BACKGROUND Measles is a highly contagious disease that caused by a measles virus.While measles vaccination is highly effective in preventing the disease,those who are unvaccinated or have not completed the vaccine ser...BACKGROUND Measles is a highly contagious disease that caused by a measles virus.While measles vaccination is highly effective in preventing the disease,those who are unvaccinated or have not completed the vaccine series are at significant risk.AIM To assess the clinical characteristics and outcomes of measles in vaccinated vs unvaccinated children in Ramadi city.METHODS Clinically confirmed cases of measles at Al-Ramadi Teaching Hospital for Ma-ternity and Children,identified between June and December 2023,were enrolled in this prospective cohort study.The cases were divided into two groups(va-ccinated and unvaccinated).The clinical characteristics and outcomes were com-pared between unvaccinated and vaccinated children.RESULTS Of 289 kids,there were 222(76.8%)children under 5 years old,and 161(55.7%)boys.Around 2/3rd children were unvaccinated.Besides,only 5(4.9%)kids from the vaccinated group received three doses.Fever,maculopapular rashes,and cough were the most common manifestations.Unvaccinated children had higher rate of developing complications(pneumonia and diarrhea with P values 0.001 and 0.01 respectively),longer hospital admission period(P value=0.008),and the need for respiratory care unit(RCU)admission comparing with the vaccinated children(4 cases for unvaccinated group vs 1 case for vaccinated group).CONCLUSION Unvaccinated kids were associated with more complications,longer admission hospital stays,and RCU admission.We recommend that public health directors utilize artificial intelligence tools to help control future measles epidemics.展开更多
BACKGROUND Patients with inflammatory bowel diseases(IBD)often miss the scheduled vaccines and have a higher risk of infection susceptibility,including vaccineprevented diseases.AIM To evaluate the vaccine coverage an...BACKGROUND Patients with inflammatory bowel diseases(IBD)often miss the scheduled vaccines and have a higher risk of infection susceptibility,including vaccineprevented diseases.AIM To evaluate the vaccine coverage and levels of the post-vaccine antibodies against measles,mumps,rubella,and hepatitis B in children with IBD.METHODS Total 98 patients:46 females(47.2%)and 52 males(52.8%)with IBD(Crohn’s disease-75%and ulcerative colitis-25%)with disease onset age-11.0(6.0;14.0)years whom clinical data,vaccination status and levels of the postvaccination antibodies(IgG)for measles,rubella,mumps,hepatitis B,measured with ELISA were prospectively evaluated.The control group consisted of 88 healthy peers from the biobank data.RESULTS Patients with IBD had lower levels of measles,rubella,and hepatitis B,except mumps,compared to controls.Incomplete vaccination/non-protective titer of the antibodies against measles,mumps rubella,and hepatitis B had 33(33.7%)/52.3%,21(21.4%)/50.4%,26(25.8)/25.6%and 26(25.8%)/55.2%,respectively.Patients with incomplete vaccination had a lower age at the diagnosis for all vaccines.The age of the IBD diagnosis≤6 years was the predictor of incomplete vaccination for measles[odds ratio(OR)=4.6,P=0.001],mumps(OR=5.0,P=0.001),rubella(OR=5.4,P=0.0005)and hepatitis B(OR=5.4,P=0.0005)and corticosteroid treatment for measles(OR=2.2,P=0.074)and mumps(OR=3.0,P=0.047)vaccines.Incomplete vaccination was the predictor of nonprotective titer of antibodies against rubella(OR=6.8,95%CI:2.3-19.9,P=0.0002)/mumps(OR=7.0,95%CI:2.4-20.8;P=0.0002).CONCLUSION Patients with IBD had low vaccine coverage and lower levels of anti-vaccine antibodies against measles,rubella,and hepatitis B.Nearly half of the IBD patients require revaccination.展开更多
BACKGROUND Children with juvenile idiopathic arthritis(JIA)and inflammatory bowel disease(IBD)face an elevated risk of severe infection owing to their diseases and the immunosuppressive treatment for disease control.A...BACKGROUND Children with juvenile idiopathic arthritis(JIA)and inflammatory bowel disease(IBD)face an elevated risk of severe infection owing to their diseases and the immunosuppressive treatment for disease control.AIM To compare scheduled vaccination coverage and the levels of post-vaccine antibodies against measles,mumps,rubella(MMR)and hepatitis B in pediatric patients with IBD and JIA.METHODS A comparative cohort study included 97 patients with IBD and 170 patients with JIA.Vaccination history was obtained from medical records,while post-vaccination immunity was assessed prospectively by measuring specific IgG antibody titers using enzyme-linked immunosorbent assays(Vector-Best JSC,Russia;IBL International,Germany)during routine visits between January 2022 and April 2023.RESULTS A complete two-dose MMR course had been administered to 66.3%of IBD patients and 55.9%of JIA patients(P=0.121).By contrast,the three-dose hepatitis B schedule was completed in 74.2%of IBD and 100%of JIA patients(P<0.001).Protective level of anti-vaccine antibodies against measles(47.7%vs 57.7%;P=0.168);mumps(75.3%vs 80.0%;P=0.366);rubella(74.4%vs 98.2%;P<0.0001);and hepatitis B(44.8%vs 50.0%;P=0.514)were detected in IBD and JIA patients,respectively.CONCLUSION Patients with IBD and JIA demonstrated different vaccination coverage patterns and levels of anti-vaccine antibodies.Routine baseline serology and timely booster vaccination should be implemented for all pediatric patients receiving chronic immunosuppression.展开更多
Introduction: The WHO’s measles control strategy is based on epidemiological surveillance and vaccination. Little is currently known about the performance of the surveillance system, particularly in outlying areas. I...Introduction: The WHO’s measles control strategy is based on epidemiological surveillance and vaccination. Little is currently known about the performance of the surveillance system, particularly in outlying areas. It is in this context that the present study was carried out to evaluate the measles epidemiological surveillance system in the Kangaba health district. Method: This was a descriptive cross-sectional study with retrospective data collection for the period from 1 January to 31 December 2022 in the Kangaba health district with 18 epidemiological surveillance officers. Data were collected using an observation grid and documentary analysis. Results: We found a simplicity of 97%, a representativeness of 95% and a reactivity of 53%. Not all notified cases were sampled (64%). Of the 17 CSCom, 8 were positive. A total of 34 confirmed cases of measles were recorded, with one death. Conclusion: Overall, the system is functional and well-established in the health centres, but it remains important to ensure that suspected cases are investigated and that the time between sampling and the availability of laboratory results is respected.展开更多
