Measles resurgence in Brazil: analysis of the 2019 epidemic in the state of São Paulo

ABSTRACT OBJECTIVE To analyze the epidemiological profile of cases and the pattern of spatial diffusion of the largest measles epidemic in Brazil that occurred in the post-elimination period in the state of São Paulo. METHOD A cross-sectional study based on confirmed measles cases in 2019. Bivariate analysis was performed for socioeconomic, clinical, and epidemiological variables, according to prior vaccination and hospitalization, combined with an analysis of spatial diffusion of cases using the Inverse Distance Weighting (IDW) method. RESULTS Of the 15,598 confirmed cases, 2,039 were hospitalized and 17 progressed to death. The epidemic peak occurred in epidemiological week 33, after confirmation of the first case, in the epidemiological week 6. Most cases were male (52.1%), aged between 18 and 29 years (38.7%), identified as whites (70%). Young adults (39.7%) and children under five years (32.8%) were the most affected age groups. A higher proportion of previous vaccination was observed in whites as compared to Blacks, browns, yellows and indigenous people (p < 0.001), as well as in the most educated group compared to the other categories (p < 0.001). The risk of hospitalization was higher in children than in the older age group (RI = 2.19; 95%CI: 1.66–2.88), as well as in the unvaccinated than in the vaccinated (RI = 1.59; 95%CI: 1.45–1.75). The pattern of diffusion by contiguity combined with diffusion by relocation followed the urban hierarchy of the main cities’ regions of influence. CONCLUSION In addition to routine vaccination in children, the findings indicate the need for immunization campaigns for young adults. In addition, studies that seek to investigate the occurrence of clusters of vulnerable populations, prone to lower vaccination coverage, are essential to broaden the understanding of the dynamics of transmission and, thus, reorienting control strategies that ensure disease elimination. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Cristina Makarenko [verfasserIn] Alexandre San Pedro [verfasserIn] Natalia Santana Paiva [verfasserIn] Jefferson Pereira Caldas dos Santos [verfasserIn] Roberto de Andrade Medronho [verfasserIn] Gerusa Gibson [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch ; Spanisch ; Portugiesisch

Erschienen:	2022

Schlagwörter:	Measles, epidemiology Disease Transmission, Infectious Epidemics Communicable Disease Control Vaccination Coverage

Übergeordnetes Werk:	In: Revista de Saúde Pública - Universidade de São Paulo, 2004, 56(2022)
Übergeordnetes Werk:	volume:56 ; year:2022

Links:	Link aufrufen Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.11606/s1518-8787.2022056003805

Katalog-ID:	DOAJ042065801

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520			\|a ABSTRACT OBJECTIVE To analyze the epidemiological profile of cases and the pattern of spatial diffusion of the largest measles epidemic in Brazil that occurred in the post-elimination period in the state of São Paulo. METHOD A cross-sectional study based on confirmed measles cases in 2019. Bivariate analysis was performed for socioeconomic, clinical, and epidemiological variables, according to prior vaccination and hospitalization, combined with an analysis of spatial diffusion of cases using the Inverse Distance Weighting (IDW) method. RESULTS Of the 15,598 confirmed cases, 2,039 were hospitalized and 17 progressed to death. The epidemic peak occurred in epidemiological week 33, after confirmation of the first case, in the epidemiological week 6. Most cases were male (52.1%), aged between 18 and 29 years (38.7%), identified as whites (70%). Young adults (39.7%) and children under five years (32.8%) were the most affected age groups. A higher proportion of previous vaccination was observed in whites as compared to Blacks, browns, yellows and indigenous people (p < 0.001), as well as in the most educated group compared to the other categories (p < 0.001). The risk of hospitalization was higher in children than in the older age group (RI = 2.19; 95%CI: 1.66–2.88), as well as in the unvaccinated than in the vaccinated (RI = 1.59; 95%CI: 1.45–1.75). The pattern of diffusion by contiguity combined with diffusion by relocation followed the urban hierarchy of the main cities’ regions of influence. CONCLUSION In addition to routine vaccination in children, the findings indicate the need for immunization campaigns for young adults. In addition, studies that seek to investigate the occurrence of clusters of vulnerable populations, prone to lower vaccination coverage, are essential to broaden the understanding of the dynamics of transmission and, thus, reorienting control strategies that ensure disease elimination.
