Evaluating the effectiveness of national measles elimination action in mainland China during 2004-2016: A multi-site interrupted time-series study.
Intervention effect
Measles in China
National Measles Elimination Action Plan
Spatiotemporal autocorrelation
Journal
Vaccine
ISSN: 1873-2518
Titre abrégé: Vaccine
Pays: Netherlands
ID NLM: 8406899
Informations de publication
Date de publication:
09 06 2020
09 06 2020
Historique:
received:
17
12
2019
revised:
13
04
2020
accepted:
20
04
2020
pubmed:
20
5
2020
medline:
28
4
2021
entrez:
20
5
2020
Statut:
ppublish
Résumé
To block transmission of measles, the China Ministry of Health endorsed the "2006-2012 National Measles Elimination Action Plan (NMEAP)" on November 11, 2006, while no published studies used mathematical models to assess the impact of this action. Also, the problem of residuals autocorrelation due to auto-correlated infectious disease data is often ignored in practice. Based on monthly counts of measles in 31 Chinese provinces during 2004-2016, a spatiotemporal auto-correlated mixed model was developed to assess the intervention effects over 10 years after the NMEAP, after controlling for seasonality and time-varying socioeconomic and meteorological factors. The first-order autoregression dynamic relationship was used to adjust the bias of conditional covariance in Quasi-likelihood function due to temporal autocorrelation and the spatial autoregressive term was used to capture the neighbor effects of adjacent provinces. There were a similar seasonal pattern and spatial differences of measles incidence among provinces, yet the spatiotemporal pattern was diminished after the intervention. The introduction of the NMEAP was associated with a reduction of 51.03% [excess risk (ER%) = -51.03%, 95% CI: -62.32% to -36.37%] in measles morbidity on average during the 10-year intervention period. The intervention effect varied with time. The significant effect was observed 15 months after the intervention onset, and then gradually increased to a stable level, but was weakened slightly after 2012. The effect of birth rate and meteorological factors on measles morbidity reduced after the NMEAP. There was clear evidence that prominent progress towards a goal of measles elimination had been achieved after the intervention, while the resurgence after 2012 indicated the goal for measles elimination by 2012 had not been reached.
Sections du résumé
BACKGROUND
To block transmission of measles, the China Ministry of Health endorsed the "2006-2012 National Measles Elimination Action Plan (NMEAP)" on November 11, 2006, while no published studies used mathematical models to assess the impact of this action. Also, the problem of residuals autocorrelation due to auto-correlated infectious disease data is often ignored in practice.
METHODS
Based on monthly counts of measles in 31 Chinese provinces during 2004-2016, a spatiotemporal auto-correlated mixed model was developed to assess the intervention effects over 10 years after the NMEAP, after controlling for seasonality and time-varying socioeconomic and meteorological factors. The first-order autoregression dynamic relationship was used to adjust the bias of conditional covariance in Quasi-likelihood function due to temporal autocorrelation and the spatial autoregressive term was used to capture the neighbor effects of adjacent provinces.
RESULTS
There were a similar seasonal pattern and spatial differences of measles incidence among provinces, yet the spatiotemporal pattern was diminished after the intervention. The introduction of the NMEAP was associated with a reduction of 51.03% [excess risk (ER%) = -51.03%, 95% CI: -62.32% to -36.37%] in measles morbidity on average during the 10-year intervention period. The intervention effect varied with time. The significant effect was observed 15 months after the intervention onset, and then gradually increased to a stable level, but was weakened slightly after 2012. The effect of birth rate and meteorological factors on measles morbidity reduced after the NMEAP.
CONCLUSIONS
There was clear evidence that prominent progress towards a goal of measles elimination had been achieved after the intervention, while the resurgence after 2012 indicated the goal for measles elimination by 2012 had not been reached.
Identifiants
pubmed: 32423770
pii: S0264-410X(20)30547-8
doi: 10.1016/j.vaccine.2020.04.053
pii:
doi:
Substances chimiques
Measles Vaccine
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
4440-4447Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.