Challenges in measuring measles case fatality ratios in settings without vital registration.
AffiliationGlobal Immunization Division, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-05, Atlanta, GA 30333, USA. email@example.com.
MetadataShow full item record
JournalEmerging Themes in Epidemiology
AbstractABSTRACT: 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.
- Measles mortality in India: a review of community based studies.
- Authors: Singh J, Sharma RS, Verghese T
- Issue date: 1994 Dec
- Case-fatality rate during a measles outbreak in eastern Niger in 2003.
- Authors: Nandy R, Handzel T, Zaneidou M, Biey J, Coddy RZ, Perry R, Strebel P, Cairns L
- Issue date: 2006 Feb 1
- Measles case fatality ratio in India a review of community based studies.
- Authors: Sudfeld CR, Halsey NA
- Issue date: 2009 Nov
- Drivers of measles mortality: the historic fatality burden of famine in Bangladesh.
- Authors: Mahmud AS, Alam N, Metcalf CJE
- Issue date: 2017 Dec
- Estimates of case-fatality ratios of measles in low-income and middle-income countries: a systematic review and modelling analysis.
- Authors: Portnoy A, Jit M, Ferrari M, Hanson M, Brenzel L, Verguet S
- Issue date: 2019 Apr