Please use this identifier to cite or link to this item: http://repositorio.ufc.br/handle/riufc/29800
Type: Artigo de Periódico
Title: Risk analysis for the reintroduction and transmission of measles in the post-elimination period in the Americas
Authors: Lemos, Daniele Rocha Queiroz
Franco, Aidee Ramirez
Garcia, Márcio Henrique de Oliveira
Pastor, Desireé
Bravo-Alcântara, Pâmela
Moraes, José Cássio de
Domingues, Carla
Cavalcanti, Luciano Pamplona de Góes
Keywords: Epidemiologia;Epidemiology;Medição de Risco;Risk Assessment
Issue Date: 2017
Publisher: Revista panamericana de salud pública
Citation: LEMOS, D. Z et al. Risk analysis for the reintroduction and transmission of measles in the post-elimination period in the Americas. Pan American Journal of Public Health, Washington, v. 41, p. 1-7, 2017.
Abstract: Objective. To propose and test a model for analyzing municipalities’ level of risk of reintroduc - tion and transmission of the measles virus in the post-elimination period in the Americas. Methods. An ecological-analytical study was conducted using data on the measles epidemic that occurred in 2013–2015 in northeastern Brazil. The variables for analysis were selected after an extensive review of scientific literature on the risk of importation of measles cases. A univariate analysis considering the presence or absence of confirmed cases of measles in 184 municipalities in the state of Ceará, Brazil, was carried out to evaluate the association between the dependent variable and 23 independent variables, grouped into four categories: 1) charac - teristics of the municipalities; 2) quality indicators for immunization programs and epidemio - logical surveillance; 3) organizational structure for the public health response; and 4) selected impact indicators. A P value < 0.05 was considered significant. All variables with P < 0.200 were analyzed using multivariate logistic regression. Based on the results, the municipalities were categorized by four levels of risk (“low,” “medium,” “high,” and “very high”). Results. The model sensitivity was 95% for concordance between municipalities classified as “high risk” and “very high risk” and those that had an epidemic between 2013 and 2015 in Ceará. Of the 38 municipalities that had an epidemic, 76% (29/38) were classified as “high risk” and “very high risk”; 146 municipalities did not report cases ( P < 0.0002). Conclusions. Given the imminent risk of reintroduction of measles circulation in the post-elimination period in the Americas, this model may be useful in identifying areas at greater risk for reintroduction and continued transmission of measles. Knowledge of vulnerable areas could trigger appropriate surveillance and monitoring to prevent sustained transmission
URI: http://www.repositorio.ufc.br/handle/riufc/29800
ISSN: 1020-4989
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