Evaluators supporting emergency response should use a flexible framework that can be adaptable in dynamic contexts and document response activities in real-time.
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Affiliation(s)
- Sara Jacenko
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sara Blough
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Gavin Grant
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rania Tohme
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jeff McFarland
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Cynthia Hatcher
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - James L Goodson
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mark Papania
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Danielle Gilliard Pella
- Division of Global Migration and Quarantine, Office of Innovation, Development, Evaluation, and Analytics, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Xi Li
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sue Lin Yee
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Alimohamadi Y, Sepandi M. Forty-seven year trend of measles in Iran: An interrupted time series analysis. Health Sci Rep 2023; 6:e1139. [PMID: 36852390 PMCID: PMC9957696 DOI: 10.1002/hsr2.1139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 02/16/2023] [Indexed: 02/27/2023] Open
Abstract
Background and Aim Measles is an acute viral infectious disease usually characterized by erythematous maculopapular rash and sometimes pneumonia, diarrhea, and Central Nervous System disturbance. The current study aimed to describe the trend of measles in Iran before and after the 1978 revolution and COVID-19 pandemic. Methods In the current quasi-experimental study, we used annual data on confirmed cases of measles in Iran, from 1974 to 2021. Data were extracted from the World Health Organization website. An interrupted time series model was used to assess the effect of different events on the incidence of measles. Results The trend of new cases increase every year until 1980 according to the preintervention slope of 2040 (95% confidence interval [CI] = -1965-2045; p < 0.31). After Iran's revolution, the occurrence of new cases significantly decreased (-845 [95% CI = -1262 to -432; p = 0.001]). After the COVID-19 pandemic, the trend of new cases significantly increased (41 [95% CI = 12-70; p = 0.006]). Conclusion It seems that social or health-related events are among the effective factors on the incidence of measles. But with maintaining vaccination coverage in the community and vaccination of immigrants, this fluctuation in the disease trend can be decreased.
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Affiliation(s)
- Yousef Alimohamadi
- Health Research Center, Life Style InstituteBaqiyatallah University of Medical SciencesTehranIran
| | - Mojtaba Sepandi
- Health Research Center, Life Style InstituteBaqiyatallah University of Medical SciencesTehranIran
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Wang H, Zhu Z, Duan X, Song J, Mao N, Cui A, Wang C, Du H, Wang Y, Li F, Zhou S, Feng D, Li C, Gao H, He J, Li L, Lei Y, Zheng H, Gong T, Hu Y, Xu C, Zhao H, Sun Z, Chen Y, Tang X, Chen M, Deng L, Wang S, Tian X, Zhang T, Si Y, Yuan F, Fan L, Mahemutijiang K, Chen Z, Chen H, Xu W, Zhang Y. Transmission Pattern of Measles Virus Circulating in China During 1993-2021: Genotyping Evidence Supports That China Is Approaching Measles Elimination. Clin Infect Dis 2023; 76:e1140-e1149. [PMID: 36037029 DOI: 10.1093/cid/ciac674] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 08/04/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To provide useful insights into measles elimination progress in China, measles surveillance data were reviewed, and the transmission patterns of measles viruses circulating in China during 1993-2021 were analyzed. METHODS Measles incidence data from the National Notifiable Disease Reporting System of the China Center for Disease Control and Prevention were analyzed. A total of 17 570 strains were obtained from 30 of 31 provinces in mainland China during 1993-2021. The recommended genotyping window was amplified. Genotyping analysis was conducted for comparison with the reference strains. Phylogenetic analyses were performed to identify genetic relationships among different lineages within the genotypes. RESULTS With high coverage of routine immunization and intensive supplementary immunization activities, measles incidence has shown a downward trend since 1993, despite 2 resurgences, reaching a historic low level in 2020-2021 (average 0.5 per million). During 1993-2021, 9 genotypes including domestic genotype H1; imported genotypes B3, D4, D8, D9, D11, G3, and H2; and vaccine-associated genotype A were identified. Among them, the genotype H1 strain circulated endemically in China for more than 25 years; the last strain was detected in Yunnan Province in September 2019. Multiple imported genotypes have been identified since 2009 showing different transmission patterns. Since April 2020, no imported strains have been detected, while vaccine-associated genotype A continues to be detected. CONCLUSIONS The evidence of low incidence during 2020-2021 and virological surveillance data in this study confirm that China is currently approaching measles elimination.
