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Estimates of case-fatality ratios of measles in low-income and middle-income countries: a systematic review and modelling analysis
BACKGROUND: In the 21st century, increases in immunisation coverage and decreases in under-5 mortality have substantially reduced the global burden of measles mortality. However, the assessment of measles mortality burden is highly dependent on estimates of case-fatality ratios for measles, which ca...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Ltd
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6418190/ https://www.ncbi.nlm.nih.gov/pubmed/30797735 http://dx.doi.org/10.1016/S2214-109X(18)30537-0 |
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author | Portnoy, Allison Jit, Mark Ferrari, Matthew Hanson, Matthew Brenzel, Logan Verguet, Stéphane |
author_facet | Portnoy, Allison Jit, Mark Ferrari, Matthew Hanson, Matthew Brenzel, Logan Verguet, Stéphane |
author_sort | Portnoy, Allison |
collection | PubMed |
description | BACKGROUND: In the 21st century, increases in immunisation coverage and decreases in under-5 mortality have substantially reduced the global burden of measles mortality. However, the assessment of measles mortality burden is highly dependent on estimates of case-fatality ratios for measles, which can vary according to geography, health systems infrastructure, prevalence of underlying risk factors, and measles endemicity. With imprecise case-fatality ratios, there is continued uncertainty about the burden of measles mortality and the effect of measles vaccination. In this study, we aimed to update the estimations of case-fatality ratios for measles, to develop a prediction model to estimate case-fatality ratios across heterogeneous groupings, and to project future case-fatality ratios for measles up to 2030. METHODS: We did a review of the literature to identify studies examining measles cases and deaths in low-income and middle-income countries in all age groups from 1980 to 2016. We extracted data on case-fatality ratios for measles overall and by age, where possible. We developed and examined several types of generalised linear models and determined the best-fit model according to the Akaike information criterion. We then selected a best-fit model to estimate measles case-fatality ratios from 1990 to 2015 and projected future case-fatality ratios for measles up to 2030. FINDINGS: We selected 124 peer-reviewed journal articles published between Jan 1, 1980, and Dec 31, 2016, for inclusion in the final review—85 community-based studies and 39 hospital-based studies. We selected a log-linear prediction model, resulting in a mean case-fatality ratio of 2·2% (95% CI 0·7–4·5) in 1990–2015. In community-based settings, the mean case-fatality ratio was 1·5% (0·5–3·1) compared with 2·9% (0·9–6·0) in hospital-based settings. The mean projected case-fatality ratio in 2016–2030 was 1·3% (0·4–3·7). INTERPRETATION: Case-fatality ratios for measles have seen substantial declines since the 1990s. Our study provides an updated estimation of case-fatality ratios that could help to refine assessment of the effect on mortality of measles control and elimination programmes. FUNDING: Bill & Melinda Gates Foundation. |
format | Online Article Text |
id | pubmed-6418190 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Elsevier Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-64181902019-03-26 Estimates of case-fatality ratios of measles in low-income and middle-income countries: a systematic review and modelling analysis Portnoy, Allison Jit, Mark Ferrari, Matthew Hanson, Matthew Brenzel, Logan Verguet, Stéphane Lancet Glob Health Article BACKGROUND: In the 21st century, increases in immunisation coverage and decreases in under-5 mortality have substantially reduced the global burden of measles mortality. However, the assessment of measles mortality burden is highly dependent on estimates of case-fatality ratios for measles, which can vary according to geography, health systems infrastructure, prevalence of underlying risk factors, and measles endemicity. With imprecise case-fatality ratios, there is continued uncertainty about the burden of measles mortality and the effect of measles vaccination. In this study, we aimed to update the estimations of case-fatality ratios for measles, to develop a prediction model to estimate case-fatality ratios across heterogeneous groupings, and to project future case-fatality ratios for measles up to 2030. METHODS: We did a review of the literature to identify studies examining measles cases and deaths in low-income and middle-income countries in all age groups from 1980 to 2016. We extracted data on case-fatality ratios for measles overall and by age, where possible. We developed and examined several types of generalised linear models and determined the best-fit model according to the Akaike information criterion. We then selected a best-fit model to estimate measles case-fatality ratios from 1990 to 2015 and projected future case-fatality ratios for measles up to 2030. FINDINGS: We selected 124 peer-reviewed journal articles published between Jan 1, 1980, and Dec 31, 2016, for inclusion in the final review—85 community-based studies and 39 hospital-based studies. We selected a log-linear prediction model, resulting in a mean case-fatality ratio of 2·2% (95% CI 0·7–4·5) in 1990–2015. In community-based settings, the mean case-fatality ratio was 1·5% (0·5–3·1) compared with 2·9% (0·9–6·0) in hospital-based settings. The mean projected case-fatality ratio in 2016–2030 was 1·3% (0·4–3·7). INTERPRETATION: Case-fatality ratios for measles have seen substantial declines since the 1990s. Our study provides an updated estimation of case-fatality ratios that could help to refine assessment of the effect on mortality of measles control and elimination programmes. FUNDING: Bill & Melinda Gates Foundation. Elsevier Ltd 2019-02-21 /pmc/articles/PMC6418190/ /pubmed/30797735 http://dx.doi.org/10.1016/S2214-109X(18)30537-0 Text en © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Portnoy, Allison Jit, Mark Ferrari, Matthew Hanson, Matthew Brenzel, Logan Verguet, Stéphane Estimates of case-fatality ratios of measles in low-income and middle-income countries: a systematic review and modelling analysis |
title | Estimates of case-fatality ratios of measles in low-income and middle-income countries: a systematic review and modelling analysis |
title_full | Estimates of case-fatality ratios of measles in low-income and middle-income countries: a systematic review and modelling analysis |
title_fullStr | Estimates of case-fatality ratios of measles in low-income and middle-income countries: a systematic review and modelling analysis |
title_full_unstemmed | Estimates of case-fatality ratios of measles in low-income and middle-income countries: a systematic review and modelling analysis |
title_short | Estimates of case-fatality ratios of measles in low-income and middle-income countries: a systematic review and modelling analysis |
title_sort | estimates of case-fatality ratios of measles in low-income and middle-income countries: a systematic review and modelling analysis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6418190/ https://www.ncbi.nlm.nih.gov/pubmed/30797735 http://dx.doi.org/10.1016/S2214-109X(18)30537-0 |
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