Local Public Health Services Research Articles

11.N. Skills building seminar: How can local public health services manage infodemics and fight misinformation?

Although misinformation has been an issue in previous public health emergencies such as black plague or spanish flu, COVID-19 pandemic highlighted its importance. Nowadays, information about health is produced so quickly that it becomes complicated to manage it efficiently. Not only scientific evidence production increased exponentially, other sources of non-validated information also emerged through websites, blogs and social media. Public health professionals must be aware of such relevant concepts, the cognitive theories that support them and what the main threats to population's health are - such as vaccine hesitancy, non compliance with public health measures and use of ineffective treatments. Due to their proximity to, and knowledge of communities, public health professionals are extremely important in infodemic management but should not neglect their online presence (particularly on social media) and the potential of partnerships with local organizations. The aim of this workshop is to provide an overview of public health services approach to infodemic management, including practical examples that can be applied by participants according to available resources.Infodemic management can be complex to handle at first, but particular areas should always be targeted in public health strategies. Social listening is a key step to understand communities' concerns and identify sources of misinformation. It provides an efficient approach to detecting rumours and eases community engagement in the response process. As a way to prevent the spread of misinformation, communities should be “inoculated” with high-quality, engaging health information which can be co-produced with citizens to increase engagement and efficiency. On the other hand, misinformation and disinformation must be countered rapidly but carefully, through fact-checking teams and collaboration with community leaders and media platforms to ensure rapid dissemination. Capacity building and training for public health professionals in infodemic management is an emergent need, the foundations of which can be introduced in this short session.This workshop will be held in a skills building seminar format facilitated by two alumni of the WHO infodemic management training It consists of four specific parts. First, we will provide a brief introduction on main infodemic concepts and cognitive theories, which will be applied in a brief online game called “Bad News”. Secondly, we will show how infodemic management can overlap common epidemic management, including focus in preparedness and monitoring. Then, we will showcase monitoring and social listening strategies and relevant interventions to prevent and tackle misinformation. Participants will be able to discuss examples of their own experiences or of those shared by panelists. Finally, we will provide useful links for more comprehensive training and practical tools that can be used at both local and national level.Key messages The overabundance of health information can be harmful. Infodemic management strategies are fundamental in dealing effectively with this public health threat.Public health services should be prepared to identify and respond to health misinformation, adapting it according to available resources and local contexts and reinforcing it through collaborations.

Evolution of Coronavirus Disease 2019 (COVID-19) Symptoms During the First 12 Months After Illness Onset.

BackgroundFew robust longitudinal data on long-term coronavirus disease 2019 (COVID-19) symptoms are available. We evaluated symptom onset, severity and recovery across the full spectrum of disease severity, up to one year after illness onset.MethodsThe RECoVERED Study is a prospective cohort study based in Amsterdam, the Netherlands. Participants aged ≥18 years were enrolled following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnosis via the local public health service and from hospitals. Standardized symptom questionnaires were completed at enrollment, 1 week and month later, and monthly thereafter. Clinical severity was defined according to World Health Organization (WHO) criteria. Kaplan-Meier methods were used to compare time from illness onset to symptom recovery, by clinical severity. We examined determinants of time to recovery using multivariable Cox proportional hazards models.ResultsBetween 11 May 2020 and 1 May 2021, 342 COVID-19 patients (192 [56%] male) were enrolled, of whom 99/342 (29%) had mild, 145/342 (42%) moderate, 56/342 (16%) severe, and 42/342 (12%) critical disease. The proportion of participants who reported at least 1 persistent symptom at 12 weeks after illness onset was greater in those with severe/critical disease (86.7% [95% confidence interval {CI} = 76.5–92.7%]) compared to those with mild or moderate disease (30.7% [95% CI = 21.1–40.9%] and 63.8% [95% CI = 54.8–71.5%], respectively). At 12 months after illness onset, two-fifths of participants (40.7% [95% CI = 34.2–7.1]) continued to report ≥1 symptom. Recovery was slower in female compared to male participants (adjusted hazard ratio [aHR] 0.65 [95% CI = .47–.92]) and those with a body mass index [BMI] ≥30kg/m2 compared to BMI <25kg/m2 (hazard ratio [HR] 0.62 [95% CI = .39–.97]).ConclusionsCOVID-19 symptoms persisted for one year after illness onset, even in some individuals with mild disease. Female sex and obesity were the most important determinants of speed of recovery from symptoms.

