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Citation

Winter, Amy K.; Wesolowski, Amy P.; Mensah, Keitly J.; Ramamonjiharisoa, Miora Bruna; Randriamanantena, Andrianmasina Herivelo; Razafindratsimandresy, Richter; Cauchemez, Simon; Lessler, Justin; Ferrari, Matthew J.; & Metcalf, C. Jessica E., et al. (2018). Revealing Measles Outbreak Risk with a Nested Immunoglobulin G Serosurvey in Madagascar. American Journal of Epidemiology, 187(10), 2219-2226. PMCID: PMC6166215

Abstract

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.

URL

http://dx.doi.org/10.1093/aje/kwy114

Reference Type

Journal Article

Year Published

2018

Journal Title

American Journal of Epidemiology

Author(s)

Winter, Amy K.
Wesolowski, Amy P.
Mensah, Keitly J.
Ramamonjiharisoa, Miora Bruna
Randriamanantena, Andrianmasina Herivelo
Razafindratsimandresy, Richter
Cauchemez, Simon
Lessler, Justin
Ferrari, Matthew J.
Metcalf, C. Jessica E.
Héraud, Jean-Michel

Article Type

Regular

PMCID

PMC6166215

Continent/Country

Madagascar

ORCiD

Lessler - 0000-0002-9741-8109