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. 2022 Jan 20:8:798031.
doi: 10.3389/fmed.2021.798031. eCollection 2021.

Trends of the Global, Regional, and National Incidence of Measles, Vaccine Coverage, and Risk Factors in 204 Countries From 1990 to 2019

Ruitong Wang  1 , Wenzhan Jing  1 , Min Liu  1 , Jue Liu  1   2   3
Affiliations

Trends of the Global, Regional, and National Incidence of Measles, Vaccine Coverage, and Risk Factors in 204 Countries From 1990 to 2019

Ruitong Wang et al. Front Med (Lausanne). .

Abstract

Background: Measles is a highly contagious disease that has caused global morbidity and mortality. Though great progress has been made in measles elimination, the resurgence of measles has been observed in recent years. As extant literature were mainly confined to data of local area, we conducted a systematic analysis to explore the trends of the incidence of measles, coverage rate, and the risk factors from 1990 to 2019 on global, regional, and national levels.

Methods: Data on cases of incidence, age standardized rate (ASR), vaccine coverage, and risk factors of measles were retrieved from the Global Burden of Disease (GBD) Study 2019 database. Estimated averaged percentage change (EAPC) of ASR was calculated to quantify the trends of measles incidence. Pearson correlation was applied to assess the association of EAPC and measles-containing vaccine coverage rate with socio-demographic index (SDI) in 2019, and the correlation between ASR and measles-containing vaccine coverage rate.

Results: Globally, there was a significant decrease in the number (84.18%) and ASR (6.13%, 95% CI: 5.41-6.84%) of measles incidence from 1990 to 2019. More than 80% of incidence cases were attributed to children under 5 and the proportion was highest in low SDI region. Countries and territories with low ASRs are mostly clustered in North America, Southern Latin America, and Western Europe, whereas those with high ASRs are mainly clustered in Africa, East Asia, and South Asia. Lower SDI was associated with higher ASR and lower vaccine coverage rate. The more the SDI value was further away from 0.6, the smaller the absolute value did EAPC have. Child wasting accounted for the most measles-related death cases, followed by child underweight, child stunting, and vitamin A deficiency.

Conclusions: Measles eradication is feasible, but urgently demands political commitment, financial support, and public engagement. In the context of COVID-19 pandemic and the global resurgence of measles, surveillance systems and routine immunization programs should be improved, while vaccine hesitancy needs to be addressed.

Keywords: incidence; measles; prevention; risk factor; trend; vaccination.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The number of measles incidence cases by age groups and SDI regions. SDI: socio-demographic index.
Figure 2
Figure 2
The global trends in measles incidence in 204 countries and territories. (A) The ASR of measles in 2019; (B) changes in number of measles incidence cases between 1990 and 2019; (C) the EAPC of measles ASR from 1990 to 2019. ASR, age-standardized rate; EAPC, estimated annual percentage change.
Figure 3
Figure 3
The correlation between measles EAPC and SDI in 2019 at national level. EAPC, estimated annual percentage change; SDI, socio-demographic index.
Figure 4
Figure 4
The global trends in MCV1 coverage in 204 countries and territories. (A) MCV1 coverage rate in 2019; (B) changes in MCV1 coverage rate between 1990 and 2019. MCV1, measles-containing vaccine, dose 1.
Figure 5
Figure 5
The correlation between measles-containing vaccine coverage and SDI in 2019 at national level. (A) The correlation between MCV1 coverage rate and SDI in 2019 at national level. (B) The correlation between MCV2 coverage rate and SDI in 2019 at national level. MCV1, measles-containing vaccine, dose 1; MCV2, measles-containing vaccine, dose 2; SDI, socio-demographic index.
Figure 6
Figure 6
The number of measles death cases by risk factors and SDI regions. SDI, socio-demographic index.
See this image and copyright information in PMC

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