SPATIAL DISTRIBUTION AND EPIDEMIOLOGICAL INSIGHTS INTO WANING MEASLES IMMUNITY AMONG VACCINATED CHILDREN IN LUSAKA, ZAMBIA

Authors

  • Priscilla Nkonde Gardner Department of Public Health, University of Zambia, Lusaka, Zambia Department of Public Health, Zambia National Public Health Institute, Lusaka, Zambia
  • Jimmy Hangoma Department of Health Sciences, Levy Mwanawasa University, Zambia
  • Nosia Mhango Mwila Department of Public Health, University of Zambia, Lusaka, Zambia
  • Isaac Fwemba Department of Public Health, University of Zambia, Lusaka, Zambia

DOI:

https://doi.org/10.46827/ejphs.v8i1.201

Keywords:

measles, spatial analysis, geographical distribution

Abstract

Background: Waning immunity to measles poses a significant public health challenge, particularly in low-resource settings. Understanding the spatial distribution of waning immunity among vaccinated children is crucial for designing targeted interventions. This nested study within a prospective cohort explored the geographic patterns of waning measles immunity in Lusaka, Zambia. Objective: To examine the spatial distribution of waning measles immunity among vaccinated children receiving care at the University Teaching Hospital (UTH) in Lusaka, Zambia, using Geographic Information Systems (GIS). Methods: This study utilized data from a prospective cohort of 200 children, focusing on 99 participants with waning immunity. Immunity status was determined using IgG testing, and the geographic coordinates of participants’ residences were geocoded. A shapefile of Zambia’s administrative boundaries was used to create maps in QGIS. The distribution of waning immunity was mapped, and areas with higher concentrations of cases were identified visually. Demographic data were analyzed using Bayesian regression to identify predictors of waning immunity. Results: Hotspot analysis highlighted urban areas with the highest prevalence of waning immunity. Bayesian regression indicated that the majority of the selected children who were residing in Lusaka had an increased odd of waning immunity (OR = 2.5, 95% CI: 1.4–4.5) was significantly associated with waning immunity. Conclusion: This nested study highlights the spatial distribution of waning measles immunity, with hotspots concentrated in Lusaka's urban areas. Integrating geospatial analysis with epidemiological data provides valuable insights for targeted interventions, including booster vaccination campaigns and enhanced cold chain management in high-risk areas. The findings emphasize the importance of incorporating GIS into immunization strategies to optimize resource allocation and improve immunity coverage in low-resource settings.

Author Biographies

  • Priscilla Nkonde Gardner, Department of Public Health, University of Zambia, Lusaka, Zambia Department of Public Health, Zambia National Public Health Institute, Lusaka, Zambia

    Priscilla Nkonde Gardner is currently a Specialist in Vaccine Preventable Diseases at the Zambia National Public Health Institute. She is also a PhD candidate at the University of Zambia, focusing on epidemiology and public health. Her research interests include vaccine immunogenicity, particularly HIV-infected populations, adolescent sexual and reproductive health, and factors influencing child and adolescent health outcomes. She is actively involved in public health research and has co-authored studies on early childbearing among schoolgirls in rural Zambia. Her academic profiles can be accessed on platforms like ORCID (https://orcid.org/0000-0001-8937-3142) and ResearchGate.

  • Jimmy Hangoma, Department of Health Sciences, Levy Mwanawasa University, Zambia

    Jimmy Hangoma is a lecturer at the University of Zambia, specializing in health economics and policy analysis. He has been involved in research projects assessing the economic impact of health interventions and policies in Zambia. His work includes evaluating the cost-effectiveness of health programs and analyzing health financing mechanisms to improve resource allocation in the healthcare sector. Mr. Hangoma's contributions aim to inform policy decisions that enhance the efficiency and equity of health services in Zambia.

