Faversani Maria Cristina de Sousa Santos, Kupek Emil, Westrupp Maria Helena Bittencourt
Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brazil.
Cad Saude Publica. 2005 Mar-Apr;21(2):535-44. doi: 10.1590/s0102-311x2005000200020. Epub 2005 Mar 21.
This ecological study, based on an analysis of secondary data from epidemiological surveillance and using the municipality (county) as the unit of analysis, showed that measles vaccine coverage was lower than necessary for eradication (95%) and control (90%) in many municipalities in the State of Santa Catarina, Brazil, both before and during the last epidemic in 1997, particularly regarding the second dose of the vaccine, applied as a component of the MMR vaccine, scheduled at 15 months of age. Low vaccine coverage was associated with higher measles incidence. However, during the 1997 epidemic small-scale measles outbreaks were recorded even in municipalities with first-dose coverage of 95% or higher, particularly among those which also had low second-dose coverage for MMR. Approximately 80% of all measles cases during 1996-2000 occurred among schoolchildren and young adults. Measles virus circulation in the municipality in the previous year and population density increased the risk of measles. Two imported cases of measles in Santa Catarina in 2004 illustrate that it would be premature to describe the current situation as one of eradication.
这项生态学研究基于对流行病学监测的二手数据进行分析，并以市（县）作为分析单位，结果显示，在巴西圣卡塔琳娜州的许多市，无论是在1997年最后一次麻疹流行之前还是流行期间，麻疹疫苗接种覆盖率均低于根除（95%）和控制（90%）所需的水平，特别是作为MMR疫苗一部分、计划在15月龄接种的第二剂疫苗。疫苗接种覆盖率低与麻疹发病率较高相关。然而，在1997年麻疹流行期间，即使在首剂接种覆盖率达到或超过95%的市也记录到小规模麻疹暴发，特别是在那些MMR第二剂接种覆盖率也较低的市。1996 - 2000年期间，约80%的麻疹病例发生在学龄儿童和青年成人中。前一年该市的麻疹病毒传播以及人口密度增加了麻疹风险。2004年圣卡塔琳娜州的两例输入性麻疹病例表明，将当前情况描述为已根除还为时过早。