Objective:To describe the situation of measles in Sri Lanka from May to November,2023 and to define the role of virology laboratory towards case confirmation and epidemiological and genetic characterization of the out...Objective:To describe the situation of measles in Sri Lanka from May to November,2023 and to define the role of virology laboratory towards case confirmation and epidemiological and genetic characterization of the outbreak.Methods:This retrospective study analyzed all samples tested for measles from 1st of May to 30th of November,2023 at National Measles Rubella Laboratory,Sri Lanka.According to the World Health Organization(WHO)algorithm,serum and oropharyngeal/nasopharyngeal swabs were tested with WHO recommended kits for anti-measles IgM and measles virus specific RNA,respectively.Selected RNA positive samples were sequenced at reference laboratory,India.Analysis of sequencing data and construction of phylogenetic tree were carried out at National Measles Rubella Laboratory.Data was analyzed using descriptive statistics.Results:Of the total 1132 serum samples and 497 oropharyngeal/nasopharyngeal swabs from 1326 patients,657(49.5%)patients were confirmed as measles by anti-measles IgM,measles virus specific RNA or both.Males(55.6%,n=365)and the age group from>20 to≤30 years(33.0%,n=217)predominated positive patients.All provinces reported measles positive cases.All samples sequenced(100%,n=42)were genotype D8 with 95.2%(n=40)bearing Victoria.Australia origin.Conclusions:We described resurgence of measles in an eliminated country,confirming the genotype to be D8,one of the two genotypes currently circulating globally.Further,the study strongly convinced the importance of a strengthened virological surveillance system in an eliminated country,despite its eliminated status.展开更多
AIM： To evaluate whether intratumoral expression of measles virus fusogenic membrane glycoproteins H and F （MV-FMG）, encoded by an adenovirus vector Ad.MV-HI F, alone or in combination with local coexpression of cy...AIM： To evaluate whether intratumoral expression of measles virus fusogenic membrane glycoproteins H and F （MV-FMG）, encoded by an adenovirus vector Ad.MV-HI F, alone or in combination with local coexpression of cytokines （IL-2, IL-12, IL-18, IL-21 or GM-CSF）, can serve as a platform for inducing tumor-specific immune responses in colon cancer.METHODS： We used confocal laser scanning microscopy and flow cytometry to analyze cell-cell fusion after expression of MV-FMG by dye colocalization. In a syngeneic bilateral subcutaneous MC38 and Colon26 colon cancer model in C57BL/6 and BALB/c mice, we assessed the effect on both the directly vector-treated tumor as well as the contralateral, not directly vector- treated tumor. We assessed the induction of a tumorspecific cytotoxic T lymphocyte （CTL） response with a lactate dehydrogenase （LDH） release assay.RESULTS： We demonstrated in vitro that transduction of MC38 and Colon26 cells with Ad.MV-H/F resulted in dye colocalization, indicative of cell-cell fusion, in addition, in the syngeneic bilateral tumor model we demonstrated a significant regression of the directly vector-inoculated tumor upon intratumoral expression of MV-FMG alone or in combination with the tested cytokines. We observed the highest anti-neoplastic efficacy with MV-FMG and lL-21 coexpression. The degree of tumor regression of the not directly vector-treated tumor correlated with the anti-neoplastic response of the directly vector-treated tumor. This regression was mediated by a tumor-specific CTL response.CONCLUSION： Our data indicate that intratumoral expression of measles virus fusogenic membrane glycoproteins is a promising tool both for direct tumor treatment as well as for tumor vaccination approaches that can be further enhanced by cytokine coexpression.展开更多
Objective:To assess the knowledge of healthcare workers on the measles vaccine and its cold chain management.Method:An institutional-based cross-sectional study was conducted from February 1 to March 30,2022 in Gondar...Objective:To assess the knowledge of healthcare workers on the measles vaccine and its cold chain management.Method:An institutional-based cross-sectional study was conducted from February 1 to March 30,2022 in Gondar City Administration public health institutions among 165 healthcare workers.Data were collected using a structured questionnaire.In addition,an on-spot observation checklist was used to assess the availability,status and management of the cold chain.A logistic regression model was used to assess the relationship between the outcome and predictor variables.Crude and adjusted odds ratios were calculated with 95%confidence intervals.Results:Overall,87(52.7%;95%CI 44.8%-60.5%)of the healthcare workers had unsatisfactory knowledge regarding the measles vaccine and its cold chain management.One hundred thirty-six(82.4%)healthcare workers correctly mentioned the recommended range of temperature(2-8℃)for measles vaccine storage.Healthcare workers aged 18-29 years(P=0.001)and 30-44 years(P=0.014)were observed as determinants of unsatisfactory knowledge on the measles vaccine and its cold chain management.One hundred and five(63.6%)of the healthcare workers did not correctly mention the type of measles vaccine used in routine immunization.More than one-third(36.4%)of the healthcare workers perceived that the measles vaccine is not safe and could cause measles.Conclusions:More than half of the healthcare workers in the study area had unsatisfactory knowledge on the measles vaccine and its cold chain management.It is necessary to provide technical support and in-service training for healthcare workers to ensure optimal immunization effectiveness.展开更多
Oncolytic measles virus(OMV) is a promising antitumor agent. However, the presence of anti-measles neutralizing antibodies(NAbs) against the hemagglutinin(H) protein of OMV is a major barrier to the therapeutic applic...Oncolytic measles virus(OMV) is a promising antitumor agent. However, the presence of anti-measles neutralizing antibodies(NAbs) against the hemagglutinin(H) protein of OMV is a major barrier to the therapeutic application of OMV in clinical practice. In order to overcome this challenge, specific types of cells have been used as carriers for OMV.Differential loading strategies appear to result in different therapeutic outcomes; despite this, only few studies have reported practical ex vivo loading strategies required for effective treatment. To this end, we systematically evaluated the antitumor efficacy of OMV using different loading strategies; this involved varying the in vitro loading duration and loading dose of OMV. We found that improved oncolysis of carrier cells was achieved by a prolonged loading duration in the absence of NAbs. However, the enhanced oncolytic effect was abrogated in the presence of NAbs. Further, we found that the expression of H protein on the surface of carrier cells was predominantly determined by the loading duration rather than the loading dose. Finally, we showed that NAbs blocked viral transfer by targeting H protein prior to the occurrence of cell-to-cell interactions. Our results provide comprehensive information on the determinants of an effective loading strategy for carrier cell-based virotherapy; these results may be useful for guiding the application of OMV as an antitumor agent in clinical practice.展开更多
