title: Risk factors for measles in young infants in an urban African area with high measles vaccination coverage.
abstract: BACKGROUND
  We examined risk factors for measles infection before measles vaccination at 9 months of age in Guinea-Bissau.
  
  
  METHODS
  Among 1524 children enrolled in a trial of early measles vaccination at 4.5 months of age, we assessed the relative risk (RR) of measles before enrollment and the incidence rate ratio between 4.5 and 9 months of age for different groups.
  
  
  RESULTS
  The incidence was high, with 4% having measles before 4.5 months and 10% having measles between 4.5 and 9 months of age. The main risk factor was the age of the mother; children of young mothers (age, 15-24 years) had lower antibody titers and higher risk of measles than children of older mothers both before 4.5 months (RR = 1.74 [1.02-2.96]) and between 4.5 and 9 months of age (incidence rate ratio = 1.59 [1.05-2.41]). Having no Bacillus Calmette-Guérin scar was associated with a higher risk of measles before 4.5 months of age (RR = 2.61 [1.54-4.45]). Children who were not breast-fed and had fever or respiratory infection at enrollment had a 2- to 4-fold higher risk of measles between 4.5 and 9 months of age.
  
  
  CONCLUSIONS
  Young mothers transmit lower titers of antibodies to their children and an increasing proportion of infants become susceptible to measles before the age of measles vaccination.
authors.affiliation: Projecto de Saúde de Bandim, INDEPTH Network, Bissau, Guinea-Bissau. c.bale@bandim.org
authors.forename: Carlito
authors.initials: C
authors.lastname: Balé
authors.forename: May-Lill
authors.initials: ML
authors.lastname: Garly
authors.forename: Cesario
authors.initials: C
authors.lastname: Martins
authors.forename: Jens
authors.initials: J
authors.lastname: Nielsen
authors.forename: Hilton
authors.initials: H
authors.lastname: Whittle
authors.forename: Peter
authors.initials: P
authors.lastname: Aaby
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D006169:Guinea-Bissau / Q000453:epidemiology; D006801:Humans; D007112:Immunity, Maternally-Acquired; D015994:Incidence; D007223:Infant; D008297:Male; D008457:Measles / Q000453:epidemiology* / Q000517:prevention & control*; D008458:Measles Vaccine / Q000276:immunology*; D012307:Risk Factors; D014505:Urban Population; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D008458:Measles Vaccine