Measles seroprevalence in Chiradzulu district, Malawi: Implications for evaluating vaccine coverage

Abstract Introduction Self-reported measles vaccination coverage is frequently used to inform vaccination strategies in resource-poor settings. However, little is known to what extent this is a reliable indicator of underlying seroprotection, information that could provide guidance ensuring the succ...

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Bibliographic Details
Published in:Vaccine 2015-08, Vol.33 (36), p.4554-4558
Main Authors: Polonsky, Jonathan A, Juan-Giner, Aitana, Hurtado, Northan, Masiku, Charlie, Kagoli, Matthew, Grais, Rebecca F
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age
Aged
Allergy and Immunology
Biomedical research
Child
Child, Preschool
Disease
Drug Utilization
Female
HIV
Hospitals
Human immunodeficiency virus
Humans
Immunization
Immunoglobulins
Infant
Infections
Malawi
Malawi - epidemiology
Male
Measles
Measles - epidemiology
Measles - prevention & control
Measles Vaccine - administration & dosage
Middle Aged
Mortality
Public health
Questionnaires
Sample size
Seroepidemiologic Studies
Studies
Vaccination
Vaccines
Young Adult
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Summary:Abstract Introduction Self-reported measles vaccination coverage is frequently used to inform vaccination strategies in resource-poor settings. However, little is known to what extent this is a reliable indicator of underlying seroprotection, information that could provide guidance ensuring the success of measles control and elimination strategies. Methods As part of a study exploring HIV infection and measles susceptibility, we conveniently sampled consenting HIV-uninfected patients presenting at the HIV voluntary counselling and testing centre, and HIV-infected patients presenting for regular care, in Chiradzulu district hospital, Malawi, between January and September 2012. Results A total of 2106 participants were recruited between January and September 2012, three quarters of whom were HIV positive. Vaccination cards were available for just 7 participants (0.36%). 91.9% of participants were measles seropositive. Older age (OR = 1.11 per year increase in age; 95%CI: 1.09–1.14) and being female (OR = 1.90; 95%CI: 1.26–2.87) were both associated with significantly increased odds for seroprotection. Prior vaccination history was associated with lower odds (Odds Ratio (OR) = 0.44; 95% confidence interval (CI): 0.22–0.85) for confirmed seropositivity. Previous measles infection was not significantly associated with seroprotection (OR = 1.31; 95%CI: 0.49–3.51). Protection by history and serological status were concordant for 64.3% of participants
ISSN:0264-410X
1873-2518
DOI:10.1016/j.vaccine.2015.07.007