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1.
  • Bravo, L, et al. (author)
  • 2021
  • swepub:Mat__t
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2.
  • Tabiri, S, et al. (author)
  • 2021
  • swepub:Mat__t
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4.
  • Glasbey, JC, et al. (author)
  • 2021
  • swepub:Mat__t
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6.
  • Khatri, C, et al. (author)
  • Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study
  • 2021
  • In: BMJ open. - : BMJ. - 2044-6055. ; 11:11, s. e050830-
  • Journal article (peer-reviewed)abstract
    • Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.SettingProspective, international, multicentre, observational cohort study.ParticipantsPatients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).Primary outcome30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.ResultsThis study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p<0.001), age >80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).ConclusionsPatients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.Trial registration numberNCT04323644
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7.
  • Kinyoki, DK, et al. (author)
  • Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017
  • 2020
  • In: Nature medicine. - : Springer Science and Business Media LLC. - 1546-170X .- 1078-8956. ; 26:5, s. 750-759
  • Journal article (peer-reviewed)abstract
    • A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic.
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9.
  • Thomas, HS, et al. (author)
  • 2019
  • swepub:Mat__t
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10.
  • Aartsen, M. G., et al. (author)
  • All-sky Search for Time-integrated Neutrino Emission from Astrophysical Sources with 7 yr of IceCube Data
  • 2017
  • In: Astrophysical Journal. - : IOP PUBLISHING LTD. - 0004-637X .- 1538-4357. ; 835:2
  • Journal article (peer-reviewed)abstract
    • Since the recent detection of an astrophysical flux of high-energy neutrinos, the question of its origin has not yet fully been answered. Much of what is known about this flux comes from a small event sample of high neutrino purity, good energy resolution, but large angular uncertainties. In searches for point-like sources, on the other hand, the best performance is given by using large statistics and good angular reconstructions. Track-like muon events produced in neutrino interactions satisfy these requirements. We present here the results of searches for point-like sources with neutrinos using data acquired by the IceCube detector over 7 yr from 2008 to 2015. The discovery potential of the analysis in the northern sky is now significantly below E(nu)(2)d phi/dE(nu) = 10(-12) TeV cm(-2) s(-1), on average 38% lower than the sensitivity of the previously published analysis of 4 yr exposure. No significant clustering of neutrinos above background expectation was observed, and implications for prominent neutrino source candidates are discussed.
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11.
  • Aartsen, M. G., et al. (author)
  • Atmospheric and astrophysical neutrinos above 1 TeV interacting in IceCube
  • 2015
  • In: Physical Review D. - 1550-7998 .- 1550-2368. ; 91:2, s. 022001-
  • Journal article (peer-reviewed)abstract
    • The IceCube Neutrino Observatory was designed primarily to search for high-energy (TeV-PeV) neutLrinos produced in distant astrophysical objects. A search for. greater than or similar to 100 TeV neutrinos interacting inside the instrumented volume has recently provided evidence for an isotropic flux of such neutrinos. At lower energies, IceCube collects large numbers of neutrinos from the weak decays of mesons in cosmic-ray air showers. Here we present the results of a search for neutrino interactions inside IceCube's instrumented volume between 1 TeV and 1 PeV in 641 days of data taken from 2010-2012, lowering the energy threshold for neutrinos from the southern sky below 10 TeV for the first time, far below the threshold of the previous high-energy analysis. Astrophysical neutrinos remain the dominant component in the southern sky down to a deposited energy of 10 TeV. From these data we derive new constraints on the diffuse astrophysical neutrino spectrum, Phi(v) = 2.06(-0.3)(+0.4) x 10(-18) (E-v = 10(5) GeV)-2.46 +/- 0.12GeV-1 cm(-2) sr(-1) s(-1) for 25 TeV < E-v < 1.4 PeV, as well as the strongest upper limit yet on the flux of neutrinos from charmed-meson decay in the atmosphere, 1.52 times the benchmark theoretical prediction used in previous IceCube results at 90% confidence.
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12.
