Reena H Doshi1, Patrick Mukadi2, Calixte Shidi3, Audry Mulumba4, Nicole A Hoff5, Sue Gerber6, Emile Okitolonda-Wemakoy7, Benoit Kebela Ilunga8, Jean-Jacques Muyembe9, Anne W Rimoin10. 1. Department of Epidemiology, UCLA Fielding School of Public Health, 650 S Charles E Young Drive, Los Angeles, CA 90095, USA. Electronic address: rhdoshi@ucla.edu. 2. Department of Microbiology, Kinshasa School of Medicine, B.P. 127 Kinshasa, Lemba, Kinshasa, Democratic Republic of the Congo. Electronic address: patrickmukadi@gmail.com. 3. Expanded Programme on Immunization, Ave de la Justice, Kinshasa, Democratic Republic of the Congo. Electronic address: shidicalixte5@yahoo.fr. 4. Expanded Programme on Immunization, Ave de la Justice, Kinshasa, Democratic Republic of the Congo. Electronic address: audrymwk@hotmail.fr. 5. Department of Epidemiology, UCLA Fielding School of Public Health, 650 S Charles E Young Drive, Los Angeles, CA 90095, USA. Electronic address: Nhoff84@ucla.edu. 6. Polio Program, Bill and Melinda Gates Foundation, 500 Fifth Avenue North, Seattle, WA 98109, USA. Electronic address: Sue.gerber@gatesfoundation.org. 7. Kinshasa School of Public Health, B.P. 127 Kinshasa, Lemba, Kinshasa, Democratic Republic of the Congo. Electronic address: okitow@yahoo.fr. 8. Division of Disease Control, Ministry of Public Health, Ave de la Justice, Kinshasa, Democratic Republic of the Congo. Electronic address: kebelailunga@gmail.com. 9. National Institute for Biomedical Research, Minister of Public Health, Avenue de la Democratie, Kinshasa, Democratic Republic of the Congo. Electronic address: muyembejj@gmail.com. 10. Department of Epidemiology, UCLA Fielding School of Public Health, 650 S Charles E Young Drive, Los Angeles, CA 90095, USA. Electronic address: arimoin@ucla.edu.
Abstract
BACKGROUND: Large-scale measles outbreaks in areas with high administrative vaccine coverage rates suggest the need to re-evaluate measles prevention and control in the Democratic Republic of Congo (DRC). Monitoring of measles Vaccine Effectiveness (VE) is a useful measure of quality control in immunization programs. We estimated measles VE among children aged 12-59 months in the Democratic Republic of Congo (DRC) using laboratory surveillance data from 2010-2012. METHODS: We used the case-based surveillance system with laboratory confirmation to conduct a case-control study using the test negative design. Cases and controls were selected based on presence (n=1044) or absence (n=1335) of measles specific antibody IgM or epidemiologic linkage. Risk factors for measles were assessed using unconditional logistic regression, stratified by age. RESULTS: Among children 12-59 months, measles vaccination was protective against measles [aOR (95%C)], 0.20 (0.15-0.26) and estimated VE was 80% (95% CI 74-85%). Year of diagnosis, 2011: 6.02 (4.16-8.72) and 2012; 8.31 (5.57-12.40) was a risk factor for measles when compared to 2010. Compared to Kinshasa, children in Bas-Congo, Kasai-Oriental, Maniema and South Kivu provinces all had higher odds of developing measles. Measles VE was similar for children 12-23 months and 24-59 months (80% and 81% respectively). CONCLUSIONS: Repeated occurrences of measles outbreaks and lower than expected VE estimates suggest the need to further evaluate measles vaccine efficacy and improve vaccine delivery strategies in DRC.
BACKGROUND: Large-scale measles outbreaks in areas with high administrative vaccine coverage rates suggest the need to re-evaluate measles prevention and control in the Democratic Republic of Congo (DRC). Monitoring of measles Vaccine Effectiveness (VE) is a useful measure of quality control in immunization programs. We estimated measles VE among children aged 12-59 months in the Democratic Republic of Congo (DRC) using laboratory surveillance data from 2010-2012. METHODS: We used the case-based surveillance system with laboratory confirmation to conduct a case-control study using the test negative design. Cases and controls were selected based on presence (n=1044) or absence (n=1335) of measles specific antibody IgM or epidemiologic linkage. Risk factors for measles were assessed using unconditional logistic regression, stratified by age. RESULTS: Among children 12-59 months, measles vaccination was protective against measles [aOR (95%C)], 0.20 (0.15-0.26) and estimated VE was 80% (95% CI 74-85%). Year of diagnosis, 2011: 6.02 (4.16-8.72) and 2012; 8.31 (5.57-12.40) was a risk factor for measles when compared to 2010. Compared to Kinshasa, children in Bas-Congo, Kasai-Oriental, Maniema and South Kivu provinces all had higher odds of developing measles. Measles VE was similar for children 12-23 months and 24-59 months (80% and 81% respectively). CONCLUSIONS: Repeated occurrences of measles outbreaks and lower than expected VE estimates suggest the need to further evaluate measles vaccine efficacy and improve vaccine delivery strategies in DRC.
Authors: Huiying Chua; Shuo Feng; Joseph A Lewnard; Sheena G Sullivan; Christopher C Blyth; Marc Lipsitch; Benjamin J Cowling Journal: Epidemiology Date: 2020-01 Impact factor: 4.822
Authors: Hayley R Ashbaugh; James D Cherry; Nicole A Hoff; Reena H Doshi; Vivian H Alfonso; Adva Gadoth; Patrick Mukadi; Stephen G Higgins; Roger Budd; Christina Randall; Guillaume Ngoie Mwamba; Emile Okitolonda-Wemakoy; Jean Jacques Muyembe-Tamfum; Sue K Gerber; Anne W Rimoin Journal: Vaccine Date: 2020-02-24 Impact factor: 3.641
Authors: Hayley R Ashbaugh; James D Cherry; Nicole A Hoff; Reena H Doshi; Vivian H Alfonso; Adva Gadoth; Patrick Mukadi; Stephen G Higgins; Roger Budd; Christina Randall; Emile Okitolonda-Wemakoy; Jean Jacques Muyembe-Tamfum; Sue K Gerber; Anne W Rimoin Journal: J Pediatric Infect Dis Soc Date: 2019-12-27 Impact factor: 3.164