[Simulating measles and rubella elimination levels according to social stratification and interaction].
OBJECTIVE
The study was aimed at comparing measles and rubella disease elimination levels in a homogeneous and heterogeneous population according to socioeconomic status with interactions amongst low- and high-income individuals and diversity in the average number of contacts amongst them.


METHODS
Effective reproductive rate simulations were deduced from a susceptibleinfected- recovered (SIR) mathematical model according to different immunisation rates using measles (1980 and 2005) and rubella (1998 and 2005) incidence data from Latin-America and the Caribbean. Low- and high-income individuals' social interaction and their average number of contacts were analysed by bipartite random network analysis. MAPLE 12 (Maplesoft Inc, Ontario Canada) software was used for making the simulations.


RESULTS
The progress made in eliminating both diseases between both periods of time was reproduced in the socially-homogeneous population. Measles (2005) would be eliminated in high- and low-income groups; however, it would only be achieved in rubella (2005) if there were a high immunity rate amongst the low-income group. If the average number of contacts were varied, then rubella would not be eliminated, even with a 95 % immunity rate.


CONCLUSIONS
Monitoring the elimination level in diseases like measles and rubella requires that socio-economic status be considered as well as the population's interaction pattern. Special attention should be paid to communities having diversity in their average number of contacts occurring in confined spaces such as displaced communities, prisons, educational establishments, or hospitals.
Hincapié-Palacio
Doracelly
D
Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia. doracely@guajiros.udea.edu.co
Ospina-Giraldo
Juan
J
Gómez-Arias
Rubén D
RD
Uyi-Afuwape
Anthony
A
Chowell-Puente
Gerardo
G
D017691:Caribbean Region / Q000453:epidemiology; D003198:Computer Simulation; D020378:Confined Spaces; D016358:Contact Tracing / Q000706:statistics & numerical data; D018864:Cultural Diversity; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007398:Interpersonal Relations; D007843:Latin America / Q000453:epidemiology; D008457:Measles / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D008458:Measles Vaccine; D008962:Models, Theoretical; D012111:Residence Characteristics; D012409:Rubella / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D012411:Rubella Vaccine; D012959:Socioeconomic Factors; D014611:Vaccination / Q000706:statistics & numerical data; D035862:Vulnerable Populations
D008458:Measles Vaccine; D012411:Rubella Vaccine