Centre for Global Health Research, Dalla Lana School of Public Health, St. Michael's Hospital, University of Toronto, Ontario, Canada.
Department of Pediatrics, King George's Medical University, Lucknow, India.
Elife. 2019 Mar 5;8:e43290. doi: 10.7554/eLife.43290.
India comprises much of the persisting global childhood measles mortality. India implemented a mass second-dose measles immunization campaign in 2010. We used interrupted time series and multilevel regression to quantify the campaign's impact on measles mortality using the nationally representative Million Death Study (including 27,000 child deaths in 1.3 million households surveyed from 2005 to 2013). 1-59 month measles mortality rates fell more in the campaign states following launch (27%) versus non-campaign states (11%). Declines were steeper in girls than boys and were specific to measles deaths. Measles mortality risk was lower for children living in a campaign district (OR 0.6, 99% CI 0.4-0.8) or born in 2009 or later (OR 0.8, 99% CI 0.7-0.9). The campaign averted up to 41,000-56,000 deaths during 2010-13, or 39-57% of the expected deaths nationally. Elimination of measles deaths in India is feasible.
印度是全球持续存在的儿童麻疹死亡率的主要国家之一。印度于 2010 年实施了大规模的第二剂麻疹免疫运动。我们使用中断时间序列和多层次回归分析,使用具有全国代表性的百万死亡研究(包括 2005 年至 2013 年期间对 130 万户家庭进行的 2.7 万名儿童死亡调查)来量化该运动对麻疹死亡率的影响。麻疹死亡率在运动州(下降 27%)比非运动州(下降 11%)下降幅度更大。女孩的下降幅度大于男孩,且专门针对麻疹死亡。生活在运动地区的儿童(OR 0.6,99%CI 0.4-0.8)或出生于 2009 年或之后的儿童(OR 0.8,99%CI 0.7-0.9)的麻疹死亡率较低。该运动在 2010 年至 2013 年期间避免了 4.1 万至 5.6 万人死亡,占全国预期死亡人数的 39-57%。在印度消除麻疹死亡是可行的。