1
|
Hassani Azad M, Dehghani Sargazi L, Salari M, Jahangiri S, Hashemi SM, Asadi SS, Ghaedi Hengami G, Ghazalgoo A, Keivanlou MH, Amini-Salehi E, Asadi Yousefabad SH. Epidemiology of measles in southern Iran: trends, challenges, and vaccination insights. Ann Med Surg (Lond) 2024; 86:3273-3280. [PMID: 38846899 PMCID: PMC11152772 DOI: 10.1097/ms9.0000000000002004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/18/2024] [Indexed: 06/09/2024] Open
Abstract
Background Measles, a highly contagious and vaccine-preventable disease, continues to present global public health challenges. This retrospective study focused on measles outbreaks in Hormozgan province, southern Iran, spanning from 2014 to 2019. Methods Between 2014 and 2019, patients suspected of having measles, as reported by medical centers in Hormozgan, were subject to a comprehensive evaluation. The diagnosis of measles was conclusively established through the use of real-time polymerase chain reaction (RT-PCR) testing. A detailed collection of pertinent data was undertaken. SPSS software, version 21, was employed for statistical analysis. Results In the current study, out of 1291 clinically suspected measles cases, 151 were PCR-confirmed, with an average age of 16.77 years (±10.46), comprising 50.9% males and 49.1% females. The annual distribution showed varied incidence: 8.4% in 2014, peaking at 18.8% in 2015, then fluctuating to 11.4% in 2016, 0.8% in 2017, and 17.9% in 2018, with no cases in 2019. Among confirmed cases, 16.5% were vaccinated, while 68.2% were not, and 15.23% had unknown vaccination status. Conclusion This retrospective study highlights the ongoing challenge of measles in Hormozgan province, Iran, from 2014 to 2019. Despite measles being preventable by vaccination, a significant number of cases were confirmed among both vaccinated and unvaccinated individuals, indicating gaps in immunization coverage and effectiveness. The fluctuating annual incidence, with a peak in 2015 and no cases in 2019, suggests variable success in disease control efforts. This underscores the need for enhanced surveillance, improved vaccination strategies, and public health interventions to effectively combat measles outbreaks in this region.
Collapse
Affiliation(s)
- Mehdi Hassani Azad
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute
| | | | | | - Samaneh Jahangiri
- Internal Medicine Resident, Research Development Unit, School of Medicine, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman
| | | | | | | | | | - Mohammad-Hossein Keivanlou
- Gastrointestinal and Liver Diseases Research Center
- Student Research Committee, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Ehsan Amini-Salehi
- Gastrointestinal and Liver Diseases Research Center
- Student Research Committee, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | | |
Collapse
|
2
|
Shen M, Sun X, Xiao Y, Liu Y, Wang C, Wang Z, Rong L, Peng Z. The impact of supplementary immunization activities on measles transmission dynamics and implications for measles elimination goals: a mathematical modelling study. J Theor Biol 2022; 551-552:111242. [PMID: 35952756 DOI: 10.1016/j.jtbi.2022.111242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 08/04/2022] [Accepted: 08/04/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Measles has re-emerged globally due to the accumulation of susceptible individuals and immunity gap, which causes challenges in eliminating measles. Routine vaccination and supplementary immunization activities (SIAs) have greatly improved measles control, but the impact of SIAs on the measles transmission dynamics remains unclear as the vaccine-induced immunity wanes. METHODS We developed a comprehensive measles transmission dynamics model by taking into account population demographics, age-specific contact patterns, seasonality, routine vaccination, SIAs, and the waning vaccine-induced immunity. The model was calibrated by the monthly age-specific cases data from 2005 to 2018 in Jiangsu Province, China, and validated by the dynamic sero-prevalence data. We aimed to investigate the short-term and long-term impact of three-time SIAs during 2009-2012 (9.68 million and 4.25 million children aged 8 months-14 years in March 2009 and September 2010, respectively, and 140,000 children aged 8 months-6 years in March 2012) on the measles disease burden and explored whether additional SIAs could accelerate the measles elimination. RESULTS We estimated that the cumulative numbers of measles cases from March 2009 to December 2012 (in the short run) and to December 2018 (in the long run) after three-time SIAs (base case) were 6,699 (95% confidence interval [CI]: 2,928-10,469), and 22,411 (15,146-29,675), which averted 45.0% (42.9%-47.0%) and 34.3% (30.7%-37.9%) of 12,226 (4,916-19,537) and 34,274 (21,350-47,199) cases without SIAs, respectively. The fraction of susceptibles for children aged 8-23 months and 2-14 years decreased from 8.3% and 10.8% in March 2009 to 5.8% and 5.8% in April 2012, respectively. However, the fraction of susceptibles aged 15-49 years and above 50 years increased gradually to about 15% in 2018 irrespective of SIAs due to the waning immunity. The measles elimination goal would be reached in 2028, and administrating additional one-off SIAs in September 2022 to children aged 8-23 months, or young adolescents aged 15-19 years could accelerate the elimination one year earlier. CONCLUSIONS SIAs have greatly reduced the measles incidence and the fraction of susceptibles, but the benefit may wane over time. Under the current interventions, Jiangsu province would reach the measles elimination goal in 2028. Additional SIAs may accelerate the measles elimination one year earlier.