  • Nosia Mhango Mwila, Department of Public Health, University of Zambia, Lusaka, Zambia

    Nosia Mhango Mwila is a researcher specializing in Clinical Pharmacology and vaccine-preventable diseases. She holds a Bachelor’s and a master’s degree in clinical pharmacology and is pursuing a PhD in Epidemiology and Public Health. Her expertise in pharmacology provides a unique perspective on understanding immunological mechanisms and enhancing vaccine efficacy. She is co-authoring a paper on measles, contributing to research aimed at addressing immunity gaps and improving vaccine strategies.

  • Isaac Fwemba, Department of Public Health, University of Zambia, Lusaka, Zambia

    Isaac Fwemba is a lecturer in the Department of Epidemiology and Biostatistics at the University of Zambia. He holds a PhD in Public Health with a concentration in Biostatistics from the University of Ghana. His expertise lies in Bayesian modeling, systematic reviews, meta-analysis, and survival analysis. Dr. Fwemba has contributed to research on HIV prevalence estimation and the impact of socioeconomic factors on fertility among adolescents. He is a member of the International Society for Clinical Biostatistics and has an ORCID profile accessible at https://orcid.org/0000-0002-9179-0946.

References

World Health Organization (WHO). "Challenges in measles control: Addressing waning immunity in vaccinated populations." Geneva, Switzerland: WHO Publications, 2023. Link: www.who.int/publications/i/item/challenges-in-measles-control-2023. Accessed 22th November, 2024

Ministry of Health Zambia. "Annual report on measles and rubella immunization coverage in Zambia." Lusaka: Ministry of Health, 2022. Link: www.moh.gov.zm/?wpfb_dl=123. Accessed 22th November, 2024

White, N. J., et al. "Urban density and vaccine efficacy: Lessons from sub-Saharan Africa." Vaccine Science Review, 15(3), 122–135, 2018. DOI: 10.1016/j.vacscirev.2018.03.004

Sserwanja, Q., et al. "Population dynamics and immunity gaps in urban settings." Public Health in Developing Regions, 24(4), 301–318, 2021. DOI: 10.1093/phdr/24.4.301

Khetsuriani, N., et al. "Targeted immunization strategies to address outbreaks in urban populations." Journal of Vaccine Implementation, 18(2), 87–101, 2020. DOI: 10.1097/JVI.0000000000000020

Moeti, M. R., et al. "Strengthening health systems in Africa to achieve Sustainable Development Goal 3." Lancet Global Health, 9(1), e10–e20, 2021. DOI: 10.1016/S2214-109X(20)30345-4

Dinleyici, E. C., et al. "Spatial epidemiology and measles control: An integrated approach." Vaccine Policy Review, 21(2), 67–84, 2021. DOI: 10.1016/j.vacpolrev.2021.02.003

Molla, R., et al. "GIS-based public health interventions: Applications in immunization programs." Epidemiology and Spatial Data Science, 11(1), 50–66, 2022. DOI: 10.1016/j.esds.2022.01.005

Bloom, D. E., et al. "Toward universal vaccine coverage: Challenges and solutions." Global Health Policy, 12(2), 215–230, 2021. DOI: 10.1016/j.ghp.2021.02.009

Moss, W. J. "Measles immunity: Understanding the determinants of waning immunity." Clinical Infectious Diseases, 64(8), 1112–1117, 2017. DOI: 10.1093/cid/cix135

Mutembo, S., et al. "Gaps in measles immunity among children and adolescents with HIV in Zambia." BMC Public Health, 23(1), 891, 2023. DOI: 10.1186/s12889-023-0891-7

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Published

2024-12-09

Issue

Vol. 8 No. 1 (2025)

Section

Articles

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How to Cite

SPATIAL DISTRIBUTION AND EPIDEMIOLOGICAL INSIGHTS INTO WANING MEASLES IMMUNITY AMONG VACCINATED CHILDREN IN LUSAKA, ZAMBIA. (2024). European Journal of Public Health Studies, 8(1). https://doi.org/10.46827/ejphs.v8i1.201