Ethnobotanical inventory of medicinal plants used by specialists in the treatment and cure of diseases in riverside communities in the amazon

The research aimed to learn about the socioeconomic profile and medicinal plants used by local specialists from three riverside communities in the municipality of Porto de Moz, Pará, Brazil. The data was collected with 10 specialists through a semi-structured questionnaire. Local specialists are mostly women (80%), with low income and a low education level. 83 medicinal ethnospecies were identified. The Lamiaceae and Fabaceae families were the most representative in the study area with 9 and 10 species, respectively. The Dysphania ambrosioides (18%) species was the most referenced one. Most of the recommendations regarding use of the medication are related to unclassified signs and symptoms, with 48 references. The young members in the communities exhibit low interest in medicinal plants. The precariousness of local public health services enhances the use of medicinal plants. The medicinal knowledge of local specialists assists in the prevention, treatment and cure of illnesses based on traditional medicine empiricism.

Edukasi Program Posyandu dimasa Pandemi Covid-19 sebagai Upaya Membentuk Persepsi Masyarakat di Wilayah Kerja Posyandu Cempaka Kelurahan Kuin Selatan Kota Banjarmasin

The purpose of this service activity is to increase public knowledge, especially mothers who have babies or children under five years (balita), about the posyandu program. Before starting counseling, a questionnaire was filled (pretest). Counseling uses power point media with the lecture, discussion and question and answer method, then after being given counseling, the same questionnaire was distributed again to be filled back (posttest), after the knowledge data before and after counseling had been obtained, then the data were analyzed using the Wilcoxon statistical test.Based on the results of community service activities in the work area of the Banjarmasin Kuin Selatan Village Cempaka Posyandu, it means that there is a significant difference in knowledge between before and after counseling using power point media, thus it can be concluded that the method of extension using power point media carried out in the work area of the Banjarmasin Kuin Selatan Village Cempaka Posyandu is able and successful in increasing the knowledge of mothers who have chldren under five years. It is recommended that the local public health service (puskesmas) can provide more intensive guidance and training to posyandu cadres, so that they can assist health workers in educating the public about health in general and information about the importance of posyandu and the activities at the posyandu itself as an effort to participate forming a positive perception of the posyandu

Short report: The potential of PCR on skin flakes from bed linens for diagnosis of scabies in an outbreak.

BackgroundScabies outbreaks are common in nursing homes in the Netherlands. In October 2018, a local public health service (PHS) in The Hague was notified of a new scabies outbreak in a nursing home in that region. The PHS initiated an outbreak investigation. Cases were defined as: possible (reported symptoms), probable (scabies-like lesions) and confirmed (PCR or microscopy in skin flakes). Head-to-toe examinations were performed of all residents and those staff members who reported symptoms suggestive of scabies. Skin scrapings of lesions were tested either with microscopy or by PCR. Experimentally for case finding, skin flakes from bed linens of residents who reported symptoms of itchiness but did not have primary lesions were sent for PCR testing.Principal findingsAll residents (41) and 37/44 staff were included in this outbreak investigation. We identified 30 possible, four probable and six confirmed cases. The overall attack rate for probable/confirmed cases was 10/78 (13%). Of the six confirmed cases, two were confirmed by PCR, three by microscopy, and one showed positive findings with both techniques. Two out of the three bed-linen specimens were PCR-positive.ConclusionsIn this outbreak of scabies in a nursing home, PCR was used on skin flakes from bed linens, which led to the detection of two additional cases. This illustrates the potential of PCR during the investigation of scabies outbreaks.

Rethinking vaccine hesitancy among minority groups

Rethinking vaccine hesitancy among minority groups

Establishment and associated factors of health records among young Chinese migrants

BackgroundMost Chinese migrants have been faced with obstacles to getting access to local public health services. Young migrants among internal migrants make a major contribution to the economy. However, the establishment of their health records has been ignored. This research was aimed at exploring the status and associated factors of the establishment of health records among young Chinese migrants.MethodsData were obtained from the 2017 China Migrants Dynamic Survey (CMDS). Chi-square test and binary logistic regression were performed to investigate the associated factors of the establishment of health records among young Chinese migrants.ResultsApproximately 30.2% of young migrants had their health records established in inflow communities. Urban residence, medical insurance (insured), and lower average monthly household income were attributed to the establishment of more health records. Young migrants who were in northeast China and across provinces and immigrated for working or engaging in trade were less likely to have health records established. Young migrants who participated in social activities and public affairs activities and took type of people in touch as natives in the inflow area showed a higher possibility of establishing health records. Meanwhile, receiving health education and hearing about national basic public health services (BPHSs) were beneficial for establishing the health records of more young migrants.ConclusionThis study showed that the health records of young migrants had a relatively low establishment rate. Sociodemographic and migration characteristics, health status, public health services, and social integration factors were all related to the health record establishment of young Chinese migrants.

Books: Blinded by Corona. How the Pandemic Ruined Britain’s Health and Wealth and What to do About it

John Ashton Gibson Square Books, 2020, PB, 254pp, £12.99, 978-1783341955 The respected public health physician John Ashton places the government, its advisors, and Public Health England (PHE) squarely in his sights in this devastating, at times polemical, analysis of the early months of the COVID-19 crisis in Britain. After a brief survey of pandemics through history he considers changes to the structure of public health in Britain since 1974, reserving his major criticism for the effects of austerity in 2008 and Andrew Lansley’s 2012 NHS reforms, which he asserts emasculated local public health services and prioritised central control from PHE. Ashton examines the origins of the novel coronavirus in China, the early Lancet paper that alerted the world to its seriousness, the tragic story of whistleblower Li Wenliang, and the disease’s progression to Britain. He recounts sounding the alarm bell on 1 February shortly after WHO declared a ‘public health emergency of international concern’ , and describes the initially secretive …

An institutional ethnography of political and legislative factors shaping online sexual health service implementation in Ontario, Canada

ABSTRACT Public health scholarship is increasingly attuned to the structural determinants of health, such as the associations between macro-level policy and population health outcomes. Yet the ways public healthcare services are specifically made available through political and legislative decisions remain relatively under-explored. Using the critical research strategy of institutional ethnography, this study charts how political leadership transitions and legislative processes animate local public health service implementation activities. We investigated the feasibility of introducing an online sexually transmitted and blood-borne infections (STBBI) testing service to improve sexual healthcare access for gay, bisexual, queer, and other men who have sex with men in Ontario, Canada. Data were collected between June 2019 and June 2020. We conducted interviews with healthcare providers, sexual health program developers and managers, and other public health professionals with expertise in STBBI testing (n = 23), stakeholder meeting observations, and analyses of key texts (e.g. provincial policies and legislation). We uncovered that interpretations of provincial legislation posed a barrier to the online STBBI testing model, and we explicated the work of gaining decision-maker support for this new service during a period of austerity. In response to the election of political leadership who de-funded local public health, participants strategically framed arguments in favour of online testing using discourses of evidence, equity, and cost savings. Our article provides an empirical case study of the mechanisms by which political and legal dimensions direct the implementation of health services, shaping population health outcomes, and health equity in turn.

The Relationship Between Homeownership and the Utilization of Local Public Health Services Among Rural Migrants in China: A Nationwide Cross-Sectional Study.

Background: Rural–urban migrants frequently suffer from overrepresented health risks but have poor access to public health services. In China, homeownership status may play a vital role in obtaining local welfare. However, the relationship between homeownership and utilization of public health services has remained largely unexplored. This study aims to address the direct linkage between homeownership and utilization of local public health services among rural migrants in China.Methods: We applied the dataset from the 2017 National Migrants Population Dynamic Monitoring Survey (NMPDMS-2017) to explore the direct relationship between homeownership and the utilization of local public health services. Logit regression was conducted to discuss the associations and to explore the interaction effect.Results: The logit estimations reveal that homeownership is positively related to the establishment of a health record and participation in health education. The interaction term of homeownership and household location and the interaction between homeownership and healthcare center location are related to the increased establishment of a health record. However, the interaction of homeownership and household location merely reveals significant correlations with the health education model.Conclusion: Homeownership is positively associated with the utilization of local public health services among rural migrants in China. Furthermore, homeowners living in urban residential communities and within the vicinity of the healthcare center are more likely to access public health services than those living in other locations.