Collapse
Affiliation(s)
- Mingwang Shen
- China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, PR China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, PR China
| | - Xiang Sun
- Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, Jiangsu, 210009, PR China
| | - Yanni Xiao
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yuanbao Liu
- Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, Jiangsu, 210009, PR China
| | - Congyue Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Zhiguo Wang
- Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, Jiangsu, 210009, PR China
| | - Libin Rong
- Department of Mathematics, University of Florida, Gainesville, FL, USA
| | - Zhihang Peng
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, PR China.
| |
Collapse
|
3
|
Karami M, Khazaei S, Zahraei SM, Mokhtari Azad T, Zahiri A, Moradi AR, Bathaei J, Javaheri M, Amiri J. Measles Outbreak in a Rural Population in Bahar District, Hamadan Province, West of Iran in 2018. J Res Health Sci 2020; 20:e00470. [PMID: 32814694 PMCID: PMC7585754 DOI: 10.34172/jrhs.2020.05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 02/19/2020] [Indexed: 12/02/2022] Open
Abstract
Background: Measles is in elimination phase in Iran. Following occurrence of two cases of measles in two children under six years old with the history of measles immunization in one of the villages affiliated to Bahar District, west of Hamadan Province, northwest of Iran, this study was conducted to determine the immunity status of people living in the village affected by the measles outbreak in spring of 2018.
Study design: A cross-sectional (descriptive-analytical) study.
Methods: Overall, 272 populations of 0-40 yr old in the village affected by outbreak were enrolled. Multistage sampling was used for choosing participants. The data collection tool was a researcher-made checklist used to collect epidemiological data including demographic characteristics and vaccination status. Blood samples were taken from them and sent to the measles reference laboratory for IgG testing. The amount of optical density (OD) greater than 0.2 was considered as positive and less than 0.1 negative, respectively.
Results: The mean age of the study population was 17.4 ±11.8 yr and the sex ratio was almost the same. Levels of antibodies against measles were positive in 63.24%, intermediate in 12.5% and negative in 24.26%. There was no significant difference between the immunity status of the subjects with gender (P=0.236) and age group (P=0.113). Pearson correlation results showed that in males there was a significant positive correlation between the age of the participants and the serum IgG level (r = 0.26, P=0.003).
Conclusion: Measles immunity in communities is not sufficient to prevent outbreaks and small epidemics, and it is recommended that periodically, serological assessments carried out at community level and especially at high-risk groups.
Collapse
Affiliation(s)
- Manoochehr Karami
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Salman Khazaei
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyed Mohsen Zahraei
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Talat Mokhtari Azad
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Ali Zahiri
- Deputy of Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Reza Moradi
- Deputy of Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Jalal Bathaei
- Deputy of Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Masoumeh Javaheri
- Deputy of Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Jalaleddin Amiri
- Department of Pediatrics, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
| |
Collapse
|
4
|
Zhou R, Yuan S, Yu W, Li L, Li Q, Guo L, Zhao Z, Song Z. Measles immunity in the China-Myanmar border region, Lincang city, Yunnan province, 2017. Hum Vaccin Immunother 2019; 16:881-885. [PMID: 31662039 DOI: 10.1080/21645515.2019.1673641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Background: A recent measles importation-related outbreak in the China-Myanmar border region required outbreak response immunization to stop the outbreak, raising the question of measles immunity in the area. We conducted two measles serological surveys to develop a seroepidemiological profile of native Chinese citizens and registered Myanmar immigrants to identify strategies to promote measles elimination in the border region.Methods: We conducted a clinic-based measles serosurvey of Myanmar registered immigrants (n = 300) and a population-based serosurvey of Chinese Lincang residents (n = 355). Serum samples were tested with enzyme-linked immunosorbent assays to assess immunity to measles.Results: We found that Myanmar immigrants had a seropositivity rate of 85.3% (95% CI: 81.3-89.4) with a GMT of 924.9 mIU/ml, and Lincang Chinese nationals had a seropositivity rate of 94.6% (95% CI:92.3-97.0) with a GMT of 1363.3 mIU/ml. Myanmar children 2-6 years of age and 7-14 years of age were more likely to be susceptible to measles than same-aged Chinese children: odds ratios 23.00 (95% CI: 5.10-103.69, P < .001) and 7.95 (95% CI: 1.66-38.01,P = .009), respectively.Conclusions: We recommend conducting a catch-up vaccination program for Myanmar children ≤15 years old.
