Estimates of measles case fatality ratios: A comprehensive review of community-based studies

Lara J. Wolfson, Rebecca F. Grais, Francisco J. Luquero, Maureen E. Birmingham, Peter M. Strebel

Research output: Contribution to journalArticle

Abstract

Background: Global deaths from measles have decreased notably in past decades, due to both increases in immunization rates and decreases in measles case fatality ratios (CFRs). While some aspects of the reduction in measles mortality can be monitored through increases in immunization coverage, estimating the level of measles deaths (in absolute terms) is problematic, particularly since incidence-based methods of estimation rely on accurate measures of measles CFRs. These ratios vary widely by geographic and epidemiologic context and even within the same community from year-to-year. Methods: To understand better the variations in CFRs, we reviewed community-based studies published between 1980 and 2008 reporting age-specific measles CFRs. Results: The results of the search consistently document that measles CFRs are highest in unvaccinated children under age 5 years; in outbreaks; the lowest CFRs occur in vaccinated children regardless of setting. The broad range of case and death definitions, study populations and geography highlight the complexities in extrapolating results for global public health planning. Conclusions: Values for measles CFRs remain imprecise, resulting in continued uncertainty about the actual toll measles exacts.

Original languageEnglish (US)
Pages (from-to)192-205
Number of pages14
JournalInternational Journal of Epidemiology
Volume38
Issue number1
DOIs
Publication statusPublished - 2009
Externally publishedYes

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Keywords

  • Case fatality ratio
  • Community-based studies
  • Measles
  • Mortality
  • Review

ASJC Scopus subject areas

  • Epidemiology

Cite this

Wolfson, L. J., Grais, R. F., Luquero, F. J., Birmingham, M. E., & Strebel, P. M. (2009). Estimates of measles case fatality ratios: A comprehensive review of community-based studies. International Journal of Epidemiology, 38(1), 192-205. https://doi.org/10.1093/ije/dyn224