BACKGROUND Gastrointestinal cytomegalovirus(CMV)disease occurs commonly in immunocompromised/immunodeficient patients with advanced human immunodeficiency virus infection,neoplasm,solid organ transplantation,hematopoi...BACKGROUND Gastrointestinal cytomegalovirus(CMV)disease occurs commonly in immunocompromised/immunodeficient patients with advanced human immunodeficiency virus infection,neoplasm,solid organ transplantation,hematopoietic stem cell transplantation,or treatment with immunosuppressants,but is rarely reported in association with measles infection.CASE SUMMARY We describe a case of extensive gastrointestinal CMV disease secondary to measles infection in a 9-mo-old boy who presented with persistent fever and bloody diarrhea.His condition was improved after ganciclovir treatment.Serological analysis of CMV showed negative immunoglobulin(Ig)M and positive IgG.Blood CMV-DNA was 9.26×103 copies/mL.The diagnosis of gastrointestinal CMV disease was confirmed by histopathological findings of intranuclear and intracytoplasmic inclusions and Owl’s eye inclusion.This case highlights the differential diagnosis and histopathological characteristics of gastrointestinal CMV infection and laboratory tests.CONCLUSION Extensive gastrointestinal CMV lesions can be induced by the immune suppression secondary to measles infection.Rational,fast,and effective laboratory examinations are essential for suspected patients.展开更多
Objective To identify measles vaccine failures in Tianjin, China using a measles virus Ig G avidity assay.Methods The China Information System for Disease Control and Prevention(CISDCP) was used to collect information...Objective To identify measles vaccine failures in Tianjin, China using a measles virus Ig G avidity assay.Methods The China Information System for Disease Control and Prevention(CISDCP) was used to collect information about measles cases and blood specimens in Tianjin from 2013 to 2015. Measlesspecific Ig M and Ig G antibodies were detected using Enzyme-Linked Immunosorbent Assay(ELISA).Avidity testing for measles Ig G was performed using a commercial enzyme immunoassay(EIA).Results A total of 284 confirmed measles cases were identified. Of this total, 262(92.25%) were in patients aged ≥ 20 years. High avidity was exhibited in 172(60.56%) cases, while 80(28.17%) cases demonstrated low avidity. High avidity was detected in only 21.43% of cases in patients aged < 1 year.The proportion of high avidity increased with age, and was significantly higher in patients aged 30–39 years at 70.07%(χ~2 = 17.27, P = 0.002). Of the 52 measles cases in patients with a history of vaccinations,41(78.85%) cases showed high avidity, indicating secondary vaccine failures(SVF). In these vaccinations,there was no significant difference(P > 0.05) in clinical severity between high avidity and low avidity cases. However, regardless of vaccination status, clinical severity was significantly lower in high avidity cases(P < 0.001) than in low avidity cases. The percentages of positive measles Ig M results in high avidity and low avidity cases were 66.28% and 91.25%, respectively. Geometric Mean Concentration(GMC) was significantly lower in high avidity cases at 33.73 U/m L, compared to 166.07 U/m L in low avidity cases.Conclusions Low clinical severity and inconclusive Ig M antibody results are more likely in high avidity measles cases. Measles cases were more common in adults. Therefore, a further dose of vaccines should be recommended for 30–39 years in Tianjin.展开更多
Objective:To investigate the importance of immunization in preventing measles infection and to determine the most useful laboratory tests for confirmation of measles.Methods:This study included pediatric cases evaluat...Objective:To investigate the importance of immunization in preventing measles infection and to determine the most useful laboratory tests for confirmation of measles.Methods:This study included pediatric cases evaluated with a presumed diagnosis of measles between December 2022 and June 2023,at Marmara University Pendik Training and Research Hospital.The effects of vaccination status and underlying disease on the clinical course,treatments,and complications were evaluated.Results:In total,117 patients were enrolled in the study with a median age of 80 months(IQR:32.5-125.0).Twelve patients with contact history were asymptomatic and had an underlying disorder,and intravenous immunoglobulin was given to them for post-exposure prophylaxis.Fifty-one patients had confirmed measles diagnosis.Ribavirin treatment was given to three patients(a newborn,a girl with rhabdomyosarcoma,and a healthy boy)with respiratory distress.Seventy-eight percent of confirmed measles cases were unvaccinated,and all hospitalized cases were unvaccinated or under-vaccinated.Four full-vaccinated children had confirmed measles infection.Measles PCR from nasopharyngeal swabs was negative in all of them,and their diagnosis was established with anti-measles IgM positivity.Conclusions:The measles vaccine is the most effective way to protect from measles and measles-related complications.Although measles can also occur in fully vaccinated patients,the disease is milder than in unvaccinated patients.Using ELISA and RT-PCR tests together may be beneficial in patients with high clinical suspicion for early diagnosis.展开更多
This study aimed to find a model to forecast monthly measles immunization coverage using Autoregressive Integrated Moving Average (ARIMA). The monthly registered data for measles immunization coverage from January 201...This study aimed to find a model to forecast monthly measles immunization coverage using Autoregressive Integrated Moving Average (ARIMA). The monthly registered data for measles immunization coverage from January 2014 to December 2018 were used for the development of the model. The best model with the smallest Normalized Bayesian Information Criterion (BIC) of 8.673 is ARIMA (0, 1, 0). ARIMA (0, 1, 0) was used to forecast the monthly measles immunization coverage for the next 36 months from January 2018 to December 2020. The results obtained prove that this model can be used for forecasting future immunization coverage and will help decision-makers to establish strategies, priorities, and proper use of immunization resources.展开更多
Objective To analyze the epidemiological characteristics of measles,mumps,and rubella(MMR)between 2014 and 2021 and identify potential strategies and measures for the prevention and control of MMR in China.Methods Dat...Objective To analyze the epidemiological characteristics of measles,mumps,and rubella(MMR)between 2014 and 2021 and identify potential strategies and measures for the prevention and control of MMR in China.Methods Data on MMR was obtained from China’s National Notifiable Disease Reporting System for the period from 2014 to 2021.Spatiotemporal distributions were analyzed using SaTScan;temporal trends were analyzed using JoinPoint;and clusters were visualized using ArcGIS.Results A total of 1,808,067 cases of MMR were reported from 2014 to 2021 in China’s mainland,most of which were children and students under the age of 20.The incidence of measles declined during 2014-2021,whereas that of mumps and rubella peaked in 2019.MMR-reported cases generally peaked from March to July;however,high numbers of mumps cases were reported from September to November in 2020-2021.Measles and rubella clusters predominantly occurred in Western China,whereas clusters of mumps were generally found in the southern region.Conclusion The relatively heterogeneous epidemiological characteristics of MMR have highlighted the weaknesses and gaps in surveillance and timely control of MMR transmission in China’s mainland.Real-time and intelligent monitoring data should be collected for evidence-based early interventions。展开更多