Collapse
Affiliation(s)
- Rongrong Zhou
- Expanded Program on Immunization Department, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Shuyi Yuan
- Expanded Program on Immunization Department, Lincang Center for Disease Control and Prevention, Lincang City, Yunnan, China
| | - Wen Yu
- Expanded Program on Immunization Department, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Liqun Li
- Expanded Program on Immunization Department, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Qiongfen Li
- Expanded Program on Immunization Department, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Licun Guo
- Expanded Program on Immunization Department, Lincang Center for Disease Control and Prevention, Lincang City, Yunnan, China
| | - Zhixian Zhao
- Expanded Program on Immunization Department, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Zhizhong Song
- Expanded Program on Immunization Department, Yunnan Center for Disease Control and Prevention, Kunming, China
| |
Collapse
|
5
|
Zhang R, Jiang H, Li F, Su N, Ding Y, Mao X, Ren D, Wang J. Key genes and pathways in measles and their interaction with environmental chemicals. Exp Ther Med 2018; 15:4890-4900. [PMID: 29805511 DOI: 10.3892/etm.2018.6050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 02/02/2018] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to explore key genes that may have a role in the pathology of measles virus infection and to clarify the interaction networks between environmental factors and differentially expressed genes (DEGs). After screening the database of the Gene Expression Omnibus of the National Center for Biotechnology Information, the dataset GSE5808 was downloaded and analyzed. A global normalization method was performed to minimize data inconsistencies and heterogeneity. DEGs during different stages of measles virus infection were explored using R software (v3.4.0). Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis of the DEGs were performed using Cytoscape 3.4.0 software. A protein-protein interaction (PPI) network of the DEGs was obtained from the STRING database v9.05. A total of 43 DEGs were obtained from four analyzed sample groups, including 10 highly expressed genes and 33 genes with decreased expression. The most enriched pathways based on KEGG analysis were fatty acid elongation, cytokine-cytokine receptor interaction and RNA degradation. The genes mentioned in the PPI network were mainly associated with protein binding and chemokine activity. A total of 219 chemicals were identified that may, jointly or on their own, interact with the 6 DEGs between the control group and patients with measles (at hospital entry), including benzo(a)pyrene (BaP) and tetrachlorodibenzodioxin (TCDD). In conclusion, the present study revealed that chemokines and environmental chemicals, e.g. BaP and TCDD, may affect the development of measles.
Collapse
Affiliation(s)
- Rongqiang Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Shaanxi University of Chinese Medicine, Xi'an, Shaanxi 712046, P.R. China
| | - Hualin Jiang
- Department of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.,Department of Medical Education, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Fengying Li
- Immunization Department of Center for Disease Control and Prevention of Xianyang, Xianyang, Shaanxi 712046, P.R. China
| | - Ning Su
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Yi Ding
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Xiang Mao
- GoDaddy Inc, Sunnyvale, CA 95131, USA
| | - Dan Ren
- Department of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Jing Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Shaanxi University of Chinese Medicine, Xi'an, Shaanxi 712046, P.R. China
| |
Collapse
|
6
|
Pei L, Yang Y, Zhao X, Zhang S, Yuan L, Liu Y, Yu Y. Identify the susceptibility profile to measles in the general population: Serological survey of measles antibodies in Shaanxi province, China, in 2016. Vaccine 2017; 35:7250-7255. [PMID: 29153585 DOI: 10.1016/j.vaccine.2017.11.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 09/17/2017] [Accepted: 11/07/2017] [Indexed: 12/12/2022]
Abstract
The reported coverage with two doses of the measles vaccine (MCV) in Shaanxi Province, China, is greater than 95%, but the measles incidence over the whole province remains high. Cross-sectional serological surveys of measles antibodies in Shaanxi Province were conducted in 2016 to assess the population's immunity. The measles IgG levels were measured in serum samples using ELISA. The geometric means concentration (GMC) levels and seroprevalence rates with 95% CIs were calculated by region, gender, and age. A total of 3574 serum samples were collected from participants aged from 2 months to 49 years. The GMC of measles antibodies was 471.3 mIU/ml (95% CI: 445.9-498.2 mIU/ml), and the seroprevalence was only 85.9% (95% CI: 84.8-87.1%). A significant difference in the GMC (P < .05) but not the seroprevalence (P > .05) was observed among the 3 regions. The report measles incidences were high in individuals aged 0-7 months (33.2/100 000) and 8-17 months (26.8/100 000). Although both measles immunity (90.7%) and MCV coverage (89.7%) were low in children aged 8-17 months, the measles seroprevalence in adults was high at greater than 90%. These results revealed that further actions may be taken to increase vaccination coverage in children aged 8 months to 5 years over the whole province and teenagers in the south region. In particular, timely administration of the first MCV dose should be emphasized to prevent measles epidemics in children aged 8-17 months. Vaccination strategies may be varied by age and region.
