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Title: | Measles in Madagascar: Assessing the State of Immunity and Disease Surveillance in the Post-COVID-19 World |
Authors: | Blazes, Libby |
Advisors: | Metcalf, C. Jessica |
Department: | Ecology and Evolutionary Biology |
Certificate Program: | Global Health and Health Policy Program |
Class Year: | 2024 |
Abstract: | Measles is a highly contagious respiratory disease, which continues to have significant health and economic impacts globally. Despite the existence of a highly effective vaccine, equitable access and distribution at the levels required for herd immunity has been difficult to achieve in many areas. This includes in the island nation of Madagascar, which was hit with a major measles outbreak in 2018. Particularly after healthcare disruptions due to the SARS-CoV-2 pandemic, several cyclones, and political instability, analysis of current immunity is vital in order to better target future vaccination campaigns and prevent another measles outbreak. To examine current immunity, vaccination data from three sources (The Demographic and Health Survey, subnational dose data from the World Health Organization, and survey data from a district-level cohort study) were assessed. Further analysis of vaccination timing and the use of a discrete-time SIR model allowed for a greater understanding of the impacts of disruptions on immunity and outbreak potential. Overall, this study found significant discrepancies in reported vaccination rates by data source, indicating the need for both improved access to vaccinations and vaccination surveillance across the country. Differences across regions also suggested the importance of collecting data at the local and district levels in order to most effectively distribute vaccinations. The direct impact of several disruptions was difficult to assess fully given data limitations; however, the SIR model suggested that following vaccination rates indicated by current sources in the coming years would contribute to another major outbreak in approximately 15 years. |
URI: | http://arks.princeton.edu/ark:/88435/dsp01m039k827s |
Type of Material: | Princeton University Senior Theses |
Language: | en |
Appears in Collections: | Ecology and Evolutionary Biology, 1992-2024 Global Health and Health Policy Program, 2017-2023 |
Files in This Item:
File | Description | Size | Format | |
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BLAZES-LIBBY-THESIS.pdf | 3.21 MB | Adobe PDF | Request a copy |
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