  • Aartsen, M. G., et al. (author)
  • Determining neutrino oscillation parameters from atmospheric muon neutrino disappearance with three years of IceCube DeepCore data
  • 2015
  • In: Physical Review D. - 1550-7998 .- 1550-2368. ; 91:7
  • Journal article (peer-reviewed)abstract
    • We present a measurement of neutrino oscillations via atmospheric muon neutrino disappearance with three years of data of the completed IceCube neutrino detector. DeepCore, a region of denser IceCube instrumentation, enables the detection and reconstruction of atmospheric muon neutrinos between 10 and 100 GeV, where a strong disappearance signal is expected. The IceCube detector volume surrounding DeepCore is used as a veto region to suppress the atmospheric muon background. Neutrino events are selected where the detected Cherenkov photons of the secondary particles minimally scatter, and the neutrino energy and arrival direction are reconstructed. Both variables are used to obtain the neutrino oscillation parameters from the data, with the best fit given by Delta m(32)(2) = 2.72(-0.20)(+0.19) x 10(-3) eV(2) and sin(2)theta(23) = 0.53(-0.12)(+0.09) (normal mass ordering assumed). The results are compatible, and comparable in precision, to those of dedicated oscillation experiments.
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13.
  • Aartsen, M. G., et al. (author)
  • Development of a general analysis and unfolding scheme and its application to measure the energy spectrum of atmospheric neutrinos with IceCube
  • 2015
  • In: European Physical Journal C. - : Springer Science and Business Media LLC. - 1434-6044 .- 1434-6052. ; 75:3
  • Journal article (peer-reviewed)abstract
    • We present the development and application of a generic analysis scheme for the measurement of neutrino spectra with the IceCube detector. This scheme is based on regularized unfolding, preceded by an event selection which uses a Minimum Redundancy Maximum Relevance algorithm to select the relevant variables and a random forest for the classification of events. The analysis has been developed using IceCube data from the 59-string configuration of the detector. 27,771 neutrino candidates were detected in 346 days of livetime. A rejection of 99.9999 % of the atmospheric muon background is achieved. The energy spectrum of the atmospheric neutrino flux is obtained using the TRUEE unfolding program. The unfolded spectrum of atmospheric muon neutrinos covers an energy range from 100 GeV to 1 PeV. Compared to the previous measurement using the detector in the 40-string configuration, the analysis presented here, extends the upper end of the atmospheric neutrino spectrum by more than a factor of two, reaching an energy region that has not been previously accessed by spectral measurements.
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14.
  • Aartsen, M. G., et al. (author)
  • Extending the Search for Muon Neutrinos Coincident with Gamma-Ray Bursts in IceCube Data
  • 2017
  • In: Astrophysical Journal. - : IOP PUBLISHING LTD. - 0004-637X .- 1538-4357. ; 843:2
  • Journal article (peer-reviewed)abstract
    • We present an all-sky search for muon neutrinos produced during the prompt γ-ray emission of 1172 gamma-ray bursts (GRBs) with the IceCube Neutrino Observatory. The detection of these neutrinos would constitute evidence for ultra-high-energy cosmic-ray (UHECR) production in GRBs, as interactions between accelerated protons and the prompt γ-ray field would yield charged pions, which decay to neutrinos. A previously reported search for muon neutrino tracks from northern hemisphere GRBs has been extended to include three additional years of IceCube data. A search for such tracks from southern hemisphere GRBs in five years of IceCube data has been introduced to enhance our sensitivity to the highest energy neutrinos. No significant correlation between neutrino events and observed GRBs is seen in the new data. Combining this result with previous muon neutrino track searches and a search for cascade signature events from all neutrino flavors, we obtain new constraints for single-zone fireball models of GRB neutrino and UHECR production.
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15.
  • Aartsen, M. G., et al. (author)
  • Multipole analysis of IceCube data to search for dark matter accumulated in the Galactic halo
  • 2015
  • In: European Physical Journal C. - : Springer Science and Business Media LLC. - 1434-6044 .- 1434-6052. ; 75:1
  • Journal article (peer-reviewed)abstract
    • Dark matter which is bound in the Galactic halo might self-annihilate and produce a flux of stable final state particles, e. g. high energy neutrinos. These neutrinos can be detected with IceCube, a cubic-kilometer sized Cherenkov detector. Given IceCube's large field of view, a characteristic anisotropy of the additional neutrino flux is expected. In this paper we describe a multipole method to search for such a large-scale anisotropy in IceCube data. This method uses the expansion coefficients of a multipole expansion of neutrino arrival directions and incorporates signal-specific weights for each expansion coefficient. We apply the technique to a high-purity muon neutrino sample from the Northern Hemisphere. The final result is compatible with the null-hypothesis. As no signal was observed, we present limits on the self-annihilation cross-section averaged over the relative velocity distribution down to 1.9x10(-23) cm(3) s(-1) for a dark matter particle mass of 700-1,000 GeV and direct annihilation into nu(nu) over bar. The resulting exclusion limits come close to exclusion limits from gamma-ray experiments, that focus on the outer Galactic halo, for high dark matter masses of a few TeV and hard annihilation channels.