Collapse
Affiliation(s)
- Lin Pei
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China; Northwest Women's and Children's Hospital, Xi'an, Shaanxi 710003, China
| | - Yuxuan Yang
- Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Xiaodan Zhao
- Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Shaobai Zhang
- Shaanxi Province Center for Disease Control and Prevention, Xi'an, Shaanxi 710054, China
| | - Lingyun Yuan
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China; Ankang Center for Disease Control and Prevention, An Kang, Shaanxi 725000, China
| | - Yamei Liu
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China; Yulin Center for Disease Control and Prevention, Yu Lin, Shaanxi 719000, China
| | - Yan Yu
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China.
| |
Collapse
|
7
|
Wang X, Ma M, Hui Z, Terry PD, Zhang Y, Su R, Wang M, Gu W, Li L. Seroprevalence of Measles Antibodies and Predictors for Seropositivity among Chinese Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E605. [PMID: 28587279 PMCID: PMC5486291 DOI: 10.3390/ijerph14060605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 05/22/2017] [Accepted: 06/02/2017] [Indexed: 11/17/2022]
Abstract
Background: Supplementary measles immunization has been implemented since 2010 throughout China, yet few studies have reported its effect in the northwest regions. Methods: A cross-sectional study was conducted among children aged 2 to 4 years old (n = 755) from February to September 2014 in 25 towns of Qian County, Shaanxi Province. Blood samples were analyzed for measles antibodies using enzyme-linked immunosorbent immunoglobulin G (IgG) assays. Socio-demographic factors were assessed by questionnaire. Data on vaccine dose were collected from town medical records. Univariate and logistic regression analyses were used to determine factors associated with measles antibody seropositivity. Results: Measles antibody seroprevalence was 91.13% (95% CI: 89.52-92.83) in our sample. Compared with children whose mother's highest education was primary school, seroprevalence was higher in children whose maternal education was middle school (adjusted OR: 1.4, 95% CI: 0.7-2.8), high school (adjusted OR: 2.4, 95% CI: 1.3-7.7), and college/university (adjusted OR: 2.9, 95% CI: 1.2-9.3). Vaccine dose was positively associated with seropositivity. Conclusions: Measles seroprevalence is high in China and is associated with the mother's education and vaccine dose.
Collapse
Affiliation(s)
- Xiaoqin Wang
- Department of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China.
| | - Mei Ma
- Department of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China.
| | - Zhaozhao Hui
- Department of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China.
| | - Paul D Terry
- Department of Medicine, University of Tennessee Medical Center, Knoxville, TN 37920, USA.
| | - Yue Zhang
- Department of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China.
| | - Rui Su
- Center for Disease Control and Prevention in Qian County, Xianyang 713300, China.
| | - Mingxu Wang
- Department of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China.
| | - Wei Gu
- Department of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China.
| | - Ling Li
- Department of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China.