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Affiliation(s)
- Huiling Wang
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhen Zhu
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaojian Duan
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jinhua Song
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Naiying Mao
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Aili Cui
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Changyin Wang
- Provincial Measles/Rubella Laboratory, Shandong Provincial Center for Disease Control and Prevention, Jinan, China
| | - Hui Du
- Provincial Measles/Rubella Laboratory, Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Yan Wang
- Provincial Measles/Rubella Laboratory, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, China
| | - Fangcai Li
- Provincial Measles/Rubella Laboratory, Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Shujie Zhou
- Provincial Measles/Rubella Laboratory, Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Daxing Feng
- Provincial Measles/Rubella Laboratory, Henan Provincial Center for Disease Control and Prevention, Zhengzhou, China
| | - Chongshan Li
- Provincial Measles/Rubella Laboratory, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Hui Gao
- Provincial Measles/Rubella Laboratory, Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, China
| | - Jilan He
- Provincial Measles/Rubella Laboratory, Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China
| | - Liqun Li
- Provincial Measles/Rubella Laboratory, Yunnan Provincial Center for Disease Control and Prevention, Kunming, China
| | - Yue Lei
- Provincial Measles/Rubella Laboratory, Tianjin Municipal Center for Disease Control and Prevention, Tianjin, China
| | - Huanying Zheng
- Provincial Measles/Rubella Laboratory, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Tian Gong
- Provincial Measles/Rubella Laboratory, Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, China
| | - Ying Hu
- Provincial Measles/Rubella Laboratory, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Changping Xu
- Provincial Measles/Rubella Laboratory, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Hua Zhao
- Provincial Measles/Rubella Laboratory, Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Zhaodan Sun
- Provincial Measles/Rubella Laboratory, Heilongjiang Provincial Center for Disease Control and Prevention, Ha'erbin, China
| | - Ying Chen
- Provincial Measles/Rubella Laboratory, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Xiaomin Tang
- Provincial Measles/Rubella Laboratory, Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China
| | - Meng Chen
- Provincial Measles/Rubella Laboratory, Beijing Municipal Center for Disease Control and Prevention, Beijing, China
| | - Lili Deng
- Provincial Measles/Rubella Laboratory, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Shuang Wang
- Provincial Measles/Rubella Laboratory, Jilin Provincial Center for Disease Control and Prevention, Changchun, China
| | - Xiaoling Tian
- Provincial Measles/Rubella Laboratory, Neimenggu Center for Disease Control and Prevention, Huhehaote, China
| | - Ting Zhang
- Provincial Measles/Rubella Laboratory, Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Yuan Si
- Provincial Measles/Rubella Laboratory, Shaanxi Provincial Center for Disease Control and Prevention, Xian, China
| | - Fang Yuan
- Provincial Measles/Rubella Laboratory, Ningxia Center for Disease Control and Prevention, Yinchuan, China
| | - Lixia Fan
- Provincial Measles/Rubella Laboratory, Qinghai Provincial Center for Disease Control and Prevention, Xining, China
| | - Kuerban Mahemutijiang
- Provincial Measles/Rubella Laboratory, Xinjiang Center for Disease Control and Prevention, Wulumuqi, China
| | - Zhifei Chen
- Provincial Measles/Rubella Laboratory, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Haiyun Chen
- Provincial Measles/Rubella Laboratory, Hainan Provincial Center for Disease Control and Prevention, Haikou, China
| | - Wenbo Xu
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yan Zhang
