Revealing Measles Outbreak Risk With a Nested Immunoglobulin G Serosurvey in Madagascar

Archive ouverte

Winter, Amy | Wesolowski, Amy | Mensah, Keitly | Ramamonjiharisoa, Miora Bruna | Randriamanantena, Andrianmasina Herivelo | Razafindratsimandresy, Richter | Cauchemez, Simon | Lessler, Justin | Ferrari, Matt, J | Metcalf, C Jess E | Heraud, Jean-Michel

Edité par CCSD ; Oxford University Press (OUP) -

International audience. Madagascar reports few measles cases annually and high vaccination campaign coverage. However, the underlying age profile of immunity and risk of a measles outbreak is unknown. We conducted a nested serological survey, testing 1,005 serum samples (collected between November 2013 and December 2015 via Madagascar's febrile rash surveillance system) for measles immunoglobulin G antibody titers. We directly estimated the age profile of immunity and compared these estimates with indirect estimates based on a birth cohort model of vaccination coverage and natural infection. Combining these estimates of the age profile of immunity in the population with an age-structured model of transmission, we further predicted the risk of a measles outbreak and the impact of mitigation strategies designed around supplementary immunization activities. The direct and indirect estimates of age-specific seroprevalence show that current measles susceptibility is over 10%, and modeling suggests that Madagascar may be at risk of a major measles epidemic.

• Description
• Sujet/Public
• Outil
• Outil d'anticipation
• Mémoire et thèse
• Gestion