Assessment of the 2010 global measles mortality reduction goal: results from a model of surveillance data.
Assessment of the 2010 global measles mortality reduction goal: results from a model of surveillance data.
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DOI：
10.1016/s0140-6736(12)60522-4
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发表时间：
2012-06-09
期刊：
影响因子：
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通讯作者：
Strebel, Peter
中科院分区：
文献类型：
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作者：
Simons, Emily;Ferrari, Matthew;Strebel, Peter
背景：2008年，世卫组织所有成员国批准了到2010年将麻疹死亡率在2000年水平上降低90%的目标。我们开发了一个模型来估计朝着这个目标取得的进展。方法：我们构建了一个状态空间模型，人口和免疫接种覆盖率估计和报告的监测数据，以估计年度全国麻疹病例，分布在各年龄段。我们估计死亡人数采用年龄特异性和国家特异性的病例死亡率估计的情况下，在每个年龄国家class. FININGS：估计全球麻疹死亡率下降74%，从535,300例死亡（95%CI 347200 - 976400），在2000年至139,300（71200 - 447800），在2010年。除世卫组织东南亚区域外，世卫组织所有区域的麻疹死亡率都降低了四分之三以上。印度占2010年估计麻疹死亡率的47%，世卫组织非洲区域占36%。解释：尽管2000 - 2007年麻疹控制取得了快速进展，但印度延迟实施加速疾病控制，非洲持续爆发，阻碍了实现2010年全球麻疹死亡率降低目标的势头。需要加强控制措施和新的政治和财政承诺，以实现降低死亡率的目标，并为未来全球根除麻疹奠定基础。
BACKGROUND: In 2008 all WHO member states endorsed a target of 90% reduction in measles mortality by 2010 over 2000 levels. We developed a model to estimate progress made towards this goal.METHODS: We constructed a state-space model with population and immunisation coverage estimates and reported surveillance data to estimate annual national measles cases, distributed across age classes. We estimated deaths by applying age-specific and country-specific case-fatality ratios to estimated cases in each age-country class.FINDINGS: Estimated global measles mortality decreased 74% from 535,300 deaths (95% CI 347,200-976,400) in 2000 to 139,300 (71,200-447,800) in 2010. Measles mortality was reduced by more than three-quarters in all WHO regions except the WHO southeast Asia region. India accounted for 47% of estimated measles mortality in 2010, and the WHO African region accounted for 36%.INTERPRETATION: Despite rapid progress in measles control from 2000 to 2007, delayed implementation of accelerated disease control in India and continued outbreaks in Africa stalled momentum towards the 2010 global measles mortality reduction goal. Intensified control measures and renewed political and financial commitment are needed to achieve mortality reduction targets and lay the foundation for future global eradication of measles.FUNDING: US Centers for Disease Control and Prevention (PMS 5U66/IP000161).