Episodic outbreaks bias estimates of age-specific force of infection: a corrected method using measles as an example

Understanding age-specific differences in infection rates can be important in predicting the magnitude of and mortality in outbreaks and targeting age groups for vaccination programmes. Standard methods to estimate age-specific rates assume that the age-specific force of infection is constant in tim...

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Bibliographic Details
Published in:Epidemiology and infection 2010-01, Vol.138 (1), p.108-116
Main Authors: FERRARI, M. J., DJIBO, A., GRAIS, R. F., GRENFELL, B. T., BJØRNSTAD, O. N.
Format: Article
Language:English
Subjects:
Adolescent
Age Distribution
Age groups
Age structure
Bias
Biological and medical sciences
Birth rate
Child
Child, Preschool
Developing countries
Disease models
Disease Outbreaks
Epidemics
Epidemiology
Estimates
estimation
Female
force of infection
Fundamental and applied biological sciences. Psychology
Human viral diseases
Humans
Incidence
Infant
Infant, Newborn
Infections
Infectious diseases
LDCs
Male
Measles
measles (rubeola)
Measles - epidemiology
Medical sciences
Methods and Modelling
Microbiology
Modeling
Models, Biological
Mortality
Niger - epidemiology
Vaccination
Vaccines
Viral diseases
Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye
Virology
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Summary:Understanding age-specific differences in infection rates can be important in predicting the magnitude of and mortality in outbreaks and targeting age groups for vaccination programmes. Standard methods to estimate age-specific rates assume that the age-specific force of infection is constant in time. However, this assumption may easily be violated in the face of a highly variable outbreak history, as recently observed for acute immunizing infections like measles, in strongly seasonal settings. Here we investigate the biases that result from ignoring such fluctuations in incidence and present a correction based on the epidemic history. We apply the method to data from a measles outbreak in Niamey, Niger and show that, despite a bimodal age distribution of cases, the estimated age-specific force of infection is unimodal and concentrated in young children (
ISSN:0950-2688
1469-4409
DOI:10.1017/S0950268809990173