Biphasic pattern in the effect of severe measles infection; the difference between additive and multiplicative scale.
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Publication Date
2021-12-14Journal Title
BMC Infect Dis
ISSN
1471-2334
Publisher
Springer Science and Business Media LLC
Volume
21
Issue
1
Language
eng
Type
Article
This Version
VoR
Metadata
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Le, N. T. H., Ho, N. T., Grenfell, B., Baker, S., & Geskus, R. B. (2021). Biphasic pattern in the effect of severe measles infection; the difference between additive and multiplicative scale.. BMC Infect Dis, 21 (1) https://doi.org/10.1186/s12879-021-06930-x
Abstract
BACKGROUND: Infection with measles virus (MeV) causes immunosuppression and increased susceptibility to other infectious diseases. Only few studies reported a duration of immunosuppression, with varying results. We investigated the effect of immunosuppression on the incidence of hospital admissions for infectious diseases in Vietnamese children. METHODS: We used retrospective data (2005 to 2015; N = 4419) from the two pediatric hospitals in Ho Chi Minh City, Vietnam. We compared the age-specific incidence of hospital admission for infectious diseases before and after hospitalization for measles. We fitted a Poisson regression model that included gender, current age, and time since measles to obtain a multiplicative effect measure. Estimates were transformed to the additive scale. RESULTS: We observed two phases in the incidence of hospital admission after measles. The first phase started with a fourfold increased rate of admissions during the first month after measles, dropping to a level quite comparable to children of the same age before measles. In the second phase, lasting until at least 6 years after measles, the admission rate decreased further, with values up to 20 times lower than in children of the same age before measles. However, on the additive scale the effect size in the second phase was much smaller than in the first phase. CONCLUSION: The first phase highlights the public health benefits of measles vaccination by preventing measles and immune amnesia. The beneficial second phase is interesting, but its strength strongly depends on the scale. It suggests a complicated interaction between MeV infection and the host immunity.
Keywords
Infectious diseases, Measles, immunosuppression, Hospitalization, Additive Scale, Multiplicative Scale, Humans, Measles virus, Incidence, Retrospective Studies, Child, Infant
Sponsorship
Wellcome Trust (106680/Z/14/Z, 106680/B/14/Z)
Identifiers
34906096, PMC8670196
External DOI: https://doi.org/10.1186/s12879-021-06930-x
This record's URL: https://www.repository.cam.ac.uk/handle/1810/333268
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