Epidemiological changes in measles infections in southern China between 2009 and 2016: a retrospective database analysis

Zheng, Huizhen; Jia, Katherine Min; Sun, Riyang; Hu, Pei; Wang, Maggie Haitian; Zee, Benny; Liang, Wenjia; Chong, Ka Chun

doi:10.1186/s12879-020-4919-x

Cited by 4 publications

(4 citation statements)

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“…Previous studies have demonstrated that infants aged 0–8 months were too young for routine immunization. The immunity in newborns was temporary and began to wane at 6 months of life, which made infants the most susceptible to rubella [ 42 , 43 ]. Another study found that women of childbearing age had lower levels of rubella antibodies, increasing the risk of congenital rubella syndrome in newborns to some extent [ 44 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

Epidemiological Features of Infectious Diseases in Children and Adolescents: A Population-Based Observational Study in Shandong Province, China, 2013–2017

Wang,

Song

et al. 2024

Children

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Background: The arrival of the big-data era provides us with a chance to elaborate the spectrum and epidemiological characteristics of infectious diseases in children and adolescents aged 0–18 years in the pre-COVID-19 pandemic era. Methods: We collected data on infectious diseases in 891,981 participants from the Cheeloo Lifespan Electronic Health Research Data-library. The incidence density of each infection was calculated and stratified by age and region. The annual percentage change (APC) in incidence was estimated by logarithmic linear regression. Results: A total of 18,183 cases of 78 infections were diagnosed, with an overall incidence density of 626.33 per 100,000 person-years (PY). Of these, 6825 cases of 50 non-notifiable infectious diseases were identified. Children aged 1–3 years had the highest incidence of infections. The overall incidence revealed a significant increasing trend from 2013 to 2017 (APC = 36.9%, p < 0.05). Hand, foot, and mouth disease, pneumonia, and influenza were the three most common diseases. The incidence of pneumonia, rubella, scarlet fever, zoster, molluscum contagiosum, and syphilis increased significantly during the study period (all p < 0.05). Taian, Binzhou, and Weihai had the highest incidence of all other cities. The incidence of gastrointestinal infections increased markedly in the eastern coastal regions. Conclusions: More stress should be placed on a number of non-notifiable infectious diseases with a high burden and a significant increasing trend. Age-based and regional targeting efforts are needed to prevent and contain infectious diseases among children and adolescents.

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Section: Discussionmentioning

confidence: 99%

Epidemiological Features of Infectious Diseases in Children and Adolescents: A Population-Based Observational Study in Shandong Province, China, 2013–2017

Wang,

Song

et al. 2024

Children

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“…Hence, it suggested strengthening routine surveillance of vaccination coverage among migrants (Chong, K. et al, 2020 and in older age group individuals (Nmor, J. C. et al, 2011). Even though great results were achieved by supplementary immunisation activities in providing herd immunity, there was a resurgence of measles cases due to insufficient immunisation coverage among children (Zheng, H. et al, 2020, (Ma, C. et al, 2014.). The study from Myanmar reported an increase in the measles mortality rate since 2016.…”

Section: Discussionmentioning

confidence: 99%

Reasons for the Resurgence of Measles in Asian Countries

Rashid

Rawi

Azizi

et al. 2021

JMS

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Measles is a highly contagious disease with life-threatening complications. It is caused by the measles virus and affects mostly children. Despite being a vaccine-preventable disease, the resurgence of measles tends to occur in several countries across the globe. This review attempts to study the prevalence of measles and its resurgence in Asian countries. A total of 28 articles from ‘PubMed’, “Science Direct”, “Cochrane Library” were selected. Globally, in the year 2019, a total of 873,250 cases of measles were reported, and of these, 138,656 cases in Asia. Among the Asian countries, the Philippines reported the highest number (48,525) of measles cases. The prevalence of measles cases in earlier eliminated countries indicates the resurgence. The data analysis of seven articles indicated measles cases were higher in the unvaccinated population than vaccinated population. Resurgent measles cases were more unvaccinated and less than one year of age. The continuous fall in the morbidity and mortality caused by measles is achieved by vaccination. In 2019, an increased number of measles cases were reported around the globe, including in Asia. A global resurgence of the disease due to several reasons such as low vaccination coverage, imported cases by travellers,

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“…While in urban China, routine vaccination services are clustered in community-level health centres and regularly delivered to age-appropriate children. Large-scale measles outbreaks re-emerged in Guangxi of southwest China during 2013–2014, even though Guangxi had achieved ≥95% coverage of routine measles vaccination 34. Most of the reported cases were children who were vaccinated untimely or incompletely.…”

Section: Introductionmentioning

confidence: 99%

Health system barriers to timely routine measles vaccinations in rural southwest China: a qualitative study on the perspectives of township vaccination professionals and village doctors

Cheng,

Lan,

Geater

et al. 2023

BMJ Open

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ObjectivesA well-functioning health system ensures timely routine measles vaccinations for age-appropriate children, minimising measles risk. However, there is limited knowledge about the impact of the performance of immunisation programmes in health systems on the timeliness of measles vaccination. This study aimed to identify health system barriers to timely routine measles vaccination in rural southwest China, integrating the perspectives of township vaccination professionals and village doctors.Design, setting and participantsQualitative study among township vaccination professionals and village doctors in rural Guangxi, southwest China.Methods20 focus group discussions (FGDs) at township level and 120 in-depth interviews (IDIs) at village level, based on a four-theme framework. We used convenience sampling to recruit 60 township vaccination professionals and 120 village doctors in 2015. Instruments used were a semistructured questionnaire and interview outlines. We collected township and village-level data focusing on themes of health resources allocation, pattern of vaccination services, management and supervision of vaccination services, and perceptions of vaccination policy. The FGDs and IDIs were audio-recorded and transcribed. Braun and Clarke’s thematic analysis approach was adopted to synthesise findings into meaningful subthemes, narrative text and illustrative quotations.ResultsThe health system barriers to timely routine vaccinations were explored across four themes. Barriers in the health resources allocation theme comprised (1) inadequacy of vaccination-related human resources (eg, lack of township vaccination professionals and lack of young village doctors), and (2) incompatible and non-identical information system of vaccination services across regions. Barriers in the pattern of vaccination services theme included inflexible vaccination services models, for example, routine vaccination services being offered monthly on fixed vaccination days, limited numbers of vaccination days per month, vaccination days being set on non-local market days, vaccination days being clustered into a specific period and absence of formal vaccination appointments. Ineffective economic incentive mechanism was identified as a barrier in the management and supervision of vaccination services theme. Low-degree participation of village doctors in routine vaccination services was identified as a barrier in the perceptions of vaccination policy theme.ConclusionsWe encourage policymakers and stakeholders to apply these findings to improve the timeliness of routine vaccination. Barriers to timely routine vaccination include inadequate allocation of vaccination-related resources and inflexible vaccination service delivery models. Financial and non-financial incentives should be used to retain and recruit vaccination professionals and village doctors. Strengthening information systems with unified data standards enables cross-regional data exchange. Optimising immunisation services and rationalising vaccination days could eliminate health system barriers and improve vaccination timeliness in rural China.

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Epidemiological changes in measles infections in southern China between 2009 and 2016: a retrospective database analysis

Abstract: Background: The incidence rate of measles in China reached a nadir in 2012 after 2 supplementary immunization activities (SIAs) were undertaken in 2009 and 2010. However, the disease began re-emerging in 2013, with a high prevalence rate observed in

Cited by 4 publications

References 25 publications

Epidemiological Features of Infectious Diseases in Children and Adolescents: A Population-Based Observational Study in Shandong Province, China, 2013–2017

Epidemiological Features of Infectious Diseases in Children and Adolescents: A Population-Based Observational Study in Shandong Province, China, 2013–2017

Reasons for the Resurgence of Measles in Asian Countries

Health system barriers to timely routine measles vaccinations in rural southwest China: a qualitative study on the perspectives of township vaccination professionals and village doctors

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