Abstract:
BACKGROUND:Vaccination has reduced the global incidence of measles to the lowest rates in history. However, local interruption of measles virus transmission requires sustained high levels of population immunity that can be challenging to achieve and maintain. The herd immunity threshold for measles is typically stipulated at 90-95%. This figure does not easily translate into age-specific immunity levels required to interrupt transmission. Previous estimates of such levels were based on speculative contact patterns based on historical data from high-income countries. The aim of this study was to determine age-specific immunity levels that would ensure elimination of measles when taking into account empirically observed contact patterns. METHODS:We combined estimated immunity levels from serological data in 17 countries with studies of age-specific mixing patterns to derive contact-adjusted immunity levels. We then compared these to case data from the 10 years following the seroprevalence studies to establish a contact-adjusted immunity threshold for elimination. We lastly combined a range of hypothetical immunity profiles with contact data from a wide range of socioeconomic and demographic settings to determine whether they would be sufficient for elimination. RESULTS:We found that contact-adjusted immunity levels were able to predict whether countries would experience outbreaks in the decade following the serological studies in about 70% of countries. The corresponding threshold level of contact-adjusted immunity was found to be 93%, corresponding to an average basic reproduction number of approximately 14. Testing different scenarios of immunity with this threshold level using contact studies from around the world, we found that 95% immunity would have to be achieved by the age of five and maintained across older age groups to guarantee elimination. This reflects a greater level of immunity required in 5-9-year-olds than established previously. CONCLUSIONS:The immunity levels we found necessary for measles elimination are higher than previous guidance. The importance of achieving high immunity levels in 5-9-year-olds presents both a challenge and an opportunity. While such high levels can be difficult to achieve, school entry provides an opportunity to ensure sufficient vaccination coverage. Combined with observations of contact patterns, further national and sub-national serological studies could serve to highlight key gaps in immunity that need to be filled in order to achieve national and regional measles elimination.
journal_name
BMC Medjournal_title
BMC medicineauthors
Funk S,Knapp JK,Lebo E,Reef SE,Dabbagh AJ,Kretsinger K,Jit M,Edmunds WJ,Strebel PMdoi
10.1186/s12916-019-1413-7subject
Has Abstractpub_date
2019-09-25 00:00:00pages
180issue
1issn
1741-7015pii
10.1186/s12916-019-1413-7journal_volume
17pub_type
杂志文章相关文献
BMC Medicine文献大全abstract:BACKGROUND:The 2012 World Health Assembly set a target for Member States to reduce premature non-communicable disease (NCD) mortality by 25% over the period 2010 to 2025. This reflected concerns about increasing NCD mortality burdens among productive adults globally. This article first considers whether the WHO target ...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-015-0313-8
更新日期:2015-03-30 00:00:00
abstract:BACKGROUND:Ancestral environmental exposures to a variety of environmental factors and toxicants have been shown to promote the epigenetic transgenerational inheritance of adult onset disease. The present work examined the potential transgenerational actions of the insecticide dichlorodiphenyltrichloroethane (DDT) on o...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-11-228
更新日期:2013-10-23 00:00:00
abstract:BACKGROUND:Guidelines recommend that clinicians should make brief opportunistic behavioural interventions to patients who are obese to increase the uptake of effective weight loss programmes. The objective was to assess the effect of this policy on socioeconomic equity. METHODS:One thousand eight hundred eighty-two co...
journal_title:BMC medicine
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12916-019-1284-y
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:The TransEurope FootRace 2009 (TEFR09) was one of the longest transcontinental ultramarathons with an extreme endurance physical load of running nearly 4,500 km in 64 days. The aim of this study was to assess the wide spectrum of adaptive responses in humans regarding the different tissues, organs and functi...
journal_title:BMC medicine
pub_type: 杂志文章,随机对照试验
doi:10.1186/1741-7015-10-78
更新日期:2012-07-19 00:00:00
abstract:BACKGROUND:Lethal and edema toxins secreted by Bacillus anthracis during anthrax infection were found to incite serious cardiovascular complications. However, the underlying mechanisms in anthrax lethal toxin-induced cardiac anomalies remain unknown. This study was designed to evaluate the impact of antioxidant enzyme ...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-10-134
更新日期:2012-11-07 00:00:00
abstract::Breast cancer is the most common cause of cancer and cancer death worldwide. Although most patients present with localized breast cancer and may be rendered disease-free with local therapy, distant recurrence is common and is the primary cause of death from the disease. Adjuvant systemic therapies are effective in red...
journal_title:BMC medicine
pub_type: 杂志文章,评审
doi:10.1186/s12916-015-0439-8
更新日期:2015-08-17 00:00:00
abstract:BACKGROUND:In an era when obesity prevalence is high throughout much of the world, there is a correspondingly pervasive and strong culture of weight stigma. For example, representative studies show that some forms of weight discrimination are more prevalent even than discrimination based on race or ethnicity. DISCUSSI...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-018-1116-5
更新日期:2018-08-15 00:00:00
abstract:BACKGROUND:We aimed to show the non-inferiority of home fortification with a daily dose of 3 mg iron in the form of iron as ferric sodium ethylenediaminetetraacetate (NaFeEDTA) compared with 12.5 mg iron as encapsulated ferrous fumarate in Kenyan children aged 12-36 months. In addition, we updated a recent meta-analysi...
journal_title:BMC medicine
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12916-017-0839-z
更新日期:2017-04-28 00:00:00
abstract::Verotoxigenic Escherichia coli (VTEC) are a specialized group of E. coli that can cause severe colonic disease and renal failure. Their pathogenicity derives from virulence factors that enable the bacteria to colonize the colon and deliver extremely powerful toxins known as verotoxins (VT) or Shiga toxins (Stx) to the...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-10-12
更新日期:2012-02-02 00:00:00
abstract:BACKGROUND:The World Health Organisation (WHO) recommends parasitological diagnosis of malaria before treatment, but use of malaria rapid diagnostic tests (mRDTs) by community health workers (CHWs) has not been fully tested within health services in south and central Asia. mRDTs could allow CHWs to diagnose malaria acc...
journal_title:BMC medicine
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12916-017-0891-8
更新日期:2017-07-07 00:00:00
abstract:BACKGROUND:Depression in tuberculosis increases the risk for adverse health outcomes. However, little is known about comorbid depression and tuberculosis in the general population. Thus, we assessed the association between depression and tuberculosis, and the decrements in health status associated with this comorbidity...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-017-0975-5
更新日期:2017-11-28 00:00:00
abstract:BACKGROUND:Chronic fatigue syndrome (CFS) is a complex multifactorial disorder. This paper reports the prevalence of chronic fatigue (CF) and CFS in an ethnically diverse population sample and tests whether prevalence varies by social adversity, social support, physical inactivity, anxiety and depression. METHODS:Anal...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-9-26
更新日期:2011-03-21 00:00:00
abstract:BACKGROUND:Fetal and neonatal mortality rates in low-income countries are at least 10-fold greater than in high-income countries. These differences have been related to poor access to and poor quality of obstetric and neonatal care. METHODS:This trial tested the hypothesis that teams of health care providers, administ...
journal_title:BMC medicine
pub_type: 杂志文章,随机对照试验
doi:10.1186/1741-7015-11-215
更新日期:2013-10-03 00:00:00
abstract:BACKGROUND:Multiple treatments are frequently available for a given condition, and clinicians and patients need a comprehensive, up-to-date synthesis of evidence for all competing treatments. We aimed to quantify the waste of research related to the failure of systematic reviews to provide a complete and up-to-date evi...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-016-0555-0
更新日期:2016-01-20 00:00:00
abstract:BACKGROUND:Clinical decision support systems assist physicians in interpreting complex patient data. However, they typically operate on a per-patient basis and do not exploit the extensive latent medical knowledge in electronic health records (EHRs). The emergence of large EHR systems offers the opportunity to integrat...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-11-194
更新日期:2013-09-02 00:00:00
abstract:BACKGROUND:Castration-resistant prostate cancer (CRPC) is associated with wide variations in survival. Recent studies of whole blood mRNA expression-based biomarkers strongly predicted survival but the genes used in these biomarker models were non-overlapping and their relationship was unknown. We developed a biomarker...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-015-0442-0
更新日期:2015-08-21 00:00:00
abstract::In recent years, the introduction and Federal Drug Administration approval of immune checkpoint inhibitor antibodies has dramatically improved the clinical outcomes for patients with advanced melanoma. These antagonist monoclonal antibodies are capable of unleashing dormant or exhausted antitumor immunity, which has l...