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650		4	\|a Disease Transmission, Infectious
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650		4	\|a Communicable Disease Control
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allfields	10.11606/s1518-8787.2022056003805 doi (DE-627)DOAJ042065801 (DE-599)DOAJf855545e5fc64c6eaccbe7160ed89edc DE-627 ger DE-627 rakwb eng spa por RA1-1270 Cristina Makarenko verfasserin aut Measles resurgence in Brazil: analysis of the 2019 epidemic in the state of São Paulo 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ABSTRACT OBJECTIVE To analyze the epidemiological profile of cases and the pattern of spatial diffusion of the largest measles epidemic in Brazil that occurred in the post-elimination period in the state of São Paulo. METHOD A cross-sectional study based on confirmed measles cases in 2019. Bivariate analysis was performed for socioeconomic, clinical, and epidemiological variables, according to prior vaccination and hospitalization, combined with an analysis of spatial diffusion of cases using the Inverse Distance Weighting (IDW) method. RESULTS Of the 15,598 confirmed cases, 2,039 were hospitalized and 17 progressed to death. The epidemic peak occurred in epidemiological week 33, after confirmation of the first case, in the epidemiological week 6. Most cases were male (52.1%), aged between 18 and 29 years (38.7%), identified as whites (70%). Young adults (39.7%) and children under five years (32.8%) were the most affected age groups. A higher proportion of previous vaccination was observed in whites as compared to Blacks, browns, yellows and indigenous people (p < 0.001), as well as in the most educated group compared to the other categories (p < 0.001). The risk of hospitalization was higher in children than in the older age group (RI = 2.19; 95%CI: 1.66–2.88), as well as in the unvaccinated than in the vaccinated (RI = 1.59; 95%CI: 1.45–1.75). The pattern of diffusion by contiguity combined with diffusion by relocation followed the urban hierarchy of the main cities’ regions of influence. CONCLUSION In addition to routine vaccination in children, the findings indicate the need for immunization campaigns for young adults. In addition, studies that seek to investigate the occurrence of clusters of vulnerable populations, prone to lower vaccination coverage, are essential to broaden the understanding of the dynamics of transmission and, thus, reorienting control strategies that ensure disease elimination. Measles, epidemiology Disease Transmission, Infectious Epidemics Communicable Disease Control Vaccination Coverage Public aspects of medicine Alexandre San Pedro verfasserin aut Natalia Santana Paiva verfasserin aut Jefferson Pereira Caldas dos Santos verfasserin aut Roberto de Andrade Medronho verfasserin aut Gerusa Gibson verfasserin aut In Revista de Saúde Pública Universidade de São Paulo, 2004 56(2022) (DE-627)324824793 (DE-600)2031055-9 15188787 nnns volume:56 year:2022 https://doi.org/10.11606/s1518-8787.2022056003805 kostenfrei https://doaj.org/article/f855545e5fc64c6eaccbe7160ed89edc kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102022000100241&lng=en&tlng=en kostenfrei http://www.scielo.br/pdf/rsp/v56/1518-8787-rsp-56-50.pdf kostenfrei https://doaj.org/toc/1518-8787 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 56 2022
spelling	10.11606/s1518-8787.2022056003805 doi (DE-627)DOAJ042065801 (DE-599)DOAJf855545e5fc64c6eaccbe7160ed89edc DE-627 ger DE-627 rakwb eng spa por RA1-1270 Cristina Makarenko verfasserin aut Measles resurgence in Brazil: analysis of the 2019 epidemic in the state of São Paulo 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ABSTRACT OBJECTIVE To analyze the epidemiological profile of cases and the pattern of spatial diffusion of the largest measles epidemic in Brazil that occurred in the post-elimination period in the state of São Paulo. METHOD A cross-sectional study based on confirmed measles cases in 2019. Bivariate analysis was performed for