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Time Series Forecasting of Measles Incidence in Pakistan, 2014-2024

Aruba Adnan¹, Olaf Berke^1,2,3,4

¹Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.

Asia-Pacific Journal of Public Health

|January 22, 2026

Abstract:

Measles remains endemic in Pakistan despite global vaccine efforts to prevent its transmission. This study sought to identify the patterns of measles cases in Pakistan, understand the reasons for its recurrence, and determine the optimal timing for measles vaccine campaigns in Pakistan to be most effective. As such, a time series analysis of the monthly measles incidence in Pakistan from 2014 to 2024, obtained from World Health Organization's international measles database, was performed to identify temporal patterns in infections. An increasing trend was identified in the monthly measles cases overtime, along with seasonal swings of low occurrences during the summer, with average lows reaching 304 cases, and a rise during the winter months, with average highs reaching 1038 cases. An automated Seasonal Auto-Regressive Integrated Moving Average (SARIMA) model was further applied to forecast the future incidence of measles, which revealed a three-fold increase in measles cases in the next two years, compared with 2023-2024. Low routine vaccine coverage, topped with climate change related migration and subsequent crowding in urban spaces were found to be major contributors to measles transmission in the country. Findings suggest that supplementary vaccination campaigns are essential and if held in August-September, can mitigate the anticipated rise in measles transmission beginning October every year.

Insights

Measles cases in Pakistan are increasing, with winter surges predicted. Strategic vaccination campaigns in August-September can effectively combat rising measles transmission.

Area of Science:

Epidemiology
Public Health
Immunization

Background:

Measles remains endemic in Pakistan, posing a significant public health challenge despite global vaccination initiatives.
Understanding transmission patterns and recurrence factors is crucial for effective control strategies.

Purpose of the Study:

To identify temporal patterns of measles incidence in Pakistan.
To investigate the drivers of measles recurrence.
To determine optimal timing for measles vaccination campaigns.

Main Methods:

Time series analysis of monthly measles incidence data (2014-2024) from the WHO international measles database.
Application of an automated Seasonal Autoregressive Integrated Moving Average (SARIMA) model for forecasting.
Analysis of contributing factors including vaccine coverage and climate change impacts.

Main Results:

An increasing trend in monthly measles cases was observed, with seasonal peaks in winter (average highs of 1038 cases) and lows in summer (average lows of 304 cases).
The SARIMA model forecasts a three-fold increase in measles cases over the next two years.
Low routine vaccine coverage, climate change-induced migration, and urban crowding are identified as key contributors to transmission.

Conclusions:

Supplementary vaccination campaigns are essential to mitigate the anticipated rise in measles cases.
Conducting these campaigns in August-September can effectively counter the seasonal increase in transmission starting in October.

Read full analysis

Keywords:

Pakistan SARIMA disease surveillance forecasting measles public health time series analysis

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