Because of the features involved with their varied kernels,differential operators relying on convolution formulations have been acknowledged as effective mathematical resources for modeling real-world issues.In this p...Because of the features involved with their varied kernels,differential operators relying on convolution formulations have been acknowledged as effective mathematical resources for modeling real-world issues.In this paper,we constructed a stochastic fractional framework of measles spreading mechanisms with dual medication immunization considering the exponential decay and Mittag-Leffler kernels.In this approach,the overall population was separated into five cohorts.Furthermore,the descriptive behavior of the system was investigated,including prerequisites for the positivity of solutions,invariant domain of the solution,presence and stability of equilibrium points,and sensitivity analysis.We included a stochastic element in every cohort and employed linear growth and Lipschitz criteria to show the existence and uniqueness of solutions.Several numerical simulations for various fractional orders and randomization intensities are illustrated.展开更多
Objective:To characterize viral co-infections among representative hospitalized measles cases during the 2014 Hanoi outbreak.Methods:Throat swabs were collected from 54 pediatric patients with confirmed measles,and mo...Objective:To characterize viral co-infections among representative hospitalized measles cases during the 2014 Hanoi outbreak.Methods:Throat swabs were collected from 54 pediatric patients with confirmed measles,and molecular diagnostics performed for 10 additional viral respiratory pathogens(Influenza A/H1N1pdm09;A/H3N2 and influenza B;Parainfluenza 1,2,3;Respiratory Synctial Virus,RSV;human Metapneumovirus,hM PV;Adenovirus and Picornavirus).Results:Twenty-one cases(38.9%) showed evidence of infection with other respiratory viruses:15 samples contained measles plus one additional virus,and 6 samples contained measles plus 2 additional viruses.Adenovirus was detected as a predominant cause of co-infections(13 cases;24.1%),followed by RSV(6 cases;11.1%),A/H1N1pdm09(3 cases;5.6%),PIV3(3 cases;3.7%),Rhinovirus(3 cases;3.7%) and hM PV(1 case;1.96%).Conclusions:Viral co-infections identified from pediatric measles cases may have contributed to increased disease severity and high rate of fatal outcomes.Optimal treatment of measles cases may require control of multiple viral respiratory pathogens.展开更多
In this article, we consider the construction of a SVIR (Susceptible, Vaccinated, Infected, Recovered) stochastic compartmental model of measles. We prove that the deterministic solution is asymptotically the average ...In this article, we consider the construction of a SVIR (Susceptible, Vaccinated, Infected, Recovered) stochastic compartmental model of measles. We prove that the deterministic solution is asymptotically the average of the stochastic solution in the case of small population size. The choice of this model takes into account the random fluctuations inherent to the epidemiological characteristics of rural populations of Niger, notably a high prevalence of measles in children under 5, coupled with a very low immunization coverage.展开更多
In this paper, we analyze the quasi-stationary distribution of the stochastic <em>SVIR</em> (Susceptible, Vaccinated, Infected, Recovered) model for the measles. The quasi-stationary distributions, as disc...In this paper, we analyze the quasi-stationary distribution of the stochastic <em>SVIR</em> (Susceptible, Vaccinated, Infected, Recovered) model for the measles. The quasi-stationary distributions, as discussed by Danoch and Seneta, have been used in biology to describe the steady state behaviour of population models which exhibit discernible stationarity before to become extinct. The stochastic <em>SVIR</em> model is a stochastic <em>SIR</em> (Susceptible, Infected, Recovered) model with vaccination and recruitment where the disease-free equilibrium is reached, regardless of the magnitude of the basic reproduction number. But the mean time until the absorption (the disease-free) can be very long. If we assume the effective reproduction number <em>R</em><em><sub>p</sub></em> < 1 or <img src="Edit_67da0b97-83f9-42ef-8a00-a13da2d59963.bmp" alt="" />, the quasi-stationary distribution can be closely approximated by geometric distribution. <em>β</em> and <em>δ</em> stands respectively, for the disease transmission coefficient and the natural rate.展开更多
Objective:To determine the concentration and rate of decay of maternal IgG antibodies against measles prevalence in infants of vaccinated or naturally infected mothers and study initial measles immunization occurs in ...Objective:To determine the concentration and rate of decay of maternal IgG antibodies against measles prevalence in infants of vaccinated or naturally infected mothers and study initial measles immunization occurs in nine-month-old children.Methods:In total,401 pregnant women and the same number of their subsequent newborns were recruited in the Bavi district of Hanoi in 2016-2017;they were divided into two groups:Older women(born before 1985,n=201)and younger women(born after 1990,n=200).Samples were collected at five time-points;week 36 of pregnancy,birth(cord),and 3,6,and 9 months after birth.Measles-specific IgG antibody levels were recorded.Results:In total,77.06% of the 401 pregnant women were seropositive for measles-specific IgG antibodies.A significantly greater proportion of mothers aged 30 and older(88.06%)and their newborn(93.53%)were seropositive compared to the mothers aged 25 and younger(66.00%),and their newborn(72.00%)(P<0.001).The infants of older mothers had significantly higher geometric mean titres(GMT)of measles IgG antibodies than the infants of younger mothers(P<0.001)at all time-points of the study period.The proportion of measles IgG antibodies together with GMT decreased from 82.97%(506.96)at the age of three months to 23.19%(45.22)at the age of nine months.Conclusions:This study provides a profile of maternal antibodies against measles in Vietnamese infants and investigates the early susceptibility to measles in both the infants of vaccinated mothers and mothers with naturally acquired immunity.These data suggest that determining the appropriate age for measles vaccination is paramount for the elimination of measles in Vietnam.展开更多