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Kalbermatter D, Jeckelmann JM, Wyss M, Shrestha N, Pliatsika D, Riedl R, Lemmin T, Plattet P, Fotiadis D. Structure and supramolecular organization of the canine distemper virus attachment glycoprotein. Proc Natl Acad Sci U S A 2023; 120:e2208866120. [PMID: 36716368 DOI: 10.1073/pnas.2208866120] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Canine distemper virus (CDV) is an enveloped RNA morbillivirus that triggers respiratory, enteric, and high incidence of severe neurological disorders. CDV induces devastating outbreaks in wild and endangered animals as well as in domestic dogs in countries associated with suboptimal vaccination programs. The receptor-binding tetrameric attachment (H)-protein is part of the morbilliviral cell entry machinery. Here, we present the cryo-electron microscopy (cryo-EM) structure and supramolecular organization of the tetrameric CDV H-protein ectodomain. The structure reveals that the morbilliviral H-protein is composed of three main domains: stalk, neck, and heads. The most unexpected feature was the inherent asymmetric architecture of the CDV H-tetramer being shaped by the neck, which folds into an almost 90° bent conformation with respect to the stalk. Consequently, two non-contacting receptor-binding H-head dimers, which are also tilted toward each other, are located on one side of an intertwined four helical bundle stalk domain. Positioning of the four protomer polypeptide chains within the neck domain is guided by a glycine residue (G158), which forms a hinge point exclusively in two protomer polypeptide chains. Molecular dynamics simulations validated the stability of the asymmetric structure under near physiological conditions and molecular docking showed that two receptor-binding sites are fully accessible. Thus, this spatial organization of the CDV H-tetramer would allow for concomitant protein interactions with the stalk and head domains without steric clashes. In summary, the structure of the CDV H-protein ectodomain provides new insights into the morbilliviral cell entry system and offers a blueprint for next-generation structure-based antiviral drug discovery.
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Chen CJ, Yang CH. Seroepidemiology of measles in immune generation in Taiwan: Prevalence of neutralizing antibody and immune response to reimmunization. J Microbiol Immunol Infect 2023:S1684-1182(23)00012-9. [PMID: 36707365 DOI: 10.1016/j.jmii.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 01/21/2023]
Abstract
BACKGROUND Secondary vaccine failure was the principal mechanic of measles reemergence in countries with high measles vaccine coverage. The information on neutralizing antibody (nAb) prevalence, epidemiological factors of waned immunity and immune response after reimmunization was essential to measles control but largely lacking in Taiwan. METHODS The nAb and factors of wanned immunity to measles were evaluated in a cohort of 333 subjects aged 11-30 years in 2010. The longitudinal immune response to reimmunization (n = 30) and potential virus exposure (n = 24) were assessed in young healthcare workers (HCWs) during a hospital outbreak. The nAb titer was used to define susceptibility to measles disease (<120 mIU/mL) and infection (120-900 mIU/mL). RESULTS In the 2010 cohort, the susceptibility to measles diseases and infections was respectively identified in 35 (10.5%) and 226 (67.9%) subjects. A generalized linear model identified earlier ages of first immunization in childhood (P = 0.0214) and subjects aged ≥18 years (versus <18 years, P = 0.0425) as significant factors associated with lower nAb titers. Reimmunization of 30 seronegative HCWs resulted in seroconversion for all, with nAb titers significantly rising on day 5, peaking on day 15 and declining in month 4 post-immunization. Similar measles-specific IgG levels were observed in 24 seropositive HCWs before and 4 months after measles contact (P = 0.2352). CONCLUSION A lack of protective immunity to measles diseases might be identified in 10% of the Taiwanese population aged 11-30 years and associated with a trend toward earlier ages of the first measles vaccination. The wanned immunity can be boosted promptly by reimmunization but with uncertain durability.