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  • Aartsen, M. G., et al. (author)
  • Observation And Characterization Of A Cosmic Muon Neutrino Flux From The Northern Hemisphere Using Six Years Of Icecube Data
  • 2016
  • In: Astrophysical Journal. - : Institute of Physics Publishing (IOPP). - 0004-637X .- 1538-4357. ; 833:1
  • Journal article (peer-reviewed)abstract
    • The IceCube Collaboration has previously discovered a high-energy astrophysical neutrino flux using neutrino events with interaction vertices contained within the instrumented volume of the IceCube detector. We present a complementary measurement using charged current muon neutrino events where the interaction vertex can be outside this volume. As a consequence of the large muon range the effective area is significantly larger but the field of view is restricted to the Northern Hemisphere. IceCube data from 2009 through 2015 have been analyzed using a likelihood approach based on the reconstructed muon energy and zenith angle. At the highest neutrino energies between 194 TeV and 7.8 PeV a significant astrophysical contribution is observed, excluding a purely atmospheric origin of these events at 5.6 sigma significance. The data are well described by an isotropic, unbroken power-law flux with a normalization at 100 TeV neutrino energy of (0.90(-0.27)(+0.30)) x 10(-18) GeV-1 cm(-2) s(-1) sr(-1) and a hard spectral index of gamma = 2.13 +/- 0.13. The observed spectrum is harder in comparison to previous IceCube analyses with lower energy thresholds which may indicate a break in the astrophysical neutrino spectrum of unknown origin. The highest-energy event observed has a reconstructed muon energy of (4.5 +/- 1.2) PeV which implies a probability of less than 0.005% for this event to be of atmospheric origin. Analyzing the arrival directions of all events with reconstructed muon energies above 200 TeV no correlation with known gamma-ray sources was found. Using the high statistics of atmospheric neutrinos we report the current best constraints on a prompt atmospheric muon neutrino flux originating from charmed meson decays which is below 1.06 in units of the flux normalization of the model in Enberg et al.
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  • Aartsen, M. G., et al. (author)
  • PINGU : a vision for neutrino and particle physics at the South Pole
  • 2017
  • In: Journal of Physics G. - : IOP Publishing. - 0954-3899 .- 1361-6471. ; 44:5
  • Journal article (peer-reviewed)abstract
    • The Precision IceCube Next Generation Upgrade (PINGU) is a proposed low-energy in-fill extension to the IceCube Neutrino Observatory. With detection technology modeled closely on the successful IceCube example, PINGU will provide a 6 Mton effective mass for neutrino detection with an energy threshold of a few GeV. With an unprecedented sample of over 60 000 atmospheric neutrinos per year in this energy range, PINGU will make highly competitive measurements of neutrino oscillation parameters in an energy range over an order of magnitude higher than long-baseline neutrino beam experiments. PINGU will measure the mixing parameters theta(23) and Delta m(32)(2), including the octant of theta(23) for a wide range of values, and determine the neutrino mass ordering at 3 sigma median significance within five years of operation. PINGU's high precision measurement of the rate of nu(T) appearance will provide essential tests of the unitarity of the 3 x 3 PMNS neutrino mixing matrix. PINGU will also improve the sensitivity of searches for low mass dark matter in the Sun, use neutrino tomography to directly probe the composition of the Earth's core, and improve IceCube's sensitivity to neutrinos from Galactic supernovae. Reoptimization of the PINGU design has permitted substantial reduction in both cost and logistical requirements while delivering performance nearly identical to configurations previously studied.
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18.
  • Aartsen, M. G., et al. (author)
  • Search for annihilating dark matter in the Sun with 3 years of IceCube data
  • 2017
  • In: European Physical Journal C. - : Springer Science and Business Media LLC. - 1434-6044 .- 1434-6052. ; 77:3
  • Journal article (peer-reviewed)abstract
    • We present results from an analysis looking for darkmatter annihilation in the Sun with the IceCube neutrino telescope. Gravitationally trapped dark matter in the Sun's core can annihilate into Standard Model particles making the Sun a source of GeV neutrinos. IceCube is able to detect neutrinos with energies > 100 GeV while its low-energy infill array DeepCore extends this to >10GeV. This analysis uses data gathered in the austral winters between May 2011 and May 2014, corresponding to 532 days of livetime when the Sun, being below the horizon, is a source of up-going neutrino events, easiest to discriminate against the dominant background of atmospheric muons. The sensitivity is a factor of two to four better than previous searches due to additional statistics and improved analysis methods involving better background rejection and reconstructions. The resultant upper limits on the spin-dependent dark matter-proton scattering cross section reach down to 1.46 x 10(-5) pb for a dark matter particle of mass 500GeV annihilating exclusively into tau(+)tau(-) particles. These are currently the most stringent limits on the spin-dependent dark matter-proton scattering cross section for WIMP masses above 50GeV.
