title: Risk factors for measles infection in 0-7 month old children in China after the 2010 nationwide measles campaign: A multi-site case-control study, 2012-2013.
abstract: Endemic measles persists in China, despite >95% reported coverage of two measles-containing vaccine doses and nationwide campaign that vaccinated more than 100 million children in 2010. We performed a case-control study in six Chinese provinces during January 2012 through June 2013 to identify risk factors for measles infection among children aged 0-7 months.
  
  
  
  Children with laboratory-confirmed measles were neighborhood matched with three controls. We interviewed parents of case and control infants on potential risk factors for measles. Adjusted matched odds ratios (mOR) and 95% confidence intervals (CIs) were calculated by multivariable conditional logistic modeling. We calculated attributable fractions for risk factors that could be interpreted as causal.
  
  
  
  Eight hundred thirty cases and 2303 controls were enrolled. In multivariable analysis, male sex (mOR 1.6 [1.3, 2.0]), age 5-7 months (mOR 3.9 [3.0, 5.1]), migration between counties (mOR 2.3 [1.6, 3.4]), outpatient hospital visits (mOR 9.4 [6.6, 13.3]) and inpatient hospitalization (mOR 107.1 [48.8, 235.1]) were significant risk factors. The calculated attributable fractions for hospital visits was 43.1% (95% CI: 40.1, 47.5%) adjusted for age, sex and migration.
  
  
  
  Hospital visitation was the largest risk factor for measles infection in infants. Improved hospital infection control practices would accelerate measles elimination in China.
authors.affiliation: National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Ma
authors.affiliation: Global Immunization Division, Centers for Disease Control and Prevention, United States.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Gregory
authors.affiliation: National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Lixin
authors.initials: L
authors.lastname: Hao
authors.affiliation: Global Immunization Division, Centers for Disease Control and Prevention, United States.
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Wannemuehler
authors.affiliation: National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Qiru
authors.initials: Q
authors.lastname: Su
authors.affiliation: National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Zhijie
authors.initials: Z
authors.lastname: An
authors.affiliation: Global Immunization Division, Centers for Disease Control and Prevention, United States.
authors.forename: Linda
authors.initials: L
authors.lastname: Quick
authors.affiliation: Expanded Program on Immunization, World Health Organization Office in China, Beijing, China.
authors.forename: Lance
authors.initials: L
authors.lastname: Rodewald
authors.affiliation: Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu Province, China.
authors.forename: Fubao
authors.initials: F
authors.lastname: Ma
authors.affiliation: Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Yan
authors.affiliation: Shandong Provincial Center for Disease Control and Prevention, Shangdong Province, China.
authors.forename: Lizhi
authors.initials: L
authors.lastname: Song
authors.affiliation: Henan Provincial Center for Disease Control and Prevention, Henan Province, China.
authors.forename: Yanyang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Yunnan Provincial Center for Disease Control and Prevention, Yunnan Province, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Kong
authors.affiliation: Gansu Provincial Center for Disease Control and Prevention, Gansu Province, China.
authors.forename: Xiaoshu
authors.initials: X
authors.lastname: Zhang
authors.affiliation: National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Huaqing
authors.initials: H
authors.lastname: Wang
authors.affiliation: National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: Global Immunization Division, Centers for Disease Control and Prevention, United States.
authors.forename: Lisa
authors.initials: L
authors.lastname: Cairns
authors.affiliation: National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Wang
authors.affiliation: National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China. Electronic address: luohm@chinacdc.cn.
authors.forename: Huiming
authors.initials: H
authors.lastname: Luo
mesh_terms: D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008457:Measles / Q000453:epidemiology*; D012307:Risk Factors
keywords: Case–control study; China; Measles; Measles elimination; Population immunity; Risk factors