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Affiliation(s)
- Chih-Jung Chen
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, 333 Taoyuan, Taiwan; School of Medicine, College of Medicine, Chang Gung University, 333 Taoyuan, Taiwan; Molecular Infectious Diseases Research Center, Chang Gung Memorial Hospital, 333 Taoyuan, Taiwan.
| | - Chin-Hui Yang
- Taiwan Centers for Disease Control, Ministry of Health and Welfare, 100 Taipei, Taiwan
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Ferren M, Lalande A, Iampietro M, Canus L, Decimo D, Gerlier D, Porotto M, Mathieu C. Early Permissiveness of Central Nervous System Cells to Measles Virus Infection Is Determined by Hyperfusogenicity and Interferon Pressure. Viruses 2023; 15:229. [PMID: 36680268 PMCID: PMC9861295 DOI: 10.3390/v15010229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
The cessation of measles virus (MeV) vaccination in more than 40 countries as a consequence of the COVID-19 pandemic is expected to significantly increase deaths due to measles. MeV can infect the central nervous system (CNS) and lead to lethal encephalitis. Substantial part of virus sequences recovered from patients' brain were mutated in the matrix and/or the fusion protein (F). Mutations of the heptad repeat domain located in the C terminal (HRC) part of the F protein were often observed and were associated to hyperfusogenicity. These mutations promote brain invasion as a hallmark of neuroadaptation. Wild-type F allows entry into the brain, followed by limited spreading compared with the massive invasion observed for hyperfusogenic MeV. Taking advantage of our ex vivo models of hamster organotypic brain cultures, we investigated how the hyperfusogenic mutations in the F HRC domain modulate virus distribution in CNS cells. In this study, we also identified the dependence of neural cells susceptibility on both their activation state and destabilization of the virus F protein. Type I interferon (IFN-I) impaired mainly astrocytes and microglial cells permissiveness contrarily to neurons, opening a new way of consideration on the development of treatments against viral encephalitis.
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Affiliation(s)
- Marion Ferren
- CIRI, Centre International de Recherche en Infectiologie, Team Neuro-Invasion, TROpism and VIRal Encephalitis, Université de Lyon, Inserm, U1111, CNRS, UMR5308, Université Claude Bernard Lyon 1, Ecole Normale Supérieure de Lyon, 69007 Lyon, France
| | - Alexandre Lalande
- CIRI, Centre International de Recherche en Infectiologie, Team Neuro-Invasion, TROpism and VIRal Encephalitis, Université de Lyon, Inserm, U1111, CNRS, UMR5308, Université Claude Bernard Lyon 1, Ecole Normale Supérieure de Lyon, 69007 Lyon, France
| | - Mathieu Iampietro
- CIRI, Centre International de Recherche en Infectiologie, Team Immunobiology of the Viral infections, Université de Lyon, Inserm, U1111, CNRS, UMR5308, Université Claude Bernard Lyon 1, Ecole Normale Supérieure de Lyon, 69007 Lyon, France
| | - Lola Canus
- CIRI, Centre International de Recherche en Infectiologie, Team Neuro-Invasion, TROpism and VIRal Encephalitis, Université de Lyon, Inserm, U1111, CNRS, UMR5308, Université Claude Bernard Lyon 1, Ecole Normale Supérieure de Lyon, 69007 Lyon, France
| | - Didier Decimo
- CIRI, Centre International de Recherche en Infectiologie, Team Neuro-Invasion, TROpism and VIRal Encephalitis, Université de Lyon, Inserm, U1111, CNRS, UMR5308, Université Claude Bernard Lyon 1, Ecole Normale Supérieure de Lyon, 69007 Lyon, France
| | - Denis Gerlier
- CIRI, Centre International de Recherche en Infectiologie, Team Neuro-Invasion, TROpism and VIRal Encephalitis, Université de Lyon, Inserm, U1111, CNRS, UMR5308, Université Claude Bernard Lyon 1, Ecole Normale Supérieure de Lyon, 69007 Lyon, France
