| Titre : | Decline in measles case fatality ratio after the introduction of measles immunization in rural Senegal. (1997) |
| Auteurs : | B. SAMB ; P. Aaby ; A.M. COLL SECK ; F. SIMONDON ; H. WHITTLE ; Unité de Recherche Maladies Infectieuses et Parasitaires. Orstom. Dakar. SEN |
| Type de document : | Article |
| Dans : | American journal of epidemiology (vol. 145, n° 1, 1997) |
| Pagination : | 51-57 |
| Langues: | Anglais |
| Mots-clés : | Rougeole ; Virose ; Infection ; Programme élargi vaccination ; Mortalité ; Epidémiologie ; Evaluation ; Incidence ; Enfant ; Homme ; Programme santé ; Sénégal ; Afrique |
| Résumé : | [BDSP. Notice produite par INIST 2gJhR0x5. Diffusion soumise à autorisation]. The epidemiology of measles has been investigated in Niakhar, a rural area of Senegal, during two periods, 1983-1986 and 1987-1990. Following a major increase in immunization coverage beginning in 1987, the case fatality ratio for all ages declined fourfold from the first to the second period (relative risk (RR)=0.24,95% confidence interval (CI) 0.13-0.46). The measles incidence for children under 10 years of age declined by 69% (95% CI 65-72) and the risk of dying of measles by 91% (95% CI 82-95). Vaccinated children who contracted measles had significantly lower case fatality ratio than unvaccinated children with measles (p=0.038). Children infected by an immunized case tended to have lower case fatality ratio than those infected by an unimmunized index case (p=0.104) and immunized index cases generated fewer secondary cases than unimmunized index cases (p<0.001). Respiratory complications were more common in secondary cases infected by an index case with respiratory complications than by an index case without such complications (RR=1.60,95% CI 1.08-2.37), which suggests that severe cases give rise to further severe cases. As expected, there was a significant increase in the proportion of vaccinated cases in the second period (RR=1.41,95% CI 1.00-1.98). Mean age at infection increased from 4 to 7 years between the two periods and the change in age structure accounted for 20% of the decline in case fatality ratio. (...) |
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