Geospatial Distribution of MMR Vaccination and Incidence in Iraq, 2001-2016
نام عام مواد
[Thesis]
نام نخستين پديدآور
Comfort, Haley
نام ساير پديدآوران
Duber, Herbert
وضعیت نشر و پخش و غیره
نام ناشر، پخش کننده و غيره
University of Washington
تاریخ نشرو بخش و غیره
2019
مشخصات ظاهری
نام خاص و کميت اثر
26
یادداشتهای مربوط به پایان نامه ها
جزئيات پايان نامه و نوع درجه آن
Master's
کسي که مدرک را اعطا کرده
University of Washington
امتياز متن
2019
یادداشتهای مربوط به خلاصه یا چکیده
متن يادداشت
The 2003 U.S.-led invasion of Iraq created health system instability, with direct and indirect public health consequences. This analysis examines the disparity in vaccine coverage, incidence, and displacement in Iraq at the governorate level for three vaccine-preventable diseases - measles, mumps, and rubella - between 2001 and 2016 using data from the Iraqi Ministry of Health and annual totals of persons of concern from the United Nations High Commissioner for Refugees. We first performed descriptive analyses to look at the geospatial variation of reported vaccine coverage and disease incidence, identifying large variability in incidence of the three diseases - on the order of 100x for measles - between governorates. In a pooled statistical analysis, using a linear mixed effects regression model, we saw an increase in incident measles cases per 100,000 persons for each additional percent unvaccinated (0.8, 95% CI: [0.4, 1.2], p-value < 0.001). Analyzing governorates individually, the statistically significant estimates varied between 1.6 to 3.7 additional cases per 100,000 persons. When incorporating persons of concern into our pooled regression model, we identified larger measles incidence for every additional 10,000 persons of concern (0.26, 95% CI: [0.19, 0.33], p-value < 0.001), holding vaccine coverage constant. These relationships were not significant for mumps or rubella. In conclusion, we found high variability in the geospatial pattern of MMR vaccine coverage and disease incidence between 2001 and 2016 that was not adequately captured by the national level summary statistics. However, the relationship between incidence and vaccine coverage is complex and complicated by other factors, so we did not expect a consistent association between the two variables.
موضوع (اسم عام یاعبارت اسمی عام)
موضوع مستند نشده
Iraq War-2003
موضوع مستند نشده
Measles
موضوع مستند نشده
Mumps
موضوع مستند نشده
Public health
موضوع مستند نشده
Spatial data
موضوع مستند نشده
Vaccines
نام شخص به منزله سر شناسه - (مسئولیت معنوی درجه اول )