title: Spatiotemporal analysis of infant measles using population attributable risk in Shandong province, 1999-2008.
abstract: BACKGROUND
  Reduction of measles incidence and mortality has been encouraging in China. However, it remains an important public health concern among infants. This study aimed to examine the space-time distribution pattern of infant measles occurrence for the period of 1999-2008 in Shandong, China.
  
  
  RESULTS
  Measles cases among infants aged younger than 1 year were obtained from the national infectious diseases reporting information system. A spatiotemporal analysis using population attributable risk percent (PAR%) was used to distinguish between multiple geographic clusters of potential interest. The analysis detected 29 statistically significant space-time clusters with the most likely cluster in Zaozhuang City from 2006 to 2008. Of the 28 secondary clusters, 22 were found in 2008. The map of PAR%, relative risk (RR) and space-time cluster analysis indicated that the clusters were generally unchanged, and were found south-west and north-west of Shandong. The Lanshan District in Linyi had the highest PAR%, while highest RR was in the Yicheng District in Zaozhuang.
  
  
  CONCLUSIONS
  There were significant space-time clusters of infant measles in Shandong over the study period. PAR% is an effective way to analyze multiple clusters from their application like RR. Interrupting measles circulation and maintaining routine coverage over 95% may be the only effective strategy to achieve measles elimination.
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China.
authors.forename: Yuhui
authors.initials: Y
authors.lastname: Zhu
authors.forename: Qing
authors.initials: Q
authors.lastname: Xu
authors.forename: Hualiang
authors.initials: H
authors.lastname: Lin
authors.forename: Dahai
authors.initials: D
authors.lastname: Yue
authors.forename: Lizhi
authors.initials: L
authors.lastname: Song
authors.forename: Changyin
authors.initials: C
authors.lastname: Wang
authors.forename: Huaiyu
authors.initials: H
authors.lastname: Tian
authors.forename: Xiaoxu
authors.initials: X
authors.lastname: Wu
authors.forename: Aiqiang
authors.initials: A
authors.lastname: Xu
authors.forename: Xiujun
authors.initials: X
authors.lastname: Li
mesh_terms: D002681:China / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008457:Measles / Q000453:epidemiology*; D062211:Spatio-Temporal Analysis