TY - JOUR
T1 - Population immunity to measles virus and the effect of HIV-1 infection after a mass measles vaccination campaign in Lusaka, Zambia
T2 - a cross-sectional survey
AU - Lowther, Sara A.
AU - Curriero, Frank C.
AU - Kalish, Brian T.
AU - Shields, Timothy M.
AU - Monze, Mwaka
AU - Moss, William J.
N1 - Funding Information:
This work was supported by the Thrasher Research Fund (02828-9). SAL was supported by the National Eye Institute Training Grant (EY 07127), pre-doctoral Clinical Trials Training Program in Vision Research, National Institutes of Health, Department of Health and Human Services.
PY - 2009
Y1 - 2009
N2 - Background: Measles control efforts are hindered by challenges in sustaining high vaccination coverage, waning immunity in HIV-1-infected children, and clustering of susceptible individuals. Our aim was to assess population immunity to measles virus after a mass vaccination campaign in a region with high HIV prevalence. Methods: 3 years after a measles supplemental immunisation activity (SIA), we undertook a cross-sectional survey in Lusaka, Zambia. Households were randomly selected from a satellite image. Children aged 9 months to 5 years from selected households were eligible for enrolment. A questionnaire was administered to the children's caregivers to obtain information about measles vaccination history and history of measles. Oral fluid samples were obtained from children and tested for antibodies to measles virus and HIV-1 by EIA. Findings: 1015 children from 668 residences provided adequate specimens. 853 (84%) children had a history of measles vaccination according to either caregiver report or immunisation card. 679 children (67%) had antibodies to measles virus, and 64 (6%) children had antibodies to HIV-1. Children with antibodies to HIV-1 were as likely to have no history of measles vaccination as those without antibodies to HIV-1 (odds ratio [OR] 1·17, 95% CI 0·57-2·41). Children without measles antibodies were more likely to have never received measles vaccine than those with antibodies (adjusted OR 2·50, 1·69-3·71). In vaccinated children, 33 (61%) of 54 children with antibodies to HIV-1 also had antibodies to measles virus, compared with 568 (71%) of 796 children without antibodies to HIV-1 (p=0·1). Interpretation: 3 years after an SIA, population immunity to measles was insufficient to interrupt measles virus transmission. The use of oral fluid and satellite images for sampling are potential methods to assess population immunity and the timing of SIAs. Funding: Thrasher Research Fund.
AB - Background: Measles control efforts are hindered by challenges in sustaining high vaccination coverage, waning immunity in HIV-1-infected children, and clustering of susceptible individuals. Our aim was to assess population immunity to measles virus after a mass vaccination campaign in a region with high HIV prevalence. Methods: 3 years after a measles supplemental immunisation activity (SIA), we undertook a cross-sectional survey in Lusaka, Zambia. Households were randomly selected from a satellite image. Children aged 9 months to 5 years from selected households were eligible for enrolment. A questionnaire was administered to the children's caregivers to obtain information about measles vaccination history and history of measles. Oral fluid samples were obtained from children and tested for antibodies to measles virus and HIV-1 by EIA. Findings: 1015 children from 668 residences provided adequate specimens. 853 (84%) children had a history of measles vaccination according to either caregiver report or immunisation card. 679 children (67%) had antibodies to measles virus, and 64 (6%) children had antibodies to HIV-1. Children with antibodies to HIV-1 were as likely to have no history of measles vaccination as those without antibodies to HIV-1 (odds ratio [OR] 1·17, 95% CI 0·57-2·41). Children without measles antibodies were more likely to have never received measles vaccine than those with antibodies (adjusted OR 2·50, 1·69-3·71). In vaccinated children, 33 (61%) of 54 children with antibodies to HIV-1 also had antibodies to measles virus, compared with 568 (71%) of 796 children without antibodies to HIV-1 (p=0·1). Interpretation: 3 years after an SIA, population immunity to measles was insufficient to interrupt measles virus transmission. The use of oral fluid and satellite images for sampling are potential methods to assess population immunity and the timing of SIAs. Funding: Thrasher Research Fund.
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U2 - 10.1016/S0140-6736(09)60142-2
DO - 10.1016/S0140-6736(09)60142-2
M3 - Article
C2 - 19211140
AN - SCOPUS:62349088643
SN - 0140-6736
VL - 373
SP - 1025
EP - 1032
JO - The Lancet
JF - The Lancet
IS - 9668
ER -