All‐of‐government response to the COVID‐19 pandemic: The case of Vietnam

All‐of‐government response to the COVID‐19 pandemic: The case of Vietnam

Heat waves and mortality: developing a local prediction model based on two kinds of heat waves

Abstract Background Heat waves (HW) will tend to have a higher impact on mortality due to climate change. The aim of this study was to develop a tailored model to predict local mortality associated to HW. Methods In this ecological study, daily temperature and daily mortality were collected from May to October of 1980 to 2017 in Coimbra, Portugal. Two definitions of HW were used: more than two consecutive days of maximum temperature (MaxT) or minimum temperature (MinT) above percentile 95 for the periods in question. Attributable general mortalities with 13 and 30 lag days were calculated and then converted to attributable general mortality rates adjusted to the resident population. Bivariate and multivariate analyses with SPSS statistics were performed with the following independent variables for each HW: MaxT, diurnal temperature variation (DTV), mean of the mean daily temperatures, month, ageing index (AI), ordinal number of the HW for that year (ONHW), duration, overlapping of another HW and existence of a public health contingency plan. Results The multivariate analyses returned a R2=0,19 for the MaxT model (MaxTM) for both 13 and 30 lag days and a R2=0,51 for the MinT model (MinTM) with 13 lag days and R2=0,45 for 30 lag days. DTV was the only variable with statistical significance in the MaxTM (p &amp;lt; 0,023; β = 0,44 for 13 lag days and p &amp;lt; 0,024; β = 0,43 for 30 lag days). In the MinTM model two variables had statistical significance: AI (p &amp;lt; 0,008; β = 1,72 for 13 lag days and p &amp;lt; 0,037; β = 0,44 for 30 lag days) and ONHW (p &amp;lt; 0,038; β= -0,44 for 30 lag days). Conclusions MaxTM and MinTM had different predictability potentials with different statistical significant independent variables. This may mean HW defined by MaxT have impact in a distinct way from HW defined by MinT. Further development of these models that include acclimatization indexes and causes of mortality may help local public health services to create more efficient, selective contingency plans. Key messages Minimum and maximum temperature defined heat waves may impact mortality differently. Local heat wave/mortality models may contribute to more efficient, selective contingency plans than regional models.

COVID-19 compassion in self-isolating old age: looking forward from family to regional and global concerns

Self-isolating with my wife, I feel gratitude and compassion for all those supporting us, particularly those who regularly deliver our food and our immediate family members who check on us frequently. My compassion goes out to those on the “frontline”, particularly my niece and her daughter who are both nurses in a major hospital and who developed and recovered from COVID-19 symptoms. More broadly, I recognise that there are many communities that have had to cope with both geophysical and socio-politically created disasters while facing the COVID-19 pandemic, among then some young women bee-keepers in Uganda. In the UK context, I have great concern that severe funding cuts for regional and local public health services and disaster planning handicapped the country’s response to coronavirus and may have been a factor in the UK’s high coronavirus death rate. I see both positive and negative changes in air pollution and urban nature in our towns and cities, but also am concerned that we collectively may lose sight of the greater crises of climate change and species extinction. We have to work for a better future by taking forward the opportunities and lessons from our reactions to the pandemic. This leads to compassion for the yet unborn, our grandchildren’s children, who might enter a less habitable, more unequal less collaborative world than the imperfect one we now enjoy.

Perceived oral health interventions by medical providers in Gugulethu, South Africa.

The purpose of this study was to explore factors that impact patients' ability to access high quality, expeditious oral health care by understanding medical professionals' knowledge of oral health, the care they provide to patients presenting with oral health complaints, and their perceptions of potential interventions to improve oral health care delivery. We conducted in depth qualitative interviews, which were analyzed using an inductive content analytical approach. The study was conducted in Gugulethu, a community located outside of Cape Town, South Africa. Local public sector health services provided free-of-charge are the main source of primary health and dental care for this population. Participants included the following medical providers: doctors, clinical nurse practitioners, professional nurses, and health promoters. Identified themes fell within the three broad subject areas: oral health knowledge, patient care, and potential interventions. Themes within oral health knowledge included (1) personal responsibility for hygiene, (2) routine oral health care, (3) lack of knowledge among medical professionals, (4) poverty, and (5) an oral-systemic connection. Participants cited both 'clinical care knowledge' and/or 'uncertainty' about patient care for oral health complaints. Participants independently suggested interventions in three broad areas: (1) education, (2) expanded provider roles, and (3) colocation of services. Our findings suggest that a variety of interventions, ranging from high to low resource investment, may impact access to and utilization of oral health services and thereby result in improved patient care. Future studies should develop and evaluate the suggested interventions in a range of care settings.

