The importance of supplementary immunisation activities to prevent measles outbreaks during the COVID-19 pandemic in Kenya.
The importance of supplementary immunisation activities to prevent measles outbreaks during the COVID-19 pandemic in Kenya.
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DOI：
10.1186/s12916-021-01906-9
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发表时间：
2021-02-03
期刊：
影响因子：
9.3
通讯作者：
Adetifa I
中科院分区：
文献类型：
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作者：
Mburu CN;Ojal J;Chebet R;Akech D;Karia B;Tuju J;Sigilai A;Abbas K;Jit M;Funk S;Smits G;van Gageldonk PGM;van der Klis FRM;Tabu C;Nokes DJ;LSHTM CMMID COVID-19 Working Group;Scott J;Flasche S;Adetifa I
COVID-19大流行扰乱了包括肯尼亚在内的大多数国家的常规麻疹免疫和补充免疫活动（SIAs）。我们评估了肯尼亚麻疹大流行期间麻疹暴发的风险，作为非洲区域的案例研究。将麻疹血清学数据、当地接触模式和疫苗接种覆盖率结合到一个队列模型中，我们预测了肯尼亚年龄调整后的人群免疫力，并估计了取消减少接触的COVID-19干预措施时爆发疫情的可能性。我们考虑了从2020年4月起减少麻疹疫苗接种覆盖率的各种情况。2020年2月，当计划的SIA被推迟时，人群免疫力接近群体免疫阈值，大规模疫情爆发的概率为34%（8-54）。随着COVID-19接触限制几乎完全放松，从2020年12月起，假设麻疹疫苗接种覆盖率下降15%、50%和100%，麻疹大规模爆发的概率将增加至38%（19-54）、46%（30-59）和54%（43-64）。到2021年12月，对于相同的覆盖场景，这一风险分别进一步增加到43%（25-56），54%（43-63）和67%（59-72）。然而，取消所有限制后麻疹爆发的风险增加可以通过在五岁以下儿童中进行≥ 95%覆盖率的SIA来克服。虽然足以控制SAR-CoV-2的接触限制暂时降低了麻疹传播性和麻疹免疫缺口爆发的风险，但一旦取消这些限制，这种风险就会迅速上升。鉴于肯尼亚取消了接触限制，实施延迟的SIAs对预防麻疹疫情至关重要。在线版本包含补充材料，可通过10.1186/s12916-021-01906-9获得。
The COVID-19 pandemic has disrupted routine measles immunisation and supplementary immunisation activities (SIAs) in most countries including Kenya. We assessed the risk of measles outbreaks during the pandemic in Kenya as a case study for the African Region. Combining measles serological data, local contact patterns, and vaccination coverage into a cohort model, we predicted the age-adjusted population immunity in Kenya and estimated the probability of outbreaks when contact-reducing COVID-19 interventions are lifted. We considered various scenarios for reduced measles vaccination coverage from April 2020. In February 2020, when a scheduled SIA was postponed, population immunity was close to the herd immunity threshold and the probability of a large outbreak was 34% (8–54). As the COVID-19 contact restrictions are nearly fully eased, from December 2020, the probability of a large measles outbreak will increase to 38% (19–54), 46% (30–59), and 54% (43–64) assuming a 15%, 50%, and 100% reduction in measles vaccination coverage. By December 2021, this risk increases further to 43% (25–56), 54% (43–63), and 67% (59–72) for the same coverage scenarios respectively. However, the increased risk of a measles outbreak following the lifting of all restrictions can be overcome by conducting a SIA with ≥ 95% coverage in under-fives. While contact restrictions sufficient for SAR-CoV-2 control temporarily reduce measles transmissibility and the risk of an outbreak from a measles immunity gap, this risk rises rapidly once these restrictions are lifted. Implementing delayed SIAs will be critical for prevention of measles outbreaks given the roll-back of contact restrictions in Kenya. The online version contains supplementary material available at 10.1186/s12916-021-01906-9.
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影响因子：
9.3
作者：
Quaife M;van Zandvoort K;Gimma A;Shah K;McCreesh N;Prem K;Barasa E;Mwanga D;Kangwana B;Pinchoff J;CMMID COVID-19 Working Group;Edmunds WJ;Jarvis CI;Austrian K
通讯作者：
Austrian K
影响因子：
5.5
作者：
Portnoy, Allison;Jit, Mark;Verguet, Stephane
通讯作者：
Verguet, Stephane
影响因子：
7.7
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Scott, J. Anthony G.;Bauni, Evasius;Williams, Thomas N.
通讯作者：
Williams, Thomas N.
影响因子：
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作者：
Smits, Gaby P.;van Gageldonk, Pieter G.;Berbers, Guy A. M.
通讯作者：
Berbers, Guy A. M.
影响因子：
34.3
作者：
Abbas, Kaja M.;van Zandvoort, Kevin;Jit, Mark
通讯作者：
Jit, Mark