journal_title:BMC medicine
pub_type: 杂志文章,评审
doi:10.1186/s12916-016-0571-0
更新日期:2016-02-06 00:00:00
abstract::Severe anemia contributes significantly to child mortality in sub-Saharan Africa. Blood transfusion is used in emergencies but carries risks. In BMC Medicine, Olupot-Olupot and colleagues report the findings of a phase II trial in children with severe anemia in Eastern Uganda. They provide important early safety and e...
journal_title:BMC medicine
pub_type: 评论,社论
doi:10.1186/1741-7015-12-68
更新日期:2014-04-25 00:00:00
abstract:BACKGROUND:Comorbidities affect outcomes in heart failure (HF), but are not reflected in current HF classification. The aim of this study is to characterize HF groups that account for higher-order interactions between comorbidities and to investigate the association between comorbidity groups and outcomes. METHODS:Lat...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-020-01881-7
更新日期:2021-01-18 00:00:00
abstract::The Mediterranean diet has been linked to a number of health benefits, including reduced mortality risk and lower incidence of cardiovascular disease. Definitions of the Mediterranean diet vary across some settings, and scores are increasingly being employed to define Mediterranean diet adherence in epidemiological st...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-12-112
更新日期:2014-07-24 00:00:00
abstract:BACKGROUND:The declining efficacy of dihydroartemisinin-piperaquine against Plasmodium falciparum in Cambodia, along with increasing numbers of recrudescent cases, suggests resistance to both artemisinin and piperaquine. Available in vitro piperaquine susceptibility assays do not correlate with treatment outcome. A nov...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-015-0539-5
更新日期:2015-12-22 00:00:00
abstract:BACKGROUND:Adiposity is a strong risk factor for cancer incidence and mortality. However, most of the evidence available has focused on body mass index (BMI) as a marker of adiposity. There is limited evidence on relationships of cancer with other adiposity markers, and if these associations are linear or not. The aim ...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-020-01848-8
更新日期:2021-01-11 00:00:00
abstract:BACKGROUND:It is critically important to conduct research on stigmatized conditions, to include marginalized groups that experience stigma, and to develop interventions to reduce stigma. However, such research is ethically challenging. Though superficial reference is frequently made to these widely acknowledged challen...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-019-1317-6
更新日期:2019-04-29 00:00:00
abstract:BACKGROUND:Mathematical and computational models for infectious diseases are increasingly used to support public-health decisions; however, their reliability is currently under debate. Real-time forecasts of epidemic spread using data-driven models have been hindered by the technical challenges posed by parameter estim...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-10-165
更新日期:2012-12-13 00:00:00
abstract:BACKGROUND:During the past decades, life expectancy has continued to increase in most high-income countries. Previous research suggests that improvements in life expectancy have primarily been driven by advances at the upper end of the health distribution, while parts of the population have lagged behind. Using data fr...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-020-01514-z
更新日期:2020-03-20 00:00:00
abstract::In the past decade, numerous studies have made connections between sequence variants in human genomes and predisposition to complex diseases. However, most of these variants lie outside of the charted regions of the human genome whose function we understand; that is, the sequences that encode proteins. Consequently, t...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-12-97
更新日期:2014-06-12 00:00:00
abstract:BACKGROUND:The placebo response in patients with diabetes mellitus is very common. A systematic evaluation needs to be updated with the current evidence about the placebo response in diabetes mellitus and the associated factors in clinical trials of anti-diabetic medicine. METHODS:Literature research was conducted in ...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-020-01787-4
更新日期:2020-11-16 00:00:00
abstract:BACKGROUND:The use of early morning sputum samples (EMS) to diagnose tuberculosis (TB) can result in treatment delay given the need for the patient to return to the clinic with the EMS, increasing the chance of patients being lost during their diagnostic workup. However, there is little evidence to support the superior...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-017-0947-9
更新日期:2017-10-27 00:00:00
abstract:BACKGROUND:Severe iodine insufficiency in pregnancy has significant consequences, but there is inadequate evidence to indicate what constitutes mild or moderate insufficiency, in terms of observed detrimental effects on pregnancy or birth outcomes. A limited number of studies have examined iodine status and birth outco...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-020-01602-0
更新日期:2020-06-11 00:00:00
abstract:BACKGROUND:The UK Clinical Aptitude Test (UKCAT) has been shown to have a modest but statistically significant ability to predict aspects of academic performance throughout medical school. Previously, this ability has been shown to be incremental to conventional measures of educational performance for the first year of...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-016-0682-7
更新日期:2016-09-26 00:00:00