Int J Infect Dis 1999; 4:14-20

Objectives: In discussions of expanded measles control, elimination, and possible eradication, better estimates of disease burden are increasingly important to target vaccination control measures. Because global surveillance for measles is inadequate, a model to quantify country-specific estimates of measles disease burden was formulated to help policy-makers consider control options. Methods: Country-specific demographics, developmental status, historic vaccine coverage rates, and age-specific vaccine efficacy and attack rates were used to determine the number of measles cases and deaths for 5-year periods. Results: The model estimates an annual global incidence of 32 million measles-susceptible persons (~25% of the global birth cohort), resulting in 28 million cases and 691 thousand deaths. Eighty-four percent (578,000) of the global deaths occur in the World Health Organization African and Southeast Asian regions. Twenty countries account for 82% of deaths attributable to measles. In nine countries, over 2% of the birth-cohort are estimated to die from measles. Conclusions: This methodology quantifies country- and age-specific measles disease burden and establishes regional and global disease patterns, allowing aggregations by income groups and regions, which aids policy formulation. The data may be continuously updated, based on dynamic changes in vaccine coverage rates and the incorporation of national vaccination campaigns.

KEYWORDS: child mortality, global disease burden, measles, models, vaccines

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