| | - Matteo Porotto
- Center for Host-Pathogen Interaction, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli,” 81100 Caserta, Italy
| | - Cyrille Mathieu
- CIRI, Centre International de Recherche en Infectiologie, Team Neuro-Invasion, TROpism and VIRal Encephalitis, Université de Lyon, Inserm, U1111, CNRS, UMR5308, Université Claude Bernard Lyon 1, Ecole Normale Supérieure de Lyon, 69007 Lyon, France
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Santacruz-Sanmartin E, Hincapié-Palacio D, Ochoa-Acosta JE, Buitrago-Giraldo S, Ospina MC. Measles Serostatus in Mothers and Their Newborns in Antioquia, Colombia: Implications for Measles Elimination. Am J Trop Med Hyg 2023; 108:93-100. [PMID: 36509051 PMCID: PMC9833067 DOI: 10.4269/ajtmh.22-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 10/01/2022] [Indexed: 12/15/2022] Open
Abstract
To describe the serostatus of measles IgG antibodies in pregnant women and newborns, placental transfer, and factors that determine being below the threshold of 150 mIU/mL, a cross-sectional study was conducted. Blood samples of 790 pregnant women at the time of delivery and 734 umbilical cord samples were analyzed from eight hospitals in the Aburrá Valley of Antioquia, Colombia. Measles IgG antibody measurement was performed with ELISA. The proportion of individuals with antibodies < 150 mIU/mL was 13.9% (95% CI: 12.2-15.8) in pregnant women and 11.1% (95% CI: 9.2-13.4) in newborns. The geometric mean of the antibody level of the pregnant women was 552 mIU/mL (95% CI: 504-605) and in the umbilical cord 662 mIU/mL (95% CI: 604-727). A positive correlation between pregnant woman and umbilical cord antibodies was found. The median ratio of measles IgG antibodies in umbilical cord/pregnant woman was 1.22 for all participants. A seroprevalence below the threshold of 150 mIU/mL was found in newborns whose mothers were born between 1983 and 1994, compared with those born before that period, when exposure to the wildtype virus was common (adjusted prevalence ratio: 3.6, 95% CI: 1.3-9.6). These findings suggest that there are gaps in measles immunity among women of childbearing age, before pregnancy. To close this immune gap and support efforts to maintain measles control, serological screening for measles antibodies should be routinely included in reproductive health and antenatal care programs to identify women without immunity who should be vaccinated before pregnancy or after delivery.
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Affiliation(s)
| | | | - Jesús E. Ochoa-Acosta
- “Héctor Abad Gómez” National Faculty of Public Health, Universidad of Antioquia, Medellin, Colombia
| | - Seti Buitrago-Giraldo
- Departmental Laboratory of Public Health, The Sectional Secretariat of Health and Social Protection of Antioquia, Medellin, Colombia
| | - Marta C. Ospina
- Departmental Laboratory of Public Health, The Sectional Secretariat of Health and Social Protection of Antioquia, Medellin, Colombia
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Opel DJ, Brewer NT, Buttenheim AM, Callaghan T, Carpiano RM, Clinton C, Elharake JA, Flowers LC, Galvani AP, Hotez PJ, Schwartz JL, Benjamin RM, Caplan A, DiResta R, Lakshmanan R, Maldonado YA, Mello MM, Parmet WE, Salmon DA, Sharfstein JM, Omer SB. The legacy of the COVID-19 pandemic for childhood vaccination in the USA. Lancet 2023; 401:75-78. [PMID: 36309017 PMCID: PMC9605265 DOI: 10.1016/s0140-6736(22)01693-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/12/2022] [Accepted: 08/25/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Douglas J Opel
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA; Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, WA, USA.