Objective:To determine health systems-related,familial,and cultural factors which influence the delivery and uptake of measles vaccination in Indonesia.Methods:Logistic regression analysis of data collected during the...Objective:To determine health systems-related,familial,and cultural factors which influence the delivery and uptake of measles vaccination in Indonesia.Methods:Logistic regression analysis of data collected during the 2007 Indonesian Demographic and Health Survey was undertaken by the authors to investigate these factors.The 2007 Indonesian Demographic and Health Survey dataset is a nationally representative,randomly sampled survey containing 15 065 children aged between 9 and 59 months.Results:72.8%of children had received the measles vaccine.Vaccination coverage was similar for males and females;however,coverage was higher amongst urban children,80.1%,compared to 68.5%in rural areas.The key findings of the regression analysis were congruent with the results of previous research targeting vaccination coverage.After controlling for all other factors,maternal age,maternal education,wealth, the use of a skilled birth attendant,and postnatal check-ups were positively and significantly (P【 0.01) correlated with measles vaccination.The number of children per household was negatively correlated(P【0.01).Conclusions:In order to enhance measles vaccination coverage in Indonesia,delivery to,and uptake by,rural and low socio-economic populations require substantial improvements.Mass health education and health systems improvements are also required.展开更多
Objective:An investigation of an outbreak of measles in a district in Nigeria was initiated following confirmation of the outbreak.The objectives of the study were to assess the size and determine the cause of the out...Objective:An investigation of an outbreak of measles in a district in Nigeria was initiated following confirmation of the outbreak.The objectives of the study were to assess the size and determine the cause of the outbreak. Methods:Visits were made to health facilities and affected communities.Cases were line-listed using specified forms and descriptive epidemiology carried out on collected data.Results:A total of 18 cases and 0 deaths were identified over a period of six weeks.Two of the cases(11%) were 【 9 months of age.The proportion of zero-dose children was 39%.Conclusion:Low herd immunity was suggested as the cause of the outbreak.展开更多
文摘BACKGROUND Measles is a highly contagious disease that caused by a measles virus.While measles vaccination is highly effective in preventing the disease,those who are unvaccinated or have not completed the vaccine series are at significant risk.AIM To assess the clinical characteristics and outcomes of measles in vaccinated vs unvaccinated children in Ramadi city.METHODS Clinically confirmed cases of measles at Al-Ramadi Teaching Hospital for Ma-ternity and Children,identified between June and December 2023,were enrolled in this prospective cohort study.The cases were divided into two groups(va-ccinated and unvaccinated).The clinical characteristics and outcomes were com-pared between unvaccinated and vaccinated children.RESULTS Of 289 kids,there were 222(76.8%)children under 5 years old,and 161(55.7%)boys.Around 2/3rd children were unvaccinated.Besides,only 5(4.9%)kids from the vaccinated group received three doses.Fever,maculopapular rashes,and cough were the most common manifestations.Unvaccinated children had higher rate of developing complications(pneumonia and diarrhea with P values 0.001 and 0.01 respectively),longer hospital admission period(P value=0.008),and the need for respiratory care unit(RCU)admission comparing with the vaccinated children(4 cases for unvaccinated group vs 1 case for vaccinated group).CONCLUSION Unvaccinated kids were associated with more complications,longer admission hospital stays,and RCU admission.We recommend that public health directors utilize artificial intelligence tools to help control future measles epidemics.
文摘BACKGROUND Patients with inflammatory bowel diseases(IBD)often miss the scheduled vaccines and have a higher risk of infection susceptibility,including vaccineprevented diseases.AIM To evaluate the vaccine coverage and levels of the post-vaccine antibodies against measles,mumps,rubella,and hepatitis B in children with IBD.METHODS Total 98 patients:46 females(47.2%)and 52 males(52.8%)with IBD(Crohn’s disease-75%and ulcerative colitis-25%)with disease onset age-11.0(6.0;14.0)years whom clinical data,vaccination status and levels of the postvaccination antibodies(IgG)for measles,rubella,mumps,hepatitis B,measured with ELISA were prospectively evaluated.The control group consisted of 88 healthy peers from the biobank data.RESULTS Patients with IBD had lower levels of measles,rubella,and hepatitis B,except mumps,compared to controls.Incomplete vaccination/non-protective titer of the antibodies against measles,mumps rubella,and hepatitis B had 33(33.7%)/52.3%,21(21.4%)/50.4%,26(25.8)/25.6%and 26(25.8%)/55.2%,respectively.Patients with incomplete vaccination had a lower age at the diagnosis for all vaccines.The age of the IBD diagnosis≤6 years was the predictor of incomplete vaccination for measles[odds ratio(OR)=4.6,P=0.001],mumps(OR=5.0,P=0.001),rubella(OR=5.4,P=0.0005)and hepatitis B(OR=5.4,P=0.0005)and corticosteroid treatment for measles(OR=2.2,P=0.074)and mumps(OR=3.0,P=0.047)vaccines.Incomplete vaccination was the predictor of nonprotective titer of antibodies against rubella(OR=6.8,95%CI:2.3-19.9,P=0.0002)/mumps(OR=7.0,95%CI:2.4-20.8;P=0.0002).CONCLUSION Patients with IBD had low vaccine coverage and lower levels of anti-vaccine antibodies against measles,rubella,and hepatitis B.Nearly half of the IBD patients require revaccination.
文摘BACKGROUND Children with juvenile idiopathic arthritis(JIA)and inflammatory bowel disease(IBD)face an elevated risk of severe infection owing to their diseases and the immunosuppressive treatment for disease control.AIM To compare scheduled vaccination coverage and the levels of post-vaccine antibodies against measles,mumps,rubella(MMR)and hepatitis B in pediatric patients with IBD and JIA.METHODS A comparative cohort study included 97 patients with IBD and 170 patients with JIA.Vaccination history was obtained from medical records,while post-vaccination immunity was assessed prospectively by measuring specific IgG antibody titers using enzyme-linked immunosorbent assays(Vector-Best JSC,Russia;IBL International,Germany)during routine visits between January 2022 and April 2023.RESULTS A complete two-dose MMR course had been administered to 66.3%of IBD patients and 55.9%of JIA patients(P=0.121).By contrast,the three-dose hepatitis B schedule was completed in 74.2%of IBD and 100%of JIA patients(P<0.001).Protective level of anti-vaccine antibodies against measles(47.7%vs 57.7%;P=0.168);mumps(75.3%vs 80.0%;P=0.366);rubella(74.4%vs 98.2%;P<0.0001);and hepatitis B(44.8%vs 50.0%;P=0.514)were detected in IBD and JIA patients,respectively.CONCLUSION Patients with IBD and JIA demonstrated different vaccination coverage patterns and levels of anti-vaccine antibodies.Routine baseline serology and timely booster vaccination should be implemented for all pediatric patients receiving chronic immunosuppression.
