THINK GLOBALLY, ACT LOCALLY: THE ROLE OF LOCAL DEMOGRAPHICS AND VACCINATION COVERAGE IN THE DYNAMIC RESPONSE OF MEASLES INFECTION TO CONTROL

Tuesday, 23rd of July 2013 Print
[source]Philosophical Transactions of Royal Society of London, Series B, Biological sciences[|source]

In this article present analyses that indicate that there is broad-scale correspondence between the theoretical predictions and the patterns observed across all countries. However, local/country variations e.g. population growth, role of migration, local vaccine programme performance and vaccine refusal rates play important roles. In practice, identifying these variations from theoretical predictions could be used to identify local units/countries that exceed programmatic expectations or are falling behind. Therefore, achieving the definitive goal of measles eradication will probably require the integration of surveillance data and quantitative models to develop control measures that are custom-tailored to local/country conditions. Interested in more details, then visit:  http://rstb.royalsocietypublishing.org/content/368/1623/20120141.full?sid=fc6877f5-1968-4c77-ab4c-b33b21f5aed9

 

 

Abstract

The global reduction of the burden of morbidity and mortality owing to measles has been a major triumph of public health. However, the continued persistence of measles infection probably not only reflects local variation in progress towards vaccination target goals, but may also reflect local variation in dynamic processes of transmission, susceptible replenishment through births and stochastic local extinction. Dynamic models predict that vaccination should increase the mean age of infection and increase inter-annual variability in incidence. Through a comparative approach, we assess national-level patterns in the mean age of infection and measles persistence. We find that while the classic predictions do hold in general, the impact of vaccination on the age distribution of cases and stochastic fadeout are mediated by local birth rate. Thus, broad-scale vaccine coverage goals are unlikely to have the same impact on the interruption of measles transmission in all demographic settings. Indeed, these results suggest that the achievement of further measles reduction or elimination goals is likely to require programmatic and vaccine coverage goals that are tailored to local demographic conditions.

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