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  • Aartsen, M. G., et al. (author)
  • Search for sterile neutrino mixing using three years of IceCube DeepCore data
  • 2017
  • In: Physical Review D. - : AMER PHYSICAL SOC. - 2470-0010 .- 2470-0029. ; 95:11
  • Journal article (peer-reviewed)abstract
    • We present a search for a light sterile neutrino using three years of atmospheric neutrino data from the DeepCore detector in the energy range of approximately 10-60 GeV. DeepCore is the low-energy subarray of the IceCube Neutrino Observatory. The standard three-neutrino paradigm can be probed by adding an additional light (Delta m(41)(2) similar to 1 eV(2)) sterile neutrino. Sterile neutrinos do not interact through the standard weak interaction and, therefore, cannot be directly detected. However, their mixing with the three active neutrino states leaves an imprint on the standard atmospheric neutrino oscillations for energies below 100 GeV. A search for such mixing via muon neutrino disappearance is presented here. The data are found to be consistent with the standard three-neutrino hypothesis. Therefore, we derive limits on the mixing matrix elements at the level of vertical bar U mu(4)vertical bar(2) < 0.11 and vertical bar U-tau 4 vertical bar(2) < 0.15 (90% C. L.) for the sterile neutrino mass splitting Delta m(41)(2) = 1.0 eV(2).
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  • Aartsen, M. G., et al. (author)
  • Searches for small-scale anisotropies from neutrino point sources with three years of IceCube data
  • 2015
  • In: Astroparticle physics. - : Elsevier BV. - 0927-6505 .- 1873-2852. ; 66, s. 39-52
  • Journal article (peer-reviewed)abstract
    • Recently, IceCube found evidence for a diffuse signal of astrophysical neutrinos in an energy range of similar to 60 TeV to the PeV-scale [1]. The origin of those events, being a key to understanding the origin of cosmic rays, is still an unsolved question. So far, analyses have not succeeded to resolve the diffuse signal into point-like sources. Searches including a maximum-likelihood-ratio test, based on the reconstructed directions and energies of the detected down- and up-going neutrino candidates, were also performed on IceCube data leading to the exclusion of bright point sources. In this paper, we present two methods to search for faint neutrino point sources in three years of IceCube data, taken between 2008 and 2011. The first method is an autocorrelation test, applied separately to the northern and southern sky. The second method is a multipole analysis, which expands the measured data in the northern hemisphere into spherical harmonics and uses the resulting expansion coefficients to separate signal from background. With both methods, the results are consistent with the background expectation with a slightly more sparse spatial distribution, corresponding to an underfluctuation. Depending on the assumed number of sources, the resulting upper limit on the flux per source in the northern hemisphere for an E-2 energy spectrum ranges from similar to 1.5. 10(-8) GeV/cm(2) s(-1), in the case of one assumed source, to similar to 4. 10(-10) GeV/cm(2) s(-1), in the case of 3500 assumed sources.
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  • Aartsen, M. G., et al. (author)
  • The Contribution Of Fermi-2Lac Blazars To Diffuse Tev-Pev Neutrino Flux
  • 2017
  • In: Astrophysical Journal. - : American Astronomical Society. - 0004-637X .- 1538-4357. ; 835:1
  • Journal article (peer-reviewed)abstract
    • The recent discovery of a diffuse cosmic neutrino flux extending up to PeV energies raises the question of which astrophysical sources generate this signal. Blazars are one class of extragalactic sources which may produce such high-energy neutrinos. We present a likelihood analysis searching for cumulative neutrino emission from blazars in the 2nd Fermi-LAT AGN catalog (2LAC) using IceCube neutrino data set 2009-12, which was optimized for the detection of individual sources. In contrast to those in previous searches with IceCube, the populations investigated contain up to hundreds of sources, the largest one being the entire blazar sample in the 2LAC catalog. No significant excess is observed, and upper limits for the cumulative flux from these populations are obtained. These constrain the maximum contribution of 2LAC blazars to the observed astrophysical neutrino flux to 27% or less between around 10 TeV and 2 PeV, assuming the equipartition of flavors on Earth and a single power-law spectrum with a spectral index of -2.5. We can still exclude the fact that 2LAC blazars (and their subpopulations) emit more than 50% of the observed neutrinos up to a spectral index as hard as -2.2 in the same energy range. Our result takes into account the fact that the neutrino source count distribution is unknown, and it does not assume strict proportionality of the neutrino flux to the measured 2LAC gamma-ray signal for each source. Additionally, we constrain recent models for neutrino emission by blazars.
