Tenley Brownwright|Zan M. Dodson|Willem G. van Panhuis
Spatial clustering of measles vaccination coverage among children in sub-Saharan Africa
University of Pittsburgh|University of Pittsburgh|University of Pittsburgh
past two decades vaccination programs greatly reduced global morbidity mortality due measles recently progress stalled even countries report high vaccination coverage rates transmission continued particularly spatially clustered subpopulations low vaccination coveragewe examined spatial heterogeneity measles vaccination coverage among children aged 1223 months ten subsaharan african countries used anselin local morans estimate clustering vaccination coverage based data demographic health surveys conducted 2008 2013 also examined role sociodemographic factors explain clustering low vaccinationwe detected 477 spatial clusters low vaccination coverage many located countries relatively high nationwide vaccination coverage rates zambia malawi also found clusters border areas transient populations clustering low vaccination coverage related low health education limited access healthcaresystematically monitoring clustered populations low vaccination coverage inform supplemental immunization activities strengthen elimination programs metrics spatial heterogeneity used routinely determine success immunization programs risk disease persistence