{ "abstract": "Background: Measles remains a major public health concern in Nigeria, contributing disproportionately to the global burden. Persistence of the disease is driven by sub-optimal vaccination coverage and heterogeneous transmission patterns, but the specific spatio-temporal dynamics and the quantitative impact of vaccination gaps at the sub-national level are not fully characterized. Objective: This study aimed to provide a comprehensive analysis of measles transmission in Nigeria from 2006 to 2025, with the specific objectives to identify spatial hotspots, quantify their temporal persistence, and evaluate the association between MCV1/MCV2 coverage and measles case ratio. Methods: We conducted a national retrospective ecological study, integrating 19 years of surveillance data (2006–2025) and geospatial information, with a focused 4-year analysis of vaccination records (2021–2024). Analytical methods included time-series decomposition, spatial autocorrelation (Local Moran’s I and Getis-Ord Gi*), and linear mixed-effects modeling to quantify vaccination effects while accounting for state-level heterogeneity. Results: Analysis of 253,595 measles cases revealed a highly clustered geographic distribution, with 86.4% of the national burden concentrated in northern Nigeria. We identified 38 persistent hotspot Local Government Areas that accounted for 23.2% of all cases. Vaccination coverage was low and disparate, with national averages of 73.8% for MCV1 and 38.4% for MCV2. Mixed-effects modeling confirmed a significant negative association between MCV1 coverage and the measles case ratio, while MCV2 coverage did not show a statistically significant independent effect. Conclusion: Measles transmission in Nigeria is driven by entrenched hotspots in the north and critical vaccination gaps threatening disease resurgence in the south. Achieving elimination requires a tailored strategy: intensive supplemental immunization activities and RI strengthening aimed at reducing endemic transmission in the northern hotspots, coupled with focused efforts to close routine immunization gaps in specific southern states.", "abstract_shown": true, "affiliations": [ "Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria", "Corona Management Systems, Kado, Abuja, Nigeria", "Department of Veterinary Tropical Diseases, University of Pretoria, Pretoria, South Africa", "African Centre for Disease Control and Prevention, Addis Ababa, Ethiopia", "Department of Medical Biochemistry, College of Medicine, Kaduna State University, Kaduna, Nigeria", "Department of Public Health, Faculty of Basic and Applied Biological Sciences, Ahmadu Bello University, Zaria, Nigeria", "Kwara State Ministry of Health, Ilorin, Nigeria", "Department of Community Medicine, Rivers State University, Rivers, Nigeria", "National Primary Healthcare Development Agency, Abuja, Nigeria" ], "article_type": "Research Article", "arxiv": null, "author_total": 10, "authors": [ { "affs": [ 0, 1 ], "name": "Sylvia Ezenwa-Ahanene" }, { "affs": [ 1, 2 ], "name": "Polycarp Dauda Madaki", "orcid": "0009-0001-8216-9779" }, { "affs": [ 3 ], "name": "Ruth Manzo Sabo" }, { "affs": [ 1, 4 ], "name": "Oghenetega ThankGod Oweh", "orcid": "0000-0002-0051-9975" }, { "affs": [ 5 ], "name": "Kalat Haruna Tauna" }, { "affs": [ 1, 5 ], "name": "Zubairu Zubairu Dalhatu" }, { "affs": [ 1, 6 ], "name": "Mustapha Sikirat Abiola" }, { "affs": [ 7 ], "name": "Ifeoma Christiana Nwadiuto" }, { "affs": [ 0, 1 ], "name": "Muzzammil Gadanya" }, { "affs": [ 1, 8 ], "name": "Abubakar Yahya Imam" } ], "bibtex": "https://research.draconitic.com/paper/29mzd9ga6dh6r.bib", "cited_by": 0, "doi": "10.1371/journal.pone.0359837", "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13712523/", "id": "29mzd9ga6dh6r", "issns": [ "1932-6203" ], "landing_url": "https://doi.org/10.1371/journal.pone.0359837", "language": "en", "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Africa" ], [ "heading", "Biology and Life Sciