Spatial-temporal pattern and drivers associated with measles resurgence from 2018 to 2023: a global perspective from...

Area of Science:

• Epidemiology
• Global Health
• Public Health Policy

Background:

• Measles resurgence poses a significant global public health challenge.
• Understanding spatial-temporal trends and contributing factors is vital for effective control.

Purpose of the Study:

• To explore global spatial-temporal measles trends.
• To identify underlying causes influencing measles incidence.

Main Methods:

• Analysis of measles incidence data from 192 countries (2018-2023).
• Integration of vaccination coverage, armed conflict, GDP per capita, and population data.
• Application of spatial-temporal models and a negative binomial mixed-effects model.

Main Results:

• Measles outbreaks shifted from Southeast Asia to sub-Saharan Africa (2018-2019), then towards Europe (2019-2023).
• Armed conflict significantly increased measles incidence (estimate=1.131, p<0.05).
• Higher second dose measles vaccine (MCV2) coverage reduced incidence (estimate=-0.052, p<0.05); lower GDP per capita correlated with higher burdens.

Conclusions:

• Achieving robust two-dose measles vaccination coverage, especially MCV2, is critical globally.
• Tailored interventions are essential for conflict-affected and low-income regions.
• Enhanced surveillance and targeted initiatives can mitigate measles spread by addressing conflict and socioeconomic drivers.