Evaluating the impact of the HIV pandemic on measles control and elimination

Rita F. Helfand, William J Moss, Rafael Harpaz, Susana Scott, Felicity Cutts

Research output: Contribution to journalArticle

Abstract

Objective: To estimate the impact of the HIV pandemic on vaccine-acquired population immunity to measles virus because high levels of population immunity are required to eliminate transmission of measles virus in large geographical areas, and HIV infection can reduce the efficacy of measles vaccination. Methods: A literature review was conducted to estimate key parameters relating to the potential impact of HIV infection on the epidemiology of measles in sub-Saharan Africa; parameters included the prevalence of HIV, child mortality, perinatal HIV transmission rates and protective immune responses to measles vaccination. These parameter estimates were incorporated into a simple model, applicable to regions that have a high prevalence of HIV, to estimate the potential impact of HIV infection on population immunity against measles. Findings: The model suggests that the HIV pandemic should not introduce an insurmountable barrier to measles control and elimination, in part because higher rates of primary and secondary vaccine failure among HIV-infected children are counteracted by their high mortality rate. The HIV pandemic could result in a 2-3% increase in the proportion of the birth cohort susceptible to measles, and more frequent supplemental immunization activities (SIAs) may be necessary to control or eliminate measles. In the model the optimal interval between SIAs was most influenced by the coverage rate for routine measles vaccination. The absence of a second opportunity for vaccination resulted in the greatest increase in the number of susceptible children. Conclusion: These results help explain the initial success of measles elimination efforts in southern Africa, where measles control has been achieved in a setting of high HIV prevalence.

Original languageEnglish (US)
Pages (from-to)329-337
Number of pages9
JournalBulletin of the World Health Organization
Volume83
Issue number5
StatePublished - May 2005

Fingerprint

Measles
Pandemics
HIV
Vaccination
HIV Infections
Measles virus
Immunity
Immunization
Vaccines
Population
Southern Africa
Child Mortality
Africa South of the Sahara
Adaptive Immunity
Epidemiology
Parturition
Mortality

Keywords

  • Africa South of the Sahara
  • Antigen-antibody reactions
  • Child
  • HIV infections/complications
  • Measles vaccine
  • Measles/immunology/ epidemiology
  • Models Statistical

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Evaluating the impact of the HIV pandemic on measles control and elimination. / Helfand, Rita F.; Moss, William J; Harpaz, Rafael; Scott, Susana; Cutts, Felicity.

In: Bulletin of the World Health Organization, Vol. 83, No. 5, 05.2005, p. 329-337.

Research output: Contribution to journalArticle

Helfand, Rita F. ; Moss, William J ; Harpaz, Rafael ; Scott, Susana ; Cutts, Felicity. / Evaluating the impact of the HIV pandemic on measles control and elimination. In: Bulletin of the World Health Organization. 2005 ; Vol. 83, No. 5. pp. 329-337.
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