What Accounts for Physical Activity during Pregnancy? A Study on the Sociodemographic Predictors of Self-Reported and Objectively Assessed Physical Activity during the 1st and 2nd Trimesters of Pregnancy.

Physical activity (PA) during pregnancy has positive health implications for both mother and child. However, current literature indicates that not all pregnant women meet the international recommendations for PA (at least 150 min/week of moderate-to-vigorous PA). The main objective of this study was to assess PA levels among pregnant women in the city of Donostia-San Sebastian and identify their main sociodemographic predictors. We recruited 441 women in the 12th week of pregnancy from the local public obstetric health services. Women wore an accelerometer for one week during two separate time points (1st and 2nd trimesters of pregnancy) and completed a questionnaire assessing several sociodemographic variables as well as self-reported PA. With this information, we estimated women’s overall PA levels during both time points. The fulfillment of PA recommendations raised up to 77% and 85% during the first and second trimesters, respectively. We found that a higher number of children and a greater preference for exercise positively predicted light-to-moderate PA, being the most consistent predictors. The availability of a greater number of cars negatively predicted moderate-to-vigorous PA.

BRCA1 and BRCA2 germline testing in Cretan isolates reveals novel and strong founder effects.

Germline BRCA1 and BRCA2 loss-of-function variants have been linked to increased breast and ovarian cancer risk, with more than 5,000 distinct pathogenic variants being reported worldwide. Among individuals of Greek descent, the BRCA1/2 variant spectrum is heterogeneous, but characterized by strong founder effects. As patients from certain geographical regions of Greece (like Crete) were underrepresented in previous studies, we hypothesized that isolated Cretans, a southern Greece islanders' population with distinct demographic, cultural and genetic features, could harbor founder BRCA1/2 mutations. A total of 304 breast or/and ovarian cancer patients of Cretan descent, fulfilling NCCN criteria for genetic testing, were tested by NGS or Sanger sequencing, followed by MLPA. Haplotype analysis was subsequently performed to investigate potential founder effects of recurrent alleles. Overall, 16.5% (50/304) of the tested patients carried 22 different pathogenic variants; 48% in BRCA1, 52% in BRCA2. Three variants, namely two in BRCA2 (Δexons 12 and 13 and c.7806-2A>T) and one in BRCA1 (c.5492del), constituting approximately half (48%) of all detected pathogenic variants, were shown to have a founder effect, with all carriers sharing common haplotypes. Remarkably, these variants were confined to Cretans and have not been identified in other regions of Greece. The high prevalence of specific BRCA1/2 pathogenic variants among Cretans, provides the possibility of cost- and time-efficient screening of the Cretan population. Integrating this knowledge in local public health services may have a significant impact on cancer prevention, and may serve as a starting point for the implementation of testing on a population level.

Housing Demand in Urban Areas and Sanitary Requirements of Dwellings in Italy.

The phenomenon of urbanisation is becoming increasingly prevalent on a global level, and the health issues regarding the urban environment are of primary importance in public health. Accordingly, the present manuscript describes an analysis of the housing conditions of Italian urban areas, referring to the city of Sassari (Sardinia), Italy, focused on the dwelling structural and sanitary conditions issued by the Italian regulations. Data relating to the housing conditions of the population were acquired by the Local Hygiene and Public Health Service (SISP), in a period between 2012 and 2016. Qualitative variables were summarised with absolute and relative (percentages) frequencies, whereas quantitative variables with means and standard deviations depending on their parametric distribution. Statistical comparisons for qualitative and quantitative variables were performed with the χ2 test or Student's t-test, respectively. A p value less than 0.05 was considered statistically significant. Finally, the dwellings and the collected variables were georeferenced on a city map. During the 2012–2016 observation period, 363 certification requests were received from 193 (53.2%) foreign-born citizens and 170 (46.8%) Italians at the SISP offices. The main reasons relate to the request for a residency permit (46.6%) and to obtain a subsidy from the local government (32.8%). Overall, 15.4% of dwellings were found to be improper, while 35.3% and 22.0% were found to be unhygienic and uninhabitable, respectively. The foreigners' homes were found to be suitable in 82.7% of cases; the housing of Italian citizens, on the contrary, was found to be suitable in 28% of the observations. The present study offers a cross section of the housing conditions of Italian urban areas, referring to the city of Sassari. To the authors' best knowledge, this observation is the first one carried out in Sardinia and one of the first observations in Italy. It has emerged that “hygienically unsuitable” homes are those that, in most cases, are located in the city centre. Moreover, the Italian population is hit by a significant housing problem, due to overcrowding, uninhabitability, and unhygienic conditions. Overall, our findings suggest that it is necessary to develop a multidisciplinary approach to guarantee public health, with safe dwellings homes and the surrounding urban context alongside the development of social relations. Nevertheless, there is still little evidence available today on the population housing conditions, especially regarding the private indoor environment, and further research is needed to bridge this knowledge gap.

