Abstract
BackgroundReduction of measles incidence and mortality has been encouraging in China. However, it remains an important public health concern among infants. This study aimed to examine the space–time distribution pattern of infant measles occurrence for the period of 1999–2008 in Shandong, China.Methods and FindingsMeasles cases among infants aged younger than 1 year were obtained from the national infectious diseases reporting information system. A spatiotemporal analysis using population attributable risk percent (PAR%) was used to distinguish between multiple geographic clusters of potential interest. The analysis detected 29 statistically significant space–time clusters with the most likely cluster in Zaozhuang City from 2006 to 2008. Of the 28 secondary clusters, 22 were found in 2008. The map of PAR%, relative risk (RR) and space–time cluster analysis indicated that the clusters were generally unchanged, and were found south-west and north-west of Shandong. The Lanshan District in Linyi had the highest PAR%, while highest RR was in the Yicheng District in Zaozhuang.ConclusionThere were significant space-time clusters of infant measles in Shandong over the study period. PAR% is an effective way to analyze multiple clusters from their application like RR. Interrupting measles circulation and maintaining routine coverage over 95% may be the only effective strategy to achieve measles elimination.
Highlights
Measles is one of the most important contagious vaccinepreventable diseases and causes millions of pediatric deaths worldwide
Interrupting measles circulation and maintaining routine coverage over 95% may be the only effective strategy to achieve measles elimination
The measles vaccine coverage among children by their first birthday has increased to 84% in 2011 from 72% in 2000, which was mainly attributed to the improved routine health service [2]
Summary
Measles is one of the most important contagious vaccinepreventable diseases and causes millions of pediatric deaths worldwide. As the goal of World Health Organization, reduction of measles incidence and mortality has achieved significant progress due to widespread use of measles vaccine since the 1980s [1]. The measles vaccine coverage among children by their first birthday has increased to 84% in 2011 from 72% in 2000, which was mainly attributed to the improved routine health service [2]. Re-emergence of measles cases has been of increasing concern in recent years. Reduction of measles incidence and mortality has been encouraging in China. It remains an important public health concern among infants. This study aimed to examine the space–time distribution pattern of infant measles occurrence for the period of 1999–2008 in Shandong, China
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