Characterizing measles transmission in India: a dynamic modeling study using verbal autopsy data

BMC Medicine

Research Article

Cindy L. Gauvreau¹  Wilson Suraweera²  Prabhat Jha²  Stéphane Verguet³  Edward O. Jones⁴  Mark Jit⁵  Shaun K. Morris⁶  Mira Johri⁷ 

[1] Canadian Partnership Against Cancer, Toronto, Ontario, Canada;Center for Global Health Research, Saint Michael’s Hospital and University of Toronto, Toronto, Ontario, Canada;Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, USA;Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK;Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK;Modelling and Economics Unit, Public Health England, London, UK;Division of Infectious Diseases, Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada;University of Montreal Hospital Research Centre (CRCHUM), Montréal, Québec, Canada;Department of Health Management, Evaluation and Policy, School of Public Health, University of Montreal, Montréal, Québec, Canada;

关键词: Measles;    Vaccine-preventable diseases;    Child health;    Immunization;    Case fatality risk;    Supplementary immunization activities;    Mathematical modeling;    India;   

DOI  :  10.1186/s12916-017-0908-3

 received in 2016-12-16, accepted in 2017-07-03,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundDecreasing trends in measles mortality have been reported in recent years. However, such estimates of measles mortality have depended heavily on assumed regional measles case fatality risks (CFRs) and made little use of mortality data from low- and middle-income countries in general and India, the country with the highest measles burden globally, in particular.MethodsWe constructed a dynamic model of measles transmission in India with parameters that were empirically inferred using spectral analysis from a time series of measles mortality extracted from the Million Death Study, an ongoing longitudinal study recording deaths across 2.4 million Indian households and attributing causes of death using verbal autopsy. The model was then used to estimate the measles CFR, the number of measles deaths, and the impact of vaccination in 2000–2015 among under-five children in India and in the states of Bihar and Uttar Pradesh (UP), two states with large populations and the highest numbers of measles deaths in India.ResultsWe obtained the following estimated CFRs among under-five children for the year 2005: 0.63% (95% confidence interval (CI): 0.40–1.00%) for India as a whole, 0.62% (0.38–1.00%) for Bihar, and 1.19% (0.80–1.75%) for UP. During 2000–2015, we estimated that 607,000 (95% CI: 383,000–958,000) under-five deaths attributed to measles occurred in India as a whole. If no routine vaccination or supplemental immunization activities had occurred from 2000 to 2015, an additional 1.6 (1.0–2.6) million deaths for under-five children would have occurred across India.ConclusionsWe developed a data- and model-driven estimation of the historical measles dynamics, CFR, and vaccination impact in India, extracting the periodicity of epidemics using spectral and coherence analysis, which allowed us to infer key parameters driving measles transmission dynamics and mortality.

【 授权许可】

CC BY   
© The Author(s). 2017