socioeconomic, clinical, and epidemiological variables, according to prior vaccination and hospitalization, combined with an analysis of spatial diffusion of cases using the Inverse Distance Weighting (IDW) method. RESULTS Of the 15,598 confirmed cases, 2,039 were hospitalized and 17 progressed to death. The epidemic peak occurred in epidemiological week 33, after confirmation of the first case, in the epidemiological week 6. Most cases were male (52.1%), aged between 18 and 29 years (38.7%), identified as whites (70%). Young adults (39.7%) and children under five years (32.8%) were the most affected age groups. A higher proportion of previous vaccination was observed in whites as compared to Blacks, browns, yellows and indigenous people (p < 0.001), as well as in the most educated group compared to the other categories (p < 0.001). The risk of hospitalization was higher in children than in the older age group (RI = 2.19; 95%CI: 1.66–2.88), as well as in the unvaccinated than in the vaccinated (RI = 1.59; 95%CI: 1.45–1.75). The pattern of diffusion by contiguity combined with diffusion by relocation followed the urban hierarchy of the main cities’ regions of influence. CONCLUSION In addition to routine vaccination in children, the findings indicate the need for immunization campaigns for young adults. In addition, studies that seek to investigate the occurrence of clusters of vulnerable populations, prone to lower vaccination coverage, are essential to broaden the understanding of the dynamics of transmission and, thus, reorienting control strategies that ensure disease elimination. Measles, epidemiology Disease Transmission, Infectious Epidemics Communicable Disease Control Vaccination Coverage Public aspects of medicine Alexandre San Pedro verfasserin aut Natalia Santana Paiva verfasserin aut Jefferson Pereira Caldas dos Santos verfasserin aut Roberto de Andrade Medronho verfasserin aut Gerusa Gibson verfasserin aut In Revista de Saúde Pública Universidade de São Paulo, 2004 56(2022) (DE-627)324824793 (DE-600)2031055-9 15188787 nnns volume:56 year:2022 https://doi.org/10.11606/s1518-8787.2022056003805 kostenfrei https://doaj.org/article/f855545e5fc64c6eaccbe7160ed89edc kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102022000100241&lng=en&tlng=en kostenfrei http://www.scielo.br/pdf/rsp/v56/1518-8787-rsp-56-50.pdf kostenfrei https://doaj.org/toc/1518-8787 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 56 2022
allfields_unstemmed	10.11606/s1518-8787.2022056003805 doi (DE-627)DOAJ042065801 (DE-599)DOAJf855545e5fc64c6eaccbe7160ed89edc DE-627 ger DE-627 rakwb eng spa por RA1-1270 Cristina Makarenko verfasserin aut Measles resurgence in Brazil: analysis of the 2019 epidemic in the state of São Paulo 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ABSTRACT OBJECTIVE To analyze the epidemiological profile of cases and the pattern of spatial diffusion of the largest measles epidemic in Brazil that occurred in the post-elimination period in the state of São Paulo. METHOD A cross-sectional study based on confirmed measles cases in 2019. Bivariate analysis was performed for socioeconomic, clinical, and epidemiological variables, according to prior vaccination and hospitalization, combined with an analysis of spatial diffusion of cases using the Inverse Distance Weighting (IDW) method. RESULTS Of the 15,598 confirmed cases, 2,039 were hospitalized and 17 progressed to death. The epidemic peak occurred in epidemiological week 33, after confirmation of the first case, in the epidemiological week 6. Most cases were male (52.1%), aged between 18 and 29 years (38.7%), identified as whites (70%). Young adults (39.7%) and children under five years (32.8%) were the most affected age groups. A higher proportion of previous vaccination was observed in whites as compared to Blacks, browns, yellows and indigenous people (p < 0.001), as well as in the most educated group compared to the other categories (p < 0.001). The risk of hospitalization was higher in children