| |
Collapse
|
8
|
Tang L, Zhou Y, Pan Y, Zhu H. Measles epidemics and seroepidemiology of population in Wujin, Changzhou city, Jiangsu province, China 2015. Vaccine 2017; 35:2925-2929. [PMID: 28433329 DOI: 10.1016/j.vaccine.2017.04.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 04/08/2017] [Accepted: 04/11/2017] [Indexed: 11/18/2022]
Abstract
The measles epidemic was rather severe in Wujin 2015, and a seroprevalence survey of measles antibody was conducted during June to September 2015 in Wjin district of Changzhou city. Blood samples were collected from community health population and convenient samples of residual blood from hospitals. Measles-specific IgG levels were measured by ELISA assay. A total of 122 measles cases were reported 2015 in Wujin district with an incidence of 8.31 per 100000 populations. A large proportion of measles cases were adults ≥20years (62.30%) and infants aged <18months (28.69%). Floating population accounted for 68.57% of all cases. 1070 blood samples aged from 9months to 49years old were collected and the overall seroprevalence and geometric mean titer (GMT) of measles were 82.71% and 551.19mIU/ml, respectively. Although the seroprevalence among children aged 9months to 4years was consistently over 90%, it began to decrease since 24months, and till the age of ≥10years, the seroprevalences were all <80%, however, the seroprevalence rised to above 80% in people over 40years. There were no significant differences between the two blood sample sources in the level of seroprevalence and GMT. Also no significant differences were observed in the seroprevalence of measles and GMT levels between genders. The seroprevalence and GMT in people with measles vaccination were higher than those without measles vaccination or people whose measles vaccination are unknown (P<0.001). Our study indicated that the adult measles cases have become a serious problem in Wujin district, which may mainly relate to the increasing size of the floating population with low measles vaccine coverage. The seroprevalence of measles decreased dramatically with increasing age since teenagers, which may mainly caused by waning vaccine-induced immunity. Therefore, it is necessary to strengthen measles vaccine in these people especially floating population.
Collapse
Affiliation(s)
- Lingyan Tang
- Department of Epidemic Prevention, Wujin District Center for Disease Control and Prevention, Changzhou 213164, Jiangsu Province, China.
| | - Yihong Zhou
- Department of Epidemic Prevention, Wujin District Center for Disease Control and Prevention, Changzhou 213164, Jiangsu Province, China
| | - Yingzi Pan
- Department of Epidemic Prevention, Wujin District Center for Disease Control and Prevention, Changzhou 213164, Jiangsu Province, China
| | - Hongming Zhu
- Department of Epidemic Prevention, Wujin District Center for Disease Control and Prevention, Changzhou 213164, Jiangsu Province, China
| |
Collapse
|
9
|
Olson D, Lamb MM, Lopez MR, Paniagua-Avila MA, Zacarias A, Samayoa-Reyes G, Cordon-Rosales C, Asturias EJ. A Rapid Epidemiological Tool to Measure the Burden of Norovirus Infection and Disease in Resource-Limited Settings. Open Forum Infect Dis 2017; 4:ofx049. [PMID: 28730158 PMCID: PMC5510458 DOI: 10.1093/ofid/ofx049] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 03/07/2017] [Indexed: 02/06/2023] Open
Abstract
Background Rapid, cost-effective tools are needed to estimate the disease burden of acute gastroenteritis (AGE) and norovirus (NoV) in resource-limited settings. Methods Households with children (6 weeks–17 years) in rural Guatemala were randomly enrolled into 2 parallel AGE surveillance systems: (1) a prospective cohort, which included an enrollment visit followed by 1 year of prospective observation using a smartphone-based weekly symptom diary; and (2) 2 sequential cross-sectional rapid active sampling (RAS) surveys. Norovirus testing was performed during enrollment (all subjects) and for prospective AGE episodes (prospective cohort only). Results The prospective cohort enrolled 207 households (469 children) from April to September 2015 followed by 471 person-years of observation; RAS survey 1 enrolled 210 households (402 children) during October to November 2015, and RAS survey 2 enrolled 210 separate households (368 children) during January to February 2016. The prospective cohort detected a NoV+ AGE prevalence of 11% and a population-attributable fraction (PAF) of −1.6% at enrollment, followed by an incidence of 1.4 episodes/100 person-years. Rapid active sampling surveys 1 and 2 identified a NoV+ AGE prevalence of 14%–21% and a PAF of 3.2%–12.4%. Conclusions Rapid active sampling surveys were practical and identified more cases of NoV infection and disease compared with a parallel prospective cohort in rural Guatemala.
