Risk factors for measles infection in 0-7 month old children in China after the 2010 nationwide measles campaign: A multi-site case-control study, 2012-2013.

Tuesday, 29th of March 2016

Vaccine. 2016 Mar 21. pii: S0264-410X(16)00128-6. doi: 10.1016/j.vaccine.2016.02.002. [Epub ahead of print]

Risk factors for measles infection in 0-7 month old children in China after the 2010 nationwide measles campaign: A multi-site case-control study, 2012-2013.

Ma C¹, Gregory CJ², Hao L¹, Wannemuehler KA², Su Q¹, An Z¹, Quick L², Rodewald L³, Ma F⁴, Yan R⁵, Song L⁶, Zhang Y⁷, Kong Y⁸, Zhang X⁹, Wang H¹, Li L¹,Cairns L², Wang N¹⁰, Luo H¹¹.

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Abstract

INTRODUCTION:

Endemic measles persists in China, despite >95% reported coverage of two measles-containing vaccine doses and nationwide campaign that vaccinated more than 100 million children in 2010. We performed a case-control study in six Chinese provinces during January 2012 through June 2013 to identify risk factors for measles infection among children aged 0-7 months.

METHODS:

Children with laboratory-confirmed measles were neighborhood matched with three controls. We interviewed parents of case and control infants on potential risk factors for measles. Adjusted matched odds ratios (mOR) and 95% confidence intervals (CIs) were calculated by multivariable conditional logistic modeling. We calculated attributable fractions for risk factors that could be interpreted as causal.

RESULTS:

Eight hundred thirty cases and 2303 controls were enrolled. In multivariable analysis, male sex (mOR 1.6 [1.3, 2.0]), age 5-7 months (mOR 3.9 [3.0, 5.1]), migration between counties (mOR 2.3 [1.6, 3.4]), outpatient hospital visits (mOR 9.4 [6.6, 13.3]) and inpatient hospitalization (mOR 107.1 [48.8, 235.1]) were significant risk factors. The calculated attributable fractions for hospital visits was 43.1% (95% CI: 40.1, 47.5%) adjusted for age, sex and migration.

CONCLUSIONS:

Hospital visitation was the largest risk factor for measles infection in infants. Improved hospital infection control practices would accelerate measles elimination in China.