文摘Introduction: The WHO’s measles control strategy is based on epidemiological surveillance and vaccination. Little is currently known about the performance of the surveillance system, particularly in outlying areas. It is in this context that the present study was carried out to evaluate the measles epidemiological surveillance system in the Kangaba health district. Method: This was a descriptive cross-sectional study with retrospective data collection for the period from 1 January to 31 December 2022 in the Kangaba health district with 18 epidemiological surveillance officers. Data were collected using an observation grid and documentary analysis. Results: We found a simplicity of 97%, a representativeness of 95% and a reactivity of 53%. Not all notified cases were sampled (64%). Of the 17 CSCom, 8 were positive. A total of 34 confirmed cases of measles were recorded, with one death. Conclusion: Overall, the system is functional and well-established in the health centres, but it remains important to ensure that suspected cases are investigated and that the time between sampling and the availability of laboratory results is respected.
文摘Objective:To describe the situation of measles in Sri Lanka from May to November,2023 and to define the role of virology laboratory towards case confirmation and epidemiological and genetic characterization of the outbreak.Methods:This retrospective study analyzed all samples tested for measles from 1st of May to 30th of November,2023 at National Measles Rubella Laboratory,Sri Lanka.According to the World Health Organization(WHO)algorithm,serum and oropharyngeal/nasopharyngeal swabs were tested with WHO recommended kits for anti-measles IgM and measles virus specific RNA,respectively.Selected RNA positive samples were sequenced at reference laboratory,India.Analysis of sequencing data and construction of phylogenetic tree were carried out at National Measles Rubella Laboratory.Data was analyzed using descriptive statistics.Results:Of the total 1132 serum samples and 497 oropharyngeal/nasopharyngeal swabs from 1326 patients,657(49.5%)patients were confirmed as measles by anti-measles IgM,measles virus specific RNA or both.Males(55.6%,n=365)and the age group from>20 to≤30 years(33.0%,n=217)predominated positive patients.All provinces reported measles positive cases.All samples sequenced(100%,n=42)were genotype D8 with 95.2%(n=40)bearing Victoria.Australia origin.Conclusions:We described resurgence of measles in an eliminated country,confirming the genotype to be D8,one of the two genotypes currently circulating globally.Further,the study strongly convinced the importance of a strengthened virological surveillance system in an eliminated country,despite its eliminated status.
基金grants from Deutsche Forschungsgemeinschaft, Wilhelm Sander-Stiftung, and Forschungsfrderung Ruhr-Universitt Bochum Medizinische Fakultt to OW
文摘AIM： To evaluate whether intratumoral expression of measles virus fusogenic membrane glycoproteins H and F （MV-FMG）, encoded by an adenovirus vector Ad.MV-HI F, alone or in combination with local coexpression of cytokines （IL-2, IL-12, IL-18, IL-21 or GM-CSF）, can serve as a platform for inducing tumor-specific immune responses in colon cancer.METHODS： We used confocal laser scanning microscopy and flow cytometry to analyze cell-cell fusion after expression of MV-FMG by dye colocalization. In a syngeneic bilateral subcutaneous MC38 and Colon26 colon cancer model in C57BL/6 and BALB/c mice, we assessed the effect on both the directly vector-treated tumor as well as the contralateral, not directly vector- treated tumor. We assessed the induction of a tumorspecific cytotoxic T lymphocyte （CTL） response with a lactate dehydrogenase （LDH） release assay.RESULTS： We demonstrated in vitro that transduction of MC38 and Colon26 cells with Ad.MV-H/F resulted in dye colocalization, indicative of cell-cell fusion, in addition, in the syngeneic bilateral tumor model we demonstrated a significant regression of the directly vector-inoculated tumor upon intratumoral expression of MV-FMG alone or in combination with the tested cytokines. We observed the highest anti-neoplastic efficacy with MV-FMG and lL-21 coexpression. The degree of tumor regression of the not directly vector-treated tumor correlated with the anti-neoplastic response of the directly vector-treated tumor. This regression was mediated by a tumor-specific CTL response.CONCLUSION： Our data indicate that intratumoral expression of measles virus fusogenic membrane glycoproteins is a promising tool both for direct tumor treatment as well as for tumor vaccination approaches that can be further enhanced by cytokine coexpression.
文摘Objective:To assess the knowledge of healthcare workers on the measles vaccine and its cold chain management.Method:An institutional-based cross-sectional study was conducted from February 1 to March 30,2022 in Gondar City Administration public health institutions among 165 healthcare workers.Data were collected using a structured questionnaire.In addition,an on-spot observation checklist was used to assess the availability,status and management of the cold chain.A logistic regression model was used to assess the relationship between the outcome and predictor variables.Crude and adjusted odds ratios were calculated with 95%confidence intervals.Results:Overall,87(52.7%;95%CI 44.8%-60.5%)of the healthcare workers had unsatisfactory knowledge regarding the measles vaccine and its cold chain management.One hundred thirty-six(82.4%)healthcare workers correctly mentioned the recommended range of temperature(2-8℃)for measles vaccine storage.Healthcare workers aged 18-29 years(P=0.001)and 30-44 years(P=0.014)were observed as determinants of unsatisfactory knowledge on the measles vaccine and its cold chain management.One hundred and five(63.6%)of the healthcare workers did not correctly mention the type of measles vaccine used in routine immunization.More than one-third(36.4%)of the healthcare workers perceived that the measles vaccine is not safe and could cause measles.Conclusions:More than half of the healthcare workers in the study area had unsatisfactory knowledge on the measles vaccine and its cold chain management.It is necessary to provide technical support and in-service training for healthcare workers to ensure optimal immunization effectiveness.
基金supported in part by the National Natural Science Foundation of China (81472820, 81773255, 81071860 and 81602702)Jiangsu Special Program for Clinical Medical Science and Technology (BL2014054)+2 种基金the Natural Science Foundation of Jiangsu Province of China (BK20160126)the Fundamental Research Funds for the Central Universities (021414380223 and 14380336/1-2)Six talent peaks project in Jiangsu Province to JW
文摘Oncolytic measles virus(OMV) is a promising antitumor agent. However, the presence of anti-measles neutralizing antibodies(NAbs) against the hemagglutinin(H) protein of OMV is a major barrier to the therapeutic application of OMV in clinical practice. In order to overcome this challenge, specific types of cells have been used as carriers for OMV.Differential loading strategies appear to result in different therapeutic outcomes; despite this, only few studies have reported practical ex vivo loading strategies required for effective treatment. To this end, we systematically evaluated the antitumor efficacy of OMV using different loading strategies; this involved varying the in vitro loading duration and loading dose of OMV. We found that improved oncolysis of carrier cells was achieved by a prolonged loading duration in the absence of NAbs. However, the enhanced oncolytic effect was abrogated in the presence of NAbs. Further, we found that the expression of H protein on the surface of carrier cells was predominantly determined by the loading duration rather than the loading dose. Finally, we showed that NAbs blocked viral transfer by targeting H protein prior to the occurrence of cell-to-cell interactions. Our results provide comprehensive information on the determinants of an effective loading strategy for carrier cell-based virotherapy; these results may be useful for guiding the application of OMV as an antitumor agent in clinical practice.
