Genotypic characterization, spatiotemporal dynamics, multilevel determinants, case detection timeliness, and forecasting of measles in Amhara Region, Ethiopia
PhD candidate: Mengistie Kassahun Tariku
Institution: Bahir Dar University, Bahir Dar, Ethiopia
Supervisors: Dr. Mulusew Andualem; Prof. Wendemagegn Embiale; Dr. Eric HY Lau
This PhD project investigates the epidemiology, transmission dynamics, and genetic characteristics of measles outbreaks in the Amhara Region of Ethiopia, with the aim of strengthening outbreak prediction and control strategies. Despite progress in reducing mortality, outbreaks persist in the Amhara Region, where immunization coverage remains insufficient for elimination. Spatiotemporal analysis and forecasting models are valuable tools for identifying high-risk populations and guiding timely interventions. However, there is limited evidence on the combined spatiotemporal patterns, multilevel determinants of infection, and timeliness of case detection in the region.
This study will analyze approximately 33,457 suspected and confirmed measles cases reported between January 1, 2015, and December 30, 2025, using ecological and retrospective cohort study designs. Bayesian hierarchical models will assess spatiotemporal patterns, while survival analysis (Cox proportional hazards or accelerated failure time models) will evaluate delays in case detection. An unmatched case-control study design (127 cases and 254 controls) will identify determinants of infection using multilevel logistic regression, incorporating individual and community-level variables. In addition, molecular analysis will be conducted on samples from 100 measles cases using PCR and whole genome sequencing to identify circulating genotypes and explore transmission linkages.
Finally, an age-structured spatial SEIR metapopulation model will be applied to forecast weekly measles cases at the woreda level, generating spatial risk maps and outbreak probabilities. The findings are expected to support improved surveillance, targeted immunization strategies, and strengthened outbreak preparedness in the Amhara Region and beyond.