Collapse
Affiliation(s)
- Daniel Olson
- Departments ofPediatrics and.,Department of Epidemiology, Colorado School of Public Health, Aurora.,Center for Global Health and.,Children's Hospital Colorado, Aurora
| | - Molly M Lamb
- Center for Global Health and.,Department of Epidemiology, Colorado School of Public Health, Aurora
| | - Maria Renee Lopez
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - M Alejandra Paniagua-Avila
- Center for Human Development, Fundacion para la Salud Integral de los Guatemaltecos,Coatepeque, Quetzaltenango, Guatemala; and.,Center for Public Health Initiatives, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Alma Zacarias
- Center for Human Development, Fundacion para la Salud Integral de los Guatemaltecos,Coatepeque, Quetzaltenango, Guatemala; and
| | - Gabriela Samayoa-Reyes
- Center for Global Health and.,Microbiology and Immunology, University of Colorado School of Medicine, Aurora
| | - Celia Cordon-Rosales
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Edwin J Asturias
- Departments ofPediatrics and.,Center for Global Health and.,Department of Epidemiology, Colorado School of Public Health, Aurora.,Children's Hospital Colorado, Aurora
| |
Collapse
|
10
|
Tang X, Geater A, McNeil E, Zhou H, Deng Q, Dong A. Timeliness and completeness of measles vaccination among children in rural areas of Guangxi, China: A stratified three-stage cluster survey. J Epidemiol 2017; 27:317-324. [PMID: 28187960 PMCID: PMC5498417 DOI: 10.1016/j.je.2016.08.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 08/07/2016] [Indexed: 12/01/2022] Open
Abstract
Background Large-scale outbreaks of measles occurred in 2013 and 2014 in rural Guangxi, a region in Southwest China with high coverage for measles-containing vaccine (MCV). This study aimed to estimate the timely vaccination coverage, the timely-and-complete vaccination coverage, and the median delay period for MCV among children aged 18–54 months in rural Guangxi. Methods Based on quartiles of measles incidence during 2011–2013, a stratified three-stage cluster survey was conducted from June through August 2015. Using weighted estimation and finite population correction, vaccination coverage and 95% confidence intervals (CIs) were calculated. Weighted Kaplan–Meier analyses were used to estimate the median delay periods for the first (MCV1) and second (MCV2) doses of the vaccine. Results A total of 1216 children were surveyed. The timely vaccination coverage rate was 58.4% (95% CI, 54.9%–62.0%) for MCV1, and 76.9% (95% CI, 73.6%–80.0%) for MCV2. The timely-and-complete vaccination coverage rate was 47.4% (95% CI, 44.0%–51.0%). The median delay period was 32 (95% CI, 27–38) days for MCV1, and 159 (95% CI, 118–195) days for MCV2. Conclusions The timeliness and completeness of measles vaccination was low, and the median delay period was long among children in rural Guangxi. Incorporating the timeliness and completeness into official routine vaccination coverage statistics may help appraise the coverage of vaccination in China. The timeliness and completeness of measles vaccination was low. The median delay period of measles vaccination was long among Guangxi children. Regions with higher measles incidence had higher rates of untimely coverage.
Collapse
Affiliation(s)
- Xianyan Tang
- Department of Epidemiology & Biostatistics, School of Public Health, Guangxi Medical University, Guangxi Zhuang Autonomous Region, China; Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Alan Geater
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
| | - Edward McNeil
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Hongxia Zhou
- Department of Epidemiology & Biostatistics, School of Public Health, Guangxi Medical University, Guangxi Zhuang Autonomous Region, China
| | - Qiuyun Deng
- Institute of Vaccination, Guangxi Center for Disease Control and Prevention, Guangxi Zhuang Autonomous Region, China
| | - Aihu Dong
- Institute of Vaccination, Guangxi Center for Disease Control and Prevention, Guangxi Zhuang Autonomous Region, China
| |
Collapse
|
11
|
Thompson KM, Odahowski CL. Systematic Review of Measles and Rubella Serology Studies. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2016; 36:1459-1486. [PMID: 26077609 DOI: 10.1111/risa.12430] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Serological tests provide information about individual immunity from historical infection or immunization. Cross-sectional serological studies provide data about the age- and sex-specific immunity levels for individuals in the studied population, and these data can provide a point of comparison for the results of transmission models. In the context of developing an integrated model for measles and rubella transmission, we reviewed the existing measles and rubella literature to identify the results of national serological studies that provided cross-sectional estimates of population immunity at the time of data collection. We systematically searched PubMed, the Science Citation Index, and references we identified from relevant articles published in English. We extracted serological data for comparison to transmission model outputs. For rubella, serological studies of women of child-bearing age provide information about the potential risks of infants born with congenital rubella syndrome. Serological studies also document the loss of maternal antibodies, which occurs at different rates for the different viruses and according to the nature of the induced immunity (i.e., infection or vaccine). The serological evidence remains limited for some areas, with studies from developed countries representing a disproportionate part of the evidence. The collection and review of serological evidence can help program managers identify immunity gaps in the population, which may help them better understand the characteristics of individuals within their populations who may participate in transmission and manage risks.