基金Shenzhen Innovation and Technology Committee,No.JCYJ20180228175150018.
文摘BACKGROUND Gastrointestinal cytomegalovirus(CMV)disease occurs commonly in immunocompromised/immunodeficient patients with advanced human immunodeficiency virus infection,neoplasm,solid organ transplantation,hematopoietic stem cell transplantation,or treatment with immunosuppressants,but is rarely reported in association with measles infection.CASE SUMMARY We describe a case of extensive gastrointestinal CMV disease secondary to measles infection in a 9-mo-old boy who presented with persistent fever and bloody diarrhea.His condition was improved after ganciclovir treatment.Serological analysis of CMV showed negative immunoglobulin(Ig)M and positive IgG.Blood CMV-DNA was 9.26×103 copies/mL.The diagnosis of gastrointestinal CMV disease was confirmed by histopathological findings of intranuclear and intracytoplasmic inclusions and Owl’s eye inclusion.This case highlights the differential diagnosis and histopathological characteristics of gastrointestinal CMV infection and laboratory tests.CONCLUSION Extensive gastrointestinal CMV lesions can be induced by the immune suppression secondary to measles infection.Rational,fast,and effective laboratory examinations are essential for suspected patients.
文摘Objective To identify measles vaccine failures in Tianjin, China using a measles virus Ig G avidity assay.Methods The China Information System for Disease Control and Prevention(CISDCP) was used to collect information about measles cases and blood specimens in Tianjin from 2013 to 2015. Measlesspecific Ig M and Ig G antibodies were detected using Enzyme-Linked Immunosorbent Assay(ELISA).Avidity testing for measles Ig G was performed using a commercial enzyme immunoassay(EIA).Results A total of 284 confirmed measles cases were identified. Of this total, 262(92.25%) were in patients aged ≥ 20 years. High avidity was exhibited in 172(60.56%) cases, while 80(28.17%) cases demonstrated low avidity. High avidity was detected in only 21.43% of cases in patients aged < 1 year.The proportion of high avidity increased with age, and was significantly higher in patients aged 30–39 years at 70.07%(χ~2 = 17.27, P = 0.002). Of the 52 measles cases in patients with a history of vaccinations,41(78.85%) cases showed high avidity, indicating secondary vaccine failures(SVF). In these vaccinations,there was no significant difference(P > 0.05) in clinical severity between high avidity and low avidity cases. However, regardless of vaccination status, clinical severity was significantly lower in high avidity cases(P < 0.001) than in low avidity cases. The percentages of positive measles Ig M results in high avidity and low avidity cases were 66.28% and 91.25%, respectively. Geometric Mean Concentration(GMC) was significantly lower in high avidity cases at 33.73 U/m L, compared to 166.07 U/m L in low avidity cases.Conclusions Low clinical severity and inconclusive Ig M antibody results are more likely in high avidity measles cases. Measles cases were more common in adults. Therefore, a further dose of vaccines should be recommended for 30–39 years in Tianjin.
文摘Objective:To investigate the importance of immunization in preventing measles infection and to determine the most useful laboratory tests for confirmation of measles.Methods:This study included pediatric cases evaluated with a presumed diagnosis of measles between December 2022 and June 2023,at Marmara University Pendik Training and Research Hospital.The effects of vaccination status and underlying disease on the clinical course,treatments,and complications were evaluated.Results:In total,117 patients were enrolled in the study with a median age of 80 months(IQR:32.5-125.0).Twelve patients with contact history were asymptomatic and had an underlying disorder,and intravenous immunoglobulin was given to them for post-exposure prophylaxis.Fifty-one patients had confirmed measles diagnosis.Ribavirin treatment was given to three patients(a newborn,a girl with rhabdomyosarcoma,and a healthy boy)with respiratory distress.Seventy-eight percent of confirmed measles cases were unvaccinated,and all hospitalized cases were unvaccinated or under-vaccinated.Four full-vaccinated children had confirmed measles infection.Measles PCR from nasopharyngeal swabs was negative in all of them,and their diagnosis was established with anti-measles IgM positivity.Conclusions:The measles vaccine is the most effective way to protect from measles and measles-related complications.Although measles can also occur in fully vaccinated patients,the disease is milder than in unvaccinated patients.Using ELISA and RT-PCR tests together may be beneficial in patients with high clinical suspicion for early diagnosis.
文摘This study aimed to find a model to forecast monthly measles immunization coverage using Autoregressive Integrated Moving Average (ARIMA). The monthly registered data for measles immunization coverage from January 2014 to December 2018 were used for the development of the model. The best model with the smallest Normalized Bayesian Information Criterion (BIC) of 8.673 is ARIMA (0, 1, 0). ARIMA (0, 1, 0) was used to forecast the monthly measles immunization coverage for the next 36 months from January 2018 to December 2020. The results obtained prove that this model can be used for forecasting future immunization coverage and will help decision-makers to establish strategies, priorities, and proper use of immunization resources.
文摘Objective To analyze the epidemiological characteristics of measles,mumps,and rubella(MMR)between 2014 and 2021 and identify potential strategies and measures for the prevention and control of MMR in China.Methods Data on MMR was obtained from China’s National Notifiable Disease Reporting System for the period from 2014 to 2021.Spatiotemporal distributions were analyzed using SaTScan;temporal trends were analyzed using JoinPoint;and clusters were visualized using ArcGIS.Results A total of 1,808,067 cases of MMR were reported from 2014 to 2021 in China’s mainland,most of which were children and students under the age of 20.The incidence of measles declined during 2014-2021,whereas that of mumps and rubella peaked in 2019.MMR-reported cases generally peaked from March to July;however,high numbers of mumps cases were reported from September to November in 2020-2021.Measles and rubella clusters predominantly occurred in Western China,whereas clusters of mumps were generally found in the southern region.Conclusion The relatively heterogeneous epidemiological characteristics of MMR have highlighted the weaknesses and gaps in surveillance and timely control of MMR transmission in China’s mainland.Real-time and intelligent monitoring data should be collected for evidence-based early interventions。
文摘Because of the features involved with their varied kernels,differential operators relying on convolution formulations have been acknowledged as effective mathematical resources for modeling real-world issues.In this paper,we constructed a stochastic fractional framework of measles spreading mechanisms with dual medication immunization considering the exponential decay and Mittag-Leffler kernels.In this approach,the overall population was separated into five cohorts.Furthermore,the descriptive behavior of the system was investigated,including prerequisites for the positivity of solutions,invariant domain of the solution,presence and stability of equilibrium points,and sensitivity analysis.We included a stochastic element in every cohort and employed linear growth and Lipschitz criteria to show the existence and uniqueness of solutions.Several numerical simulations for various fractional orders and randomization intensities are illustrated.
