Abstract：
Rubella infection during pregnancy can result in miscarriage or infants with a constellation of birth defects known as congenital rubella syndrome (CRS). When coverage is inadequate, rubella vaccination can increase CRS cases by increasing the average age of infection. Thus, the World Health Organisation recommends that countries introducing rubella vaccine be able to vaccinate at least 80% of each birth cohort. Previous studies have focused on national-level analyses and have overlooked sub-national variation in introduction risk. We characterised the sub-national heterogeneity in rubella transmission within Nigeria and modelled local rubella vaccine introduction under different scenarios to refine the set of conditions and strategies required for safe rubella vaccine use. Across Nigeria, the basic reproduction number ranged from 2.6 to 6.2. Consequently, the conditions for safe vaccination varied across states with low-risk areas requiring coverage levels well below 80 %. In high-risk settings, inadequate routine coverage needed to be supplemented by campaigns that allowed for gradual improvements in vaccination coverage over time. Understanding local heterogeneities in both short-term and long-term epidemic dynamics can permit earlier nationwide introduction of rubella vaccination and identify sub-national areas suitable for program monitoring, program improvement and campaign support.
摘要：
怀孕期间的风疹感染可导致流产或具有称为先天性风疹综合征（CRS）的出生缺陷的婴儿。当覆盖率不足时，风疹疫苗接种可以通过增加平均感染年龄来增加CRS病例。因此，世界卫生组织建议，使用风疹疫苗的国家能够为每个出生队列的至少80％接种疫苗。以前的研究侧重于国家层面的分析，忽视了引进风险的国家以下差异。我们对尼日利亚境内风疹传播的国家以下异质性进行了表征，并对不同情况下的当地风疹疫苗引入进行了建模，以完善安全使用风疹疫苗所需的一系列条件和策略。在整个尼日利亚，基本繁殖数从2.6到6.2不等。因此,安全疫苗接种的条件因各州而异,低风险地区的覆盖率远低于80%.在高风险环境中，常规覆盖率不足,需要通过允许随着时间的推移逐步改善疫苗接种覆盖率的运动来补充.了解短期和长期流行动态中的本地异质性可以允许在全国范围内更早地引入风疹疫苗接种，并确定适合计划监测的地方地区。项目改进和竞选支持。