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  • Cromwell, EA, et al. (author)
  • Predicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning
  • 2021
  • In: PLoS neglected tropical diseases. - : Public Library of Science (PLoS). - 1935-2735. ; 15:7, s. e0008824-
  • Journal article (peer-reviewed)abstract
    • Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0·71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50·2% exceed this threshold for suitability in at least one 5 × 5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify.
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  • Czarnewski, P, et al. (author)
  • Conserved transcriptomic profile between mouse and human colitis allows unsupervised patient stratification
  • 2019
  • In: Nature communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 10:1, s. 2892-
  • Journal article (peer-reviewed)abstract
    • Clinical manifestations and response to therapies in ulcerative colitis (UC) are heterogeneous, yet patient classification criteria for tailored therapies are currently lacking. Here, we present an unsupervised molecular classification of UC patients, concordant with response to therapy in independent retrospective cohorts. We show that classical clustering of UC patient tissue transcriptomic data sets does not identify clinically relevant profiles, likely due to associated covariates. To overcome this, we compare cross-sectional human data sets with a newly generated longitudinal transcriptome profile of murine DSS-induced colitis. We show that the majority of colitis risk-associated gene expression peaks during the inflammatory rather than the recovery phase. Moreover, we achieve UC patient clustering into two distinct transcriptomic profiles, differing in neutrophil-related gene activation. Notably, 87% of patients in UC1 cluster are unresponsive to two most widely used biological therapies. These results demonstrate that cross-species comparison enables stratification of patients undistinguishable by other molecular approaches.
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  • Graetz, N, et al. (author)
  • Mapping disparities in education across low- and middle-income countries
  • 2020
  • In: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 577:77907789, s. 235-238
  • Journal article (peer-reviewed)abstract
    • Educational attainment is an important social determinant of maternal, newborn, and child health1–3. As a tool for promoting gender equity, it has gained increasing traction in popular media, international aid strategies, and global agenda-setting4–6. The global health agenda is increasingly focused on evidence of precision public health, which illustrates the subnational distribution of disease and illness7,8; however, an agenda focused on future equity must integrate comparable evidence on the distribution of social determinants of health9–11. Here we expand on the available precision SDG evidence by estimating the subnational distribution of educational attainment, including the proportions of individuals who have completed key levels of schooling, across all low- and middle-income countries from 2000 to 2017. Previous analyses have focused on geographical disparities in average attainment across Africa or for specific countries, but—to our knowledge—no analysis has examined the subnational proportions of individuals who completed specific levels of education across all low- and middle-income countries12–14. By geolocating subnational data for more than 184 million person-years across 528 data sources, we precisely identify inequalities across geography as well as within populations.
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  • Sbarra, AN, et al. (author)
  • Mapping routine measles vaccination in low- and middle-income countries
  • 2021
  • In: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 589:7842, s. 415-
  • Journal article (peer-reviewed)abstract
    • The safe, highly effective measles vaccine has been recommended globally since 1974, yet in 2017 there were more than 17 million cases of measles and 83,400 deaths in children under 5 years old, and more than 99% of both occurred in low- and middle-income countries (LMICs)1–4. Globally comparable, annual, local estimates of routine first-dose measles-containing vaccine (MCV1) coverage are critical for understanding geographically precise immunity patterns, progress towards the targets of the Global Vaccine Action Plan (GVAP), and high-risk areas amid disruptions to vaccination programmes caused by coronavirus disease 2019 (COVID-19)5–8. Here we generated annual estimates of routine childhood MCV1 coverage at 5 × 5-km2pixel and second administrative levels from 2000 to 2019 in 101 LMICs, quantified geographical inequality and assessed vaccination status by geographical remoteness. After widespread MCV1 gains from 2000 to 2010, coverage regressed in more than half of the districts between 2010 and 2019, leaving many LMICs far from the GVAP goal of 80% coverage in all districts by 2019. MCV1 coverage was lower in rural than in urban locations, although a larger proportion of unvaccinated children overall lived in urban locations; strategies to provide essential vaccination services should address both geographical contexts. These results provide a tool for decision-makers to strengthen routine MCV1 immunization programmes and provide equitable disease protection for all children.
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