基金funded by the Vietnam National Foundation for Science and Technology Development under grant number-106YS.04-2013.03
文摘Objective:To characterize viral co-infections among representative hospitalized measles cases during the 2014 Hanoi outbreak.Methods:Throat swabs were collected from 54 pediatric patients with confirmed measles,and molecular diagnostics performed for 10 additional viral respiratory pathogens(Influenza A/H1N1pdm09;A/H3N2 and influenza B;Parainfluenza 1,2,3;Respiratory Synctial Virus,RSV;human Metapneumovirus,hM PV;Adenovirus and Picornavirus).Results:Twenty-one cases(38.9%) showed evidence of infection with other respiratory viruses:15 samples contained measles plus one additional virus,and 6 samples contained measles plus 2 additional viruses.Adenovirus was detected as a predominant cause of co-infections(13 cases;24.1%),followed by RSV(6 cases;11.1%),A/H1N1pdm09(3 cases;5.6%),PIV3(3 cases;3.7%),Rhinovirus(3 cases;3.7%) and hM PV(1 case;1.96%).Conclusions:Viral co-infections identified from pediatric measles cases may have contributed to increased disease severity and high rate of fatal outcomes.Optimal treatment of measles cases may require control of multiple viral respiratory pathogens.
文摘In this article, we consider the construction of a SVIR (Susceptible, Vaccinated, Infected, Recovered) stochastic compartmental model of measles. We prove that the deterministic solution is asymptotically the average of the stochastic solution in the case of small population size. The choice of this model takes into account the random fluctuations inherent to the epidemiological characteristics of rural populations of Niger, notably a high prevalence of measles in children under 5, coupled with a very low immunization coverage.
文摘In this paper, we analyze the quasi-stationary distribution of the stochastic <em>SVIR</em> (Susceptible, Vaccinated, Infected, Recovered) model for the measles. The quasi-stationary distributions, as discussed by Danoch and Seneta, have been used in biology to describe the steady state behaviour of population models which exhibit discernible stationarity before to become extinct. The stochastic <em>SVIR</em> model is a stochastic <em>SIR</em> (Susceptible, Infected, Recovered) model with vaccination and recruitment where the disease-free equilibrium is reached, regardless of the magnitude of the basic reproduction number. But the mean time until the absorption (the disease-free) can be very long. If we assume the effective reproduction number <em>R</em><em><sub>p</sub></em> < 1 or <img src="Edit_67da0b97-83f9-42ef-8a00-a13da2d59963.bmp" alt="" />, the quasi-stationary distribution can be closely approximated by geometric distribution. <em>β</em> and <em>δ</em> stands respectively, for the disease transmission coefficient and the natural rate.
文摘Objective:To determine the concentration and rate of decay of maternal IgG antibodies against measles prevalence in infants of vaccinated or naturally infected mothers and study initial measles immunization occurs in nine-month-old children.Methods:In total,401 pregnant women and the same number of their subsequent newborns were recruited in the Bavi district of Hanoi in 2016-2017;they were divided into two groups:Older women(born before 1985,n=201)and younger women(born after 1990,n=200).Samples were collected at five time-points;week 36 of pregnancy,birth(cord),and 3,6,and 9 months after birth.Measles-specific IgG antibody levels were recorded.Results:In total,77.06% of the 401 pregnant women were seropositive for measles-specific IgG antibodies.A significantly greater proportion of mothers aged 30 and older(88.06%)and their newborn(93.53%)were seropositive compared to the mothers aged 25 and younger(66.00%),and their newborn(72.00%)(P<0.001).The infants of older mothers had significantly higher geometric mean titres(GMT)of measles IgG antibodies than the infants of younger mothers(P<0.001)at all time-points of the study period.The proportion of measles IgG antibodies together with GMT decreased from 82.97%(506.96)at the age of three months to 23.19%(45.22)at the age of nine months.Conclusions:This study provides a profile of maternal antibodies against measles in Vietnamese infants and investigates the early susceptibility to measles in both the infants of vaccinated mothers and mothers with naturally acquired immunity.These data suggest that determining the appropriate age for measles vaccination is paramount for the elimination of measles in Vietnam.
基金funded through the Governor Sanderson Scholarship in Population Health(Dr.Haruhisa Handa Leadership Scholarship Program) grant awarded to the first author by the School of Population Health,University of Western Australia
文摘Objective:To determine health systems-related,familial,and cultural factors which influence the delivery and uptake of measles vaccination in Indonesia.Methods:Logistic regression analysis of data collected during the 2007 Indonesian Demographic and Health Survey was undertaken by the authors to investigate these factors.The 2007 Indonesian Demographic and Health Survey dataset is a nationally representative,randomly sampled survey containing 15 065 children aged between 9 and 59 months.Results:72.8%of children had received the measles vaccine.Vaccination coverage was similar for males and females;however,coverage was higher amongst urban children,80.1%,compared to 68.5%in rural areas.The key findings of the regression analysis were congruent with the results of previous research targeting vaccination coverage.After controlling for all other factors,maternal age,maternal education,wealth, the use of a skilled birth attendant,and postnatal check-ups were positively and significantly (P【 0.01) correlated with measles vaccination.The number of children per household was negatively correlated(P【0.01).Conclusions:In order to enhance measles vaccination coverage in Indonesia,delivery to,and uptake by,rural and low socio-economic populations require substantial improvements.Mass health education and health systems improvements are also required.
文摘Objective:An investigation of an outbreak of measles in a district in Nigeria was initiated following confirmation of the outbreak.The objectives of the study were to assess the size and determine the cause of the outbreak. Methods:Visits were made to health facilities and affected communities.Cases were line-listed using specified forms and descriptive epidemiology carried out on collected data.Results:A total of 18 cases and 0 deaths were identified over a period of six weeks.Two of the cases(11%) were 【 9 months of age.The proportion of zero-dose children was 39%.Conclusion:Low herd immunity was suggested as the cause of the outbreak.