What price public health? Funding the local public health system in England post-2013

ABSTRACT In April 2013 the local public health function in England was returned from the National Health Service (NHS) to local government, reversing the transfer to the NHS made in 1974 with the abolition of the medical officer of health. Although many in the field had long felt that local government was the appropriate home for public health given its wide-ranging responsibilities for the social determinants of health, the timing was poor. Local government was in the third year of what continued to be an unprecedented ten-year period of austerity imposed by central government with cumulative cuts of the order of 40% for many local authorities. And despite an initial commitment to a ring-fenced public health grant, this grant has been cut each year since 2015–2016 in addition to the wider local authority funding cuts which have had inevitable knock-on effects on the public health function. Crucial public health services such as early years, smoking cessation and sexual health services have all been cut. Despite these cuts the UK government continues to claim a commitment to improving public health and tackling inequalities in health. This study examines the government’s discourse on funding local public health services, and the ways in which it has responded to critics through a detailed documentary analysis of key government white papers, ministerial statements and its responses to criticisms, particularly from parliamentary select committees and professional bodies. The paper concludes by considering the implications for effective local public health action in a national regime of austerity.

Challenges and lessons learned in promoting adoption of standardized local public health service delivery data through the application of the Public Health Activities and Services Tracking model.

Population-level prevention activities are often publicly invisible and excluded in planning and policymaking. This creates an incomplete picture of prevention service-related inputs, particularly at the local level. We describe the process and lessons learned by the Public Health Activities and Services Tracking team in promoting adoption of standardized service delivery measures developed to assess public health inputs and guide system transformations. The 3 factors depicted in our Public Health Activities and Services Tracking model-data need and use, data access, and standardized measures-must be realized to promote collection of standard public health system data. Bureaucratic, resource, system, and policy challenges hampered our efforts toward adoption of the standardized measures we promoted. Substantial investments of time, resources, and coordination appear necessary for systems to adopt changes needed for collecting comparable service delivery data. Lessons from our process of promoting adoption of standardized measures provide recommendations to support future efforts to measure public health system contributions to the public's health.

Economic burden and associated factors of measles patients in Zhejiang Province, China

ABSTRACTThis study aimed to figure out the economic burden of measles patients and explore the associated factors for total cost in measles cases that occurred in the year 2015 from Jiaxing, Jinhua, and Taizhou cities in Zhejiang Province, China. Direct interviews were conducted to collect information on patient expenses during treatment, including outpatient expenses, hospitalization expenses, self-treatment fees, productivity loss, and transportation fees. Descriptive epidemiological methods and chi-square tests were used to assess the direct and indirect cost of measles patients. Ordinal logistic regression was applied to explore the possible factors contributing to cost. A total of 136 measles cases were investigated and the average direct cost, indirect cost, and total cost were #747.14, #520.12, and #1,267.26, respectively. Direct cost accounted for 58.96% of the total cost, which was significantly higher than the indirect cost (P < 0.001). In 2015, 1,386 confirmed cases were reported in the Zhejiang Province, and the overall direct, indirect, and total economic burden reached #1.04 million, #0.72 million, and #1.76 million, respectively. Quality-adjusted life years for measles patient were calculated to be 76.06 in Zhejiang, 2015. Hospitalization, occupation, complication, disease duration, age, and site had a significant influence on the total cost according to ordinal logistic regression, with the maximum contribution from hospitalization. Measles resulted in heavy economic burdens, and local public health departments or community health service centers should spare no effort to maintain a high rate of vaccination coverage and protect susceptible populations.