than in the older age group (RI = 2.19; 95%CI: 1.66–2.88), as well as in the unvaccinated than in the vaccinated (RI = 1.59; 95%CI: 1.45–1.75). The pattern of diffusion by contiguity combined with diffusion by relocation followed the urban hierarchy of the main cities’ regions of influence. CONCLUSION In addition to routine vaccination in children, the findings indicate the need for immunization campaigns for young adults. In addition, studies that seek to investigate the occurrence of clusters of vulnerable populations, prone to lower vaccination coverage, are essential to broaden the understanding of the dynamics of transmission and, thus, reorienting control strategies that ensure disease elimination. Measles, epidemiology Disease Transmission, Infectious Epidemics Communicable Disease Control Vaccination Coverage Public aspects of medicine Alexandre San Pedro verfasserin aut Natalia Santana Paiva verfasserin aut Jefferson Pereira Caldas dos Santos verfasserin aut Roberto de Andrade Medronho verfasserin aut Gerusa Gibson verfasserin aut In Revista de Saúde Pública Universidade de São Paulo, 2004 56(2022) (DE-627)324824793 (DE-600)2031055-9 15188787 nnns volume:56 year:2022 https://doi.org/10.11606/s1518-8787.2022056003805 kostenfrei https://doaj.org/article/f855545e5fc64c6eaccbe7160ed89edc kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102022000100241&lng=en&tlng=en kostenfrei http://www.scielo.br/pdf/rsp/v56/1518-8787-rsp-56-50.pdf kostenfrei https://doaj.org/toc/1518-8787 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 56 2022
allfieldsGer	10.11606/s1518-8787.2022056003805 doi (DE-627)DOAJ042065801 (DE-599)DOAJf855545e5fc64c6eaccbe7160ed89edc DE-627 ger DE-627 rakwb eng spa por RA1-1270 Cristina Makarenko verfasserin aut Measles resurgence in Brazil: analysis of the 2019 epidemic in the state of São Paulo 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ABSTRACT OBJECTIVE To analyze the epidemiological profile of cases and the pattern of spatial diffusion of the largest measles epidemic in Brazil that occurred in the post-elimination period in the state of São Paulo. METHOD A cross-sectional study based on confirmed measles cases in 2019. Bivariate analysis was performed for socioeconomic, clinical, and epidemiological variables, according to prior vaccination and hospitalization, combined with an analysis of spatial diffusion of cases using the Inverse Distance Weighting (IDW) method. RESULTS Of the 15,598 confirmed cases, 2,039 were hospitalized and 17 progressed to death. The epidemic peak occurred in epidemiological week 33, after confirmation of the first case, in the epidemiological week 6. Most cases were male (52.1%), aged between 18 and 29 years (38.7%), identified as whites (70%). Young adults (39.7%) and children under five years (32.8%) were the most affected age groups. A higher proportion of previous vaccination was observed in whites as compared to Blacks, browns, yellows and indigenous people (p < 0.001), as well as in the most educated group compared to the other categories (p < 0.001). The risk of hospitalization was higher in children than in the older age group (RI = 2.19; 95%CI: 1.66–2.88), as well as in the unvaccinated than in the vaccinated (RI = 1.59; 95%CI: 1.45–1.75). The pattern of diffusion by contiguity combined with diffusion by relocation followed the urban hierarchy of the main cities’ regions of influence. CONCLUSION In addition to routine vaccination in children, the findings indicate the need for immunization campaigns for young adults. In addition, studies that seek to investigate the occurrence of clusters of vulnerable populations, prone to lower vaccination coverage, are essential to broaden the understanding of the dynamics of transmission and, thus, reorienting control strategies that ensure disease elimination. Measles, epidemiology Disease Transmission, Infectious Epidemics Communicable Disease Control Vaccination Coverage Public aspects of medicine Alexandre San Pedro verfasserin aut Natalia Santana