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Alison M Buttenheim
- Department of Family and Community Health, University of Pennsylvania School of Nursing and Center for Health Incentives, University of Pennsylvania, Philadelphia, PA, USA; Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA
| | - Timothy Callaghan
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, USA
| | | | - Chelsea Clinton
- Clinton Foundation, New York, NY, USA; Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jad A Elharake
- Yale Institute for Global Health, New Haven, CT, USA; Department of Internal Medicine (Infectious Diseases), Yale School of Medicine, New Haven, CT, USA
| | - Lisa C Flowers
- Department of Obstetrics & Gynecology, Emory University, Atlanta, GA, USA
| | - Alison P Galvani
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT, USA
| | - Peter J Hotez
- Texas Children's Center for Vaccine Development, Baylor College of Medicine, Houston, TX, USA; Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA; Department of Molecular Virology & Microbiology, Baylor College of Medicine, Houston, TX, USA; National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA; Department of Biology, Baylor University, Waco, TX, USA; Hagler Institute for Advanced Study, Texas A&M University, College Station, TX, USA; Scowcroft Institute of International Affairs, Bush School of Government and Public Service, Texas A&M University, College Station, TX, USA; James A Baker III Institute for Public Policy, Rice University, Houston, TX, USA
| | - Jason L Schwartz
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
| | | | - Arthur Caplan
- New York University Langone School of Medicine, New York University, New York, NY, USA
| | - Renee DiResta
- Stanford Internet Observatory, Stanford University, Stanford, CA, USA
| | | | | | - Michelle M Mello
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA; Stanford Law School, Stanford, CA, USA; Department of Health Policy, Stanford University School of Medicine, Stanford, CA, USA
| | - Wendy E Parmet
- Center for Health Policy & Law, Northeastern University, Boston, MA, USA
| | - Daniel A Salmon
- Institute for Vaccine Safety, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joshua M Sharfstein
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Saad B Omer
- Yale Institute for Global Health, New Haven, CT, USA; Department of Internal Medicine (Infectious Diseases), Yale School of Medicine, New Haven, CT, USA; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA; Yale School of Nursing, Orange, CT, USA
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50
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Bukuno S, Asholie A, Girma Z, Haji Y. Measles Outbreak Investigation in Garda Marta District, Southwestern Ethiopia, 2022: Community-Based Case-Control Study. Infect Drug Resist 2023; 16:2681-2694. [PMID: 37168516 PMCID: PMC10166209 DOI: 10.2147/idr.s405802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/22/2023] [Indexed: 05/13/2023] Open
Abstract
Background A measles outbreak can occur in the presence of an increased number of unvaccinated children; however, the vaccine was available many decades ago, and it is the foremost cause of child mortality, claiming 568 lives (mostly children) worldwide each day. The investigation was aimed at assessing the magnitude and identifying contributing factors for the measles outbreak in the Garda Marta District of Gamo Zone, Southwestern Ethiopia. Methods From January 20 to February 10, 2022, a descriptive and unmatched case-control study was used to describe the measles outbreak and identify the associated risk factors for measles infection. The descriptive analysis employed all 140 cases from the line list, while the case-control study used 51 cases and 102 controls to investigate factors associated with measles infection. Epi-data version 4.6.0.6 was used to code and enter data, which was then exported to SPSS version 27 for analysis. A standardized questionnaire was used to collect data. To declare statistical significance for the association, multivariable logistic regression with an adjusted odds ratio (AOR) and 95% CI was used. Results From a total of 140 measles cases reported from October 12, 2021, to March 09, 2022, 75 (54%) were females. Marta Laddo kebele was most affected (104 cases). Being unvaccinated (AOR: 2.84, 95% CI: 1.10-7.32), having a travel history (AOR: 4.24, 95% CI: 1.61-11.15), having a contact history (AOR: 6.34, 95% CI: 2.35-17.40), being unaware of the mode of transmission (AOR: 2.68, 95% CI: 1.16-6.37), and having moderate acute malnutrition (AOR: 4.44, 95% CI: 1.74-11.31) were factors significantly associated with the measles outbreak. Conclusion Being unvaccinated, travel history to measles outbreak area, contact history, knowledge of caretakers/mothers on the mode of transmission, and acute malnutrition were associated with the measles outbreak in the district. Therefore, strengthening routine measles immunization, mounting vaccination awareness and nutritional screening are recommended.
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Affiliation(s)
- Silas Bukuno
- Resident at Ethiopian Field Epidemiology and Laboratory Training Program, School of Public Health, Hawassa University, Hawassa, Ethiopia
- Correspondence: Silas Bukuno, Tel +251932-21-4757, Email
| | - Agunie Asholie
- College of Medicine and Health Science, School of Public Health, Hawassa University, Hawassa, Ethiopia
| | - Zeleke Girma
- Department of Public Health, School of Public Health, Arba Minch University, Arba Minch, Ethiopia
| | - Yusuf Haji
- College of Medicine and Health Science, School of Public Health, Hawassa University, Hawassa, Ethiopia
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