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.

Monday, 1st of August 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 R⁵Song 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 twomeasles-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.

Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.