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The geography of measles vaccination in the African Great Lakes region

Author(s): Takahashi, Saki; Metcalf, C. Jessica E.; Ferrari, Matthew J.; Tatem, Andrew J.; Lessler, Justin

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Abstract: Expanded access to measles vaccination was among the most successful public health interventions of recent decades. All WHO regions currently target measles elimination by 2020, yet continued measles circulation makes that goal seem elusive. Using Demographic and Health Surveys with generalized additive models, we quantify spatial patterns of measles vaccination in ten contiguous countries in the African Great Lakes region between 2009–2014. Seven countries have ‘coldspots’ where vaccine coverage is below the WHO target of 80%. Over 14 million children under 5 years of age live in coldspots across the region, and a total of 8–12 million children are unvaccinated. Spatial patterns of vaccination do not map directly onto sub-national administrative units and transnational coldspots exist. Clustering of low vaccination areas may allow for pockets of susceptibility that sustain circulation despite high overall coverage. Targeting at-risk areas and transnational coordination are likely required to eliminate measles in the region.
Publication Date: 25-May-2017
Electronic Publication Date: 25-May-2017
Citation: Takahashi, Saki, Metcalf, C. Jessica E., Ferrari, Matthew J., Tatem, Andrew J., Lessler, Justin. (2017). The geography of measles vaccination in the African Great Lakes region. Nature Communications, 8:15585. doi:10.1038/ncomms15585
DOI: doi:10.1038/ncomms15585
EISSN: 2041-1723
Pages: 1 - 9
Type of Material: Journal Article
Journal/Proceeding Title: Nature Communications
Version: Final published version. This is an open access article.



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