Collapse
Affiliation(s)
- Kimberly M Thompson
- Kid Risk, Inc, Orlando, FL, USA
- University of Central Florida, College of Medicine, Orlando, FL, USA
| | | |
Collapse
|
12
|
A 16-year review of seroprevalence studies on measles and rubella. Vaccine 2016; 34:4110-4118. [PMID: 27340097 DOI: 10.1016/j.vaccine.2016.06.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 05/15/2016] [Accepted: 06/01/2016] [Indexed: 01/31/2023]
Abstract
The determination of the seroprevalence of vaccine-preventable diseases is critical in monitoring the efficacy of vaccination programmes and to assess the gaps in population immunity but requires extensive organisation and is time and resource intensive. The results of the studies are frequently reported in peer-reviewed scientific, government and non-government publications. A review of scientific literature was undertaken to advise the development of WHO guidelines for the assessment of measles and rubella seroprevalence. A search of the National Library of Medicine's PubMed online publications using key words of 'measles', 'rubella', combined with 'serosurvey', 'seroprevalence', 'immunity' and 'population immunity' was conducted. A total of 97 articles published between January 1998 and June 2014 were retrieved, 68 describing serosurveys for measles and 58 serosurveys for rubella, conducted in 37 and 36 different countries respectively. Only 13 (19%) and 8 (14%) respectively were UN classified "least developed countries". The study sample varied markedly and included combinations of male and female infants, children, adolescents and adults. The study sizes also varied with 28% and 33% of measles and rubella studies respectively, having greater than 2000 participants. Microtitre plate enzyme immunoassays were used in 52 (76%) measles studies and 40 (69%) rubella studies. A total of 39 (57%) measles and 44 (76%) rubella studies reported quantitative test results. Seroprevalence ranged from 60.8% to 95.9% for measles and 53.0% to 99.3% for rubella studies. The review highlighted that infants lost maternally-acquired immunity within 9months of birth and were unprotected until vaccination. Two groups at higher risk of infection were identified: young adults between the ages of 15 and 30years and immigrants.
Collapse
|
13
|
Tang X, Geater A, McNeil E, Zhou H, Deng Q, Dong A, Li Q. Parental migration and children's timely measles vaccination in rural China: a cross-sectional study. Trop Med Int Health 2016; 21:886-94. [DOI: 10.1111/tmi.12719] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Xianyan Tang
- Department of Epidemiology and Biostatistics; School of Public Health; Guangxi Medical University; Guangxi Zhuang Autonomous Region China
- Epidemiology Unit; Faculty of Medicine; Prince of Songkla University; Hat Yai Thailand
| | - Alan Geater
- Epidemiology Unit; Faculty of Medicine; Prince of Songkla University; Hat Yai Thailand
| | - Edward McNeil
- Epidemiology Unit; Faculty of Medicine; Prince of Songkla University; Hat Yai Thailand
| | - Hongxia Zhou
- Department of Epidemiology and Biostatistics; School of Public Health; Guangxi Medical University; Guangxi Zhuang Autonomous Region China
| | - Qiuyun Deng
- Institute of Vaccination; Guangxi Center for Disease Control and Prevention; Guangxi Zhuang Autonomous Region China
| | - Aihu Dong
- Institute of Vaccination; Guangxi Center for Disease Control and Prevention; Guangxi Zhuang Autonomous Region China
| | - Qiao Li
- Department of Epidemiology and Biostatistics; School of Public Health; Guangxi Medical University; Guangxi Zhuang Autonomous Region China
| |
Collapse
|
14
|
Zahoor MA, Saqalein M, Nawaz Z. ELISA for detection of humoral immunity against measles. EXCLI JOURNAL 2015; 14:1133-4. [PMID: 26600757 PMCID: PMC4652628 DOI: 10.17179/excli2015-607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 10/18/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Muhammad Asif Zahoor
- Department of Microbiology, Govt. College University, Faisalabad-Pakistan,*To whom correspondence should be addressed: Muhammad Asif Zahoor, Department of Microbiology, Govt. College University, Faisalabad-Pakistan; Tel: 92-41-9201205, E-mail:
| | - Muhammad Saqalein
- Department of Microbiology, Govt. College University, Faisalabad-Pakistan
| | - Zeeshan Nawaz
- Department of Microbiology, Govt. College University, Faisalabad-Pakistan
| |
Collapse
|
15
|
Wang Z, Yan R, He H, Li Q, Chen G, Yang S, Chen E. Difficulties in eliminating measles and controlling rubella and mumps: a cross-sectional study of a first measles and rubella vaccination and a second measles, mumps, and rubella vaccination. PLoS One 2014; 9:e89361. [PMID: 24586717 PMCID: PMC3930734 DOI: 10.1371/journal.pone.0089361] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 01/22/2014] [Indexed: 11/25/2022] Open
Abstract
