Challenges in measuring measles case fatality ratios in settings without vital registration.
Affiliation
Global Immunization Division, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-05, Atlanta, GA 30333, USA. kfc4@cdc.gov.Issue Date
2010
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Emerging Themes in EpidemiologyAbstract
ABSTRACT: Measles, a highly infectious vaccine-preventable viral disease, is potentially fatal. Historically, measles case-fatality ratios (CFRs) have been reported to vary from 0.1% in the developed world to as high as 30% in emergency settings. Estimates of the global burden of mortality from measles, critical to prioritizing measles vaccination among other health interventions, are highly sensitive to the CFR estimates used in modeling; however, due to the lack of reliable, up-to-date data, considerable debate exists as to what CFR estimates are appropriate to use. To determine current measles CFRs in high-burden settings without vital registration we have conducted six retrospective measles mortality studies in such settings. This paper examines the methodological challenges of this work and our solutions to these challenges, including the integration of lessons from retrospective all-cause mortality studies into CFR studies, approaches to laboratory confirmation of outbreaks, and means of obtaining a representative sample of case-patients. Our experiences are relevant to those conducting retrospective CFR studies for measles or other diseases, and to those interested in all-cause mortality studies.PubMed ID
20642812Additional Links
http://www.ete-online.comType
ArticleLanguage
enISSN
1742-7622ae974a485f413a2113503eed53cd6c53
10.1186/1742-7622-7-4
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