Paiva verfasserin aut Jefferson Pereira Caldas dos Santos verfasserin aut Roberto de Andrade Medronho verfasserin aut Gerusa Gibson verfasserin aut In Revista de Saúde Pública Universidade de São Paulo, 2004 56(2022) (DE-627)324824793 (DE-600)2031055-9 15188787 nnns volume:56 year:2022 https://doi.org/10.11606/s1518-8787.2022056003805 kostenfrei https://doaj.org/article/f855545e5fc64c6eaccbe7160ed89edc kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102022000100241&lng=en&tlng=en kostenfrei http://www.scielo.br/pdf/rsp/v56/1518-8787-rsp-56-50.pdf kostenfrei https://doaj.org/toc/1518-8787 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 56 2022
allfieldsSound	10.11606/s1518-8787.2022056003805 doi (DE-627)DOAJ042065801 (DE-599)DOAJf855545e5fc64c6eaccbe7160ed89edc DE-627 ger DE-627 rakwb eng spa por RA1-1270 Cristina Makarenko verfasserin aut Measles resurgence in Brazil: analysis of the 2019 epidemic in the state of São Paulo 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ABSTRACT OBJECTIVE To analyze the epidemiological profile of cases and the pattern of spatial diffusion of the largest measles epidemic in Brazil that occurred in the post-elimination period in the state of São Paulo. METHOD A cross-sectional study based on confirmed measles cases in 2019. Bivariate analysis was performed for socioeconomic, clinical, and epidemiological variables, according to prior vaccination and hospitalization, combined with an analysis of spatial diffusion of cases using the Inverse Distance Weighting (IDW) method. RESULTS Of the 15,598 confirmed cases, 2,039 were hospitalized and 17 progressed to death. The epidemic peak occurred in epidemiological week 33, after confirmation of the first case, in the epidemiological week 6. Most cases were male (52.1%), aged between 18 and 29 years (38.7%), identified as whites (70%). Young adults (39.7%) and children under five years (32.8%) were the most affected age groups. A higher proportion of previous vaccination was observed in whites as compared to Blacks, browns, yellows and indigenous people (p < 0.001), as well as in the most educated group compared to the other categories (p < 0.001). The risk of hospitalization was higher in children than in the older age group (RI = 2.19; 95%CI: 1.66–2.88), as well as in the unvaccinated than in the vaccinated (RI = 1.59; 95%CI: 1.45–1.75). The pattern of diffusion by contiguity combined with diffusion by relocation followed the urban hierarchy of the main cities’ regions of influence. CONCLUSION In addition to routine vaccination in children, the findings indicate the need for immunization campaigns for young adults. In addition, studies that seek to investigate the occurrence of clusters of vulnerable populations, prone to lower vaccination coverage, are essential to broaden the understanding of the dynamics of transmission and, thus, reorienting control strategies that ensure disease elimination. Measles, epidemiology Disease Transmission, Infectious Epidemics Communicable Disease Control Vaccination Coverage Public aspects of medicine Alexandre San Pedro verfasserin aut Natalia Santana Paiva verfasserin aut Jefferson Pereira Caldas dos Santos verfasserin aut Roberto de Andrade Medronho verfasserin aut Gerusa Gibson verfasserin aut In Revista de Saúde Pública Universidade de São Paulo, 2004 56(2022) (DE-627)324824793 (DE-600)2031055-9 15188787 nnns volume:56 year:2022 https://doi.org/10.11606/s1518-8787.2022056003805 kostenfrei https://doaj.org/article/f855545e5fc64c6eaccbe7160ed89edc kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102022000100241&lng=en&tlng=en kostenfrei http://www.scielo.br/pdf/rsp/v56/1518-8787-rsp-56-50.pdf kostenfrei https://doaj.org/toc/1518-8787 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 56 2022
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authorswithroles_txt_mv	Cristina Makarenko @@aut@@ Alexandre San Pedro @@aut@@ Natalia Santana Paiva @@aut@@ Jefferson Pereira Caldas dos Santos @@aut@@ Roberto de Andrade Medronho @@aut@@ Gerusa Gibson @@aut@@
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spellingShingle	Cristina Makarenko misc RA1-1270 misc Measles, epidemiology misc Disease Transmission, Infectious misc Epidemics misc Communicable Disease Control misc Vaccination Coverage misc Public aspects of medicine Measles resurgence in Brazil: analysis of the 2019 epidemic in the state of São Paulo
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topic_title	RA1-1270 Measles resurgence in Brazil: analysis of the 2019 epidemic in the state of São Paulo Measles, epidemiology Disease Transmission, Infectious Epidemics Communicable Disease Control Vaccination Coverage
topic	misc RA1-1270 misc Measles, epidemiology misc Disease Transmission, Infectious misc Epidemics misc Communicable Disease Control misc Vaccination Coverage misc Public aspects of medicine
topic_unstemmed	misc RA1-1270 misc Measles, epidemiology misc Disease Transmission, Infectious misc Epidemics misc Communicable Disease Control misc Vaccination Coverage misc Public aspects of medicine
topic_browse	misc RA1-1270 misc Measles, epidemiology misc Disease Transmission, Infectious misc Epidemics misc Communicable Disease Control misc Vaccination Coverage misc Public aspects of medicine
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title	Measles resurgence in Brazil: analysis of the 2019 epidemic in the state of São Paulo
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title_full	Measles resurgence in Brazil: analysis of the 2019 epidemic in the state of São Paulo
author_sort	Cristina Makarenko
journal	Revista de Saúde Pública
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author_browse	Cristina Makarenko Alexandre San Pedro Natalia Santana Paiva Jefferson Pereira Caldas dos Santos Roberto de Andrade Medronho Gerusa Gibson
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title_sort	measles resurgence in brazil: analysis of the 2019 epidemic in the state of são paulo
callnumber	RA1-1270
title_auth	Measles resurgence in Brazil: analysis of the 2019 epidemic in the state of São Paulo
abstract	ABSTRACT OBJECTIVE To analyze the epidemiological profile of cases and the pattern of spatial diffusion of the largest measles epidemic in Brazil that occurred in the post-elimination period in the state of São Paulo. METHOD A cross-sectional study based on confirmed measles cases in 2019. Bivariate analysis was performed for socioeconomic, clinical, and epidemiological variables, according to prior vaccination and hospitalization, combined with an analysis of spatial diffusion of cases using the Inverse Distance Weighting (IDW) method. RESULTS Of the 15,598 confirmed cases, 2,039 were hospitalized and 17 progressed to death. The epidemic peak occurred in epidemiological week 33, after confirmation of the first case, in the epidemiological week 6. Most cases were male (52.1%), aged between 18 and 29 years (38.7%), identified as whites (70%). Young adults (39.7%) and children under five years (32.8%) were the most affected age groups. A higher proportion of previous vaccination was observed in whites as compared to Blacks, browns, yellows and indigenous people (p < 0.001), as well as in the most educated group compared to the other categories (p < 0.001). The risk of hospitalization was higher in children than in the older age group (RI = 2.19; 95%CI: 1.66–2.88), as well as in the unvaccinated than in the vaccinated (RI = 1.59; 95%CI: 1.45–1.75). The pattern of diffusion by contiguity combined with diffusion by relocation followed the urban hierarchy of the main cities’ regions of influence. CONCLUSION In addition to routine vaccination in children, the findings indicate the need for immunization campaigns for young adults. In addition, studies that seek to investigate the occurrence of clusters of vulnerable populations, prone to lower vaccination coverage, are essential to broaden the understanding of the dynamics of transmission and, thus, reorienting control strategies that ensure disease elimination.
abstractGer	ABSTRACT OBJECTIVE To analyze the epidemiological profile of cases and the pattern of spatial diffusion of the largest measles epidemic in Brazil that occurred in the post-elimination period in the state of São Paulo. METHOD A cross-sectional study based on confirmed measles cases in 2019. Bivariate analysis was performed for socioeconomic, clinical, and epidemiological variables, according to prior vaccination and hospitalization, combined with an analysis of spatial diffusion of cases using the Inverse Distance Weighting (IDW) method. RESULTS Of the 15,598 confirmed cases, 2,039 were hospitalized and 17 progressed to death. The epidemic peak occurred in epidemiological week 33, after confirmation of the first case, in the epidemiological week 6. Most cases were male (52.1%), aged between 18 and 29 years (38.7%), identified as whites (70%). Young adults (39.7%) and children under five years (32.8%) were the most affected age groups. A higher proportion of previous vaccination was observed in whites as compared to Blacks, browns, yellows and indigenous people (p < 0.001), as well as in the most educated group compared to the other categories (p < 0.001). The risk of hospitalization was higher in children than in the older age group (RI = 2.19; 95%CI: 1.66–2.88), as well as in the unvaccinated than in the vaccinated (RI = 1.59; 95%CI: 1.45–1.75). The pattern of diffusion by contiguity combined with diffusion by relocation followed the urban hierarchy of the main cities’ regions of influence. CONCLUSION In addition to routine vaccination in children, the findings indicate the need for immunization campaigns for young adults. In addition, studies that seek to investigate the occurrence of clusters of vulnerable populations, prone to lower vaccination coverage, are essential to broaden the understanding of the dynamics of transmission and, thus, reorienting control strategies that ensure disease elimination.
abstract_unstemmed	ABSTRACT OBJECTIVE To analyze the epidemiological profile of cases and the pattern of spatial diffusion of the largest measles epidemic in Brazil that occurred in the post-elimination period in the state of São Paulo. METHOD A cross-sectional study based on confirmed measles cases in 2019. Bivariate analysis was performed for socioeconomic, clinical, and epidemiological variables, according to prior vaccination and hospitalization, combined with an analysis of spatial diffusion of cases using the Inverse Distance Weighting (IDW) method. RESULTS Of the 15,598 confirmed cases, 2,039 were hospitalized and 17 progressed to death. The epidemic peak occurred in epidemiological week 33, after confirmation of the first case, in the epidemiological week 6. Most cases were male (52.1%), aged between 18 and 29 years (38.7%), identified as whites (70%). Young adults (39.7%) and children under five years (32.8%) were the most affected age groups. A higher proportion of previous vaccination was observed in whites as compared to Blacks, browns, yellows and indigenous people (p < 0.001), as well as in the most educated group compared to the other categories (p < 0.001). The risk of hospitalization was higher in children than in the older age group (RI = 2.19; 95%CI: 1.66–2.88), as well as in the unvaccinated than in the vaccinated (RI = 1.59; 95%CI: 1.45–1.75). The pattern of diffusion by contiguity combined with diffusion by relocation followed the urban hierarchy of the main cities’ regions of influence. CONCLUSION In addition to routine vaccination in children, the findings indicate the need for immunization campaigns for young adults. In addition, studies that seek to investigate the occurrence of clusters of vulnerable populations, prone to lower vaccination coverage, are essential to broaden the understanding of the dynamics of transmission and, thus, reorienting control strategies that ensure disease elimination.
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title_short	Measles resurgence in Brazil: analysis of the 2019 epidemic in the state of São Paulo
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author2	Alexandre San Pedro Natalia Santana Paiva Jefferson Pereira Caldas dos Santos Roberto de Andrade Medronho Gerusa Gibson
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up_date	2024-07-03T23:29:01.923Z
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