Estimates of measles case fatality ratios: a comprehensive review of community-based studies
Estimates of measles case fatality ratios: a comprehensive review of community-based studies
复制标题
DOI：
10.1093/ije/dyn224
复制
发表时间：
2009-02-01
影响因子：
7.7
通讯作者：
Strebel, Peter M.
中科院分区：
文献类型：
--
作者：
Wolfson, Lara J.;Garis, Rebecca F.;Strebel, Peter M.
背景 过去几十年来，由于免疫接种率的提高和麻疹病死率（CFR）的下降，全球麻疹死亡人数显着下降。虽然麻疹死亡率下降的某些方面可以通过增加免疫覆盖率来监测，但估计麻疹死亡水平（绝对值）是有问题的，特别是因为基于发病率的估计方法依赖于麻疹病死率的准确测量。这些比率因地理和流行病学背景的不同而存在很大差异，甚至在同一社区内每年的病死率差异也很大。方法为了更好地了解病死率的变化，我们回顾了 1980 年至 2008 年间发表的报告特定年龄麻疹病死率的社区研究。结果搜索结果一致证明，麻疹病死率在未接种疫苗的 5 岁以下儿童中最高；疫情爆发时；无论环境如何，接种疫苗的儿童病死率最低。病例和死亡定义、研究人群和地理范围广泛，凸显了为全球公共卫生规划推断结果的复杂性。结论 麻疹病死率的数值仍然不精确，导致麻疹实际死亡人数仍然存在不确定性。
Background Global deaths from measles have decreased notably in past decades, due to both increases in immunization rates and decreases in measles case fatality ratios (CFRs). While some aspects of the reduction in measles mortality can be monitored through increases in immunization coverage, estimating the level of measles deaths (in absolute terms) is problematic, particularly since incidence-based methods of estimation rely on accurate measures of measles CFRs. These ratios vary widely by geographic and epidemiologic context and even within the same community from year-to-year.Methods To understand better the variations in CFRs, we reviewed community-based studies published between 1980 and 2008 reporting age-specific measles CFRs.Results The results of the search consistently document that measles CFRs are highest in unvaccinated children under age 5 years; in outbreaks; the lowest CFRs occur in vaccinated children regardless of setting. The broad range of case and death definitions, study populations and geography highlight the complexities in extrapolating results for global public health planning.Conclusions Values for measles CFRs remain imprecise, resulting in continued uncertainty about the actual toll measles exacts.