Background The reported coverage of the measles–rubella (MR) or measles–mumps–rubella (MMR) vaccine is greater than 99.0% in Zhejiang province. However, the incidence of measles, mumps, and rubella remains high. In this study, we assessed MMR seropositivity and disease distribution by age on the basis of the current vaccination program, wherein the first dose of MR is administered at 8 months and the second dose of MMR is administered at 18–24 months. Methods Cross-sectional serological surveys of MMR antibodies were conducted by collecting epidemiological data in Zhejiang province, China in 2011. In total, 1015 participants were randomly selected from two surveillance sites. Serum MMR-specific immunoglobulin G levels were tested by enzyme-linked immunosorbent assay. The geometric mean titers and seroprevalence with 95% confidence intervals (CIs) were calculated by age and gender. Proportions of different dose of vaccine by age by vaccine were also identified. Statistically significant differences between categories were assessed by the Chi-square test. Results Over 95% seroprevalence rates of measles were seen in all age groups except <7 months infants. Children aged 5–9 years were shown lower seropositivity rates of mumps while elder adolescences and young adults were presented lower rubella seroprevalence. Especially, rubella seropositivity was significantly lower in female adults than in male. Nine measles cases were unvaccinated or unknown vaccination history. Among them, 66.67% (6/9) patients were aged 20–29 years while 33.33% (3/9) were infants aged 8–12 months. In addition, 57.75% (648/1122) patients with mumps were children aged 5–9 years, and 50.54% (94/186) rubella cases were aged 15–39 years. Conclusions A timely two-dose MMR vaccination schedule is recommended, with the first dose at 8 months and the second dose at 18–24 months. An MR vaccination speed-up campaign may be necessary for elder adolescents and young adults, particularly young females.
Collapse
Affiliation(s)
- Zhifang Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, P. R. China
| | - Rui Yan
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, P. R. China
| | - Hanqing He
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, P. R. China
| | - Qian Li
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, P. R. China
| | - Guohua Chen
- Cixi City Center for Disease Control and Prevention, Cixi, Ningbo, P. R. China
| | - Shengxu Yang
- Sanmen County Center for Disease Control and Prevention, Sanmen, Taizhou, P. R. China
| | - Enfu Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, P. R. China
- * E-mail:
| |
Collapse
|
16
|
Xiong Y, Wang D, Lin W, Tang H, Chen S, Ni J. Age-related changes in serological susceptibility patterns to measles: results from a seroepidemiological study in Dongguan, China. Hum Vaccin Immunother 2014; 10:1097-03. [PMID: 24448194 DOI: 10.4161/hv.27734] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The present study was performed to determine the seroprevalence of IgG measles antibodies in Dongguan residents (irrespective of vaccination status), to analyze the changes in age-related serological susceptibility patterns. A total of 1960 residents aged 0-60 years and 315 mother-infant pairs were studied. Serum IgG antibodies against measles virus were measured by ELISA. The overall seroprevalence was 93.4% in the general population in Dongguan, China. In subgroups aged 1-29 years who were likely vaccinated, there was a declining trend of seropositivity with age from 98.6% at 1-4 years to 85.7% at 20-29 years (P<0.0001). Seroprevalence were near or>95% in the older population (30-39 years and ≥ 40 years) who had not been immunized against measles. Age and sex were independent factors associated with seropositivity. Seroprevalence in pregnant women and their newborns was 87.0% and 84.1%, respectively. Our results suggest that the waning vaccine-induced immunity may be the main cause of increased serological susceptibility in young adults and young infants. An additional vaccination strategy that targets young adults is important for elimination of measles.
Collapse
Affiliation(s)
- Yongzhen Xiong
- School Clinic; Guangdong Medical College; Dongguan, PR China
| | - Dong Wang
- Department of Immunization Program; Dongguan Center for Disease Control and Prevention; Dongguan, PR China
| | - Weiyan Lin
- Department of Epidemiology and Biostatistics; Guangdong Medical College; Dongguan, PR China
| | - Hao Tang
- Department of Epidemiology and Biostatistics; Guangdong Medical College; Dongguan, PR China
| | - Shaoli Chen
- Department of Immunization Program; Dongguan Center for Disease Control and Prevention; Dongguan, PR China
| | - Jindong Ni
- Department of Epidemiology and Biostatistics; Guangdong Medical College; Dongguan, PR China
| |
Collapse
|