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Biphasic pattern in the effect of severe measles infection; the difference between additive and multiplicative scale

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.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1186/s12879-021-06930-x

Authors


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Role:
Author
ORCID:
0000-0002-3756-7217
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Tropical Medicine
Role:
Author
ORCID:
0000-0003-1308-5755
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Tropical Medicine
Role:
Author
ORCID:
0000-0002-2740-3155


Publisher:
BioMed Central
Journal:
BMC Infectious Diseases More from this journal
Volume:
21
Issue:
1
Article number:
1249
Publication date:
2021-12-14
Acceptance date:
2021-12-01
DOI:
EISSN:
1471-2334
Pmid:
34906096


Language:
English
Keywords:
Pubs id:
1232093
Local pid:
pubs:1232093
Deposit date:
2022-04-12

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