Drivers of measles mortality: the historic fatality burden of famine in Bangladesh.
Epidemiol Infect
; 145(16): 3361-3369, 2017 12.
Article
en En
| MEDLINE
| ID: mdl-29168439
ABSTRACT
Measles is a major cause of childhood morbidity and mortality in many parts of the world. Estimates of the case-fatality rate (CFR) of measles have varied widely from place to place, as well as in the same location over time. Amongst populations that have experienced famine or armed conflict, measles CFR can be especially high, although past work has mostly focused on refugee populations. Here, we estimate measles CFR between 1970 and 1991 in a rural region of Bangladesh, which experienced civil war and famine in the 1970s. We use historical measles mortality data and a mechanistic model of measles transmission to estimate the CFR of measles. We first demonstrate the ability of this model to recover the CFR in the absence of incidence data, using simulated mortality data. Our method produces CFR estimates that correspond closely to independent estimates from surveillance data and we can capture both the magnitude and the change in CFR suggested by these previous estimates. We use this method to quantify the sharp increase in CFR that resulted in a large number of deaths during a measles outbreak in the region in 1976. Most of the children who died during this outbreak were born during a famine in 1974, or in the 2 years preceding the famine. Our results suggest that the period of turmoil during and after the 1971 war and the sustained effects of the famine, is likely to have contributed to the high fatality burden of the 1976 measles outbreak in Matlab.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Inanición
/
Brotes de Enfermedades
/
Sarampión
Tipo de estudio:
Prognostic_studies
Límite:
Child, preschool
/
Female
/
Humans
/
Infant
País/Región como asunto:
Asia
Idioma:
En
Revista:
Epidemiol Infect
Asunto de la revista:
DOENCAS TRANSMISSIVEIS
/
EPIDEMIOLOGIA
Año:
2017
Tipo del documento:
Article
País de afiliación:
Estados Unidos