Spatial–temporal pattern and drivers associated with measles resurgence from 2018 to 2023: a global perspective from 192 countries
Introduction The resurgence of measles, a highly contagious infectious disease, has become a serious global public health issue. In this study, we aimed to explore global spatial–temporal measles trends and the underlying causes to help formulate effective intervention strategies.Methods We analysed...
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BMJ Publishing Group
2025-05-01
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| Series: | BMJ Public Health |
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| author | Jingzhi Li Ying Shen Xiang Xu Xiaoli Wang Zhuowei Luo |
| author_facet | Jingzhi Li Ying Shen Xiang Xu Xiaoli Wang Zhuowei Luo |
| author_sort | Jingzhi Li |
| collection | DOAJ |
| description | Introduction The resurgence of measles, a highly contagious infectious disease, has become a serious global public health issue. In this study, we aimed to explore global spatial–temporal measles trends and the underlying causes to help formulate effective intervention strategies.Methods We analysed measles incidence data from 192 countries, integrating measles vaccination coverage from WHO/UNICEF Estimates of National Immunization Coverage, armed conflict data from the Uppsala Conflict Data Program and gross domestic product (GDP) per capita and population data from the World Bank’s World Development Indicators. Hot spot analysis, mean centre and standard deviational ellipse models were used to examine the geographic and temporal shifts in measles outbreaks. A negative binomial mixed‐effects model was then constructed to determine the influence of population size, GDP per capita, measles vaccine coverage and armed conflict on measles incidence.Results Our findings showed a pronounced southward shift in measles outbreaks from Southeast Asia to sub-Saharan Africa between 2018 and 2019, followed by a northward progression towards Europe from 2019 to 2023. The negative binomial model indicated that armed conflict significantly increased measles incidence (estimate=1.131, p<0.05) and that higher second dose of measles vaccine (MCV2) coverage reduced incidence (estimate=–0.052, p<0.05). Additionally, regions with lower GDP per capita experienced elevated measles burdens, reflecting resource constraints and diminished vaccination infrastructure.Conclusions Ensuring robust two-dose vaccination coverage, particularly for MCV2, remains critical for reducing measles incidence worldwide. These results underscore the importance of tailored interventions, especially in conflict‐affected and lower‐income regions. Enhanced spatiotemporal surveillance and targeted public health initiatives can help address both the direct impact of armed conflict on health systems and the broader socioeconomic drivers that facilitate measles outbreaks. |
| format | Article |
| id | doaj-art-ab970cb06dad4557b52e0881e5cbe3ac |
| institution | OA Journals |
| issn | 2753-4294 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Public Health |
| spelling | doaj-art-ab970cb06dad4557b52e0881e5cbe3ac2025-08-20T02:38:27ZengBMJ Publishing GroupBMJ Public Health2753-42942025-05-013110.1136/bmjph-2024-001912Spatial–temporal pattern and drivers associated with measles resurgence from 2018 to 2023: a global perspective from 192 countriesJingzhi Li0Ying Shen1Xiang Xu2Xiaoli Wang3Zhuowei Luo4Beijing Center for Disease Prevention and Control, Beijing, ChinaNational Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, ChinaBeijing Center for Disease Prevention and Control, Beijing, ChinaDepartment of Medicine, Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USABeijing Center for Disease Prevention and Control, Beijing, ChinaIntroduction The resurgence of measles, a highly contagious infectious disease, has become a serious global public health issue. In this study, we aimed to explore global spatial–temporal measles trends and the underlying causes to help formulate effective intervention strategies.Methods We analysed measles incidence data from 192 countries, integrating measles vaccination coverage from WHO/UNICEF Estimates of National Immunization Coverage, armed conflict data from the Uppsala Conflict Data Program and gross domestic product (GDP) per capita and population data from the World Bank’s World Development Indicators. Hot spot analysis, mean centre and standard deviational ellipse models were used to examine the geographic and temporal shifts in measles outbreaks. A negative binomial mixed‐effects model was then constructed to determine the influence of population size, GDP per capita, measles vaccine coverage and armed conflict on measles incidence.Results Our findings showed a pronounced southward shift in measles outbreaks from Southeast Asia to sub-Saharan Africa between 2018 and 2019, followed by a northward progression towards Europe from 2019 to 2023. The negative binomial model indicated that armed conflict significantly increased measles incidence (estimate=1.131, p<0.05) and that higher second dose of measles vaccine (MCV2) coverage reduced incidence (estimate=–0.052, p<0.05). Additionally, regions with lower GDP per capita experienced elevated measles burdens, reflecting resource constraints and diminished vaccination infrastructure.Conclusions Ensuring robust two-dose vaccination coverage, particularly for MCV2, remains critical for reducing measles incidence worldwide. These results underscore the importance of tailored interventions, especially in conflict‐affected and lower‐income regions. Enhanced spatiotemporal surveillance and targeted public health initiatives can help address both the direct impact of armed conflict on health systems and the broader socioeconomic drivers that facilitate measles outbreaks.https://bmjpublichealth.bmj.com/content/3/1/e001912.full |
| spellingShingle | Jingzhi Li Ying Shen Xiang Xu Xiaoli Wang Zhuowei Luo Spatial–temporal pattern and drivers associated with measles resurgence from 2018 to 2023: a global perspective from 192 countries BMJ Public Health |
| title | Spatial–temporal pattern and drivers associated with measles resurgence from 2018 to 2023: a global perspective from 192 countries |
| title_full | Spatial–temporal pattern and drivers associated with measles resurgence from 2018 to 2023: a global perspective from 192 countries |
| title_fullStr | Spatial–temporal pattern and drivers associated with measles resurgence from 2018 to 2023: a global perspective from 192 countries |
| title_full_unstemmed | Spatial–temporal pattern and drivers associated with measles resurgence from 2018 to 2023: a global perspective from 192 countries |
| title_short | Spatial–temporal pattern and drivers associated with measles resurgence from 2018 to 2023: a global perspective from 192 countries |
| title_sort | spatial temporal pattern and drivers associated with measles resurgence from 2018 to 2023 a global perspective from 192 countries |
| url | https://bmjpublichealth.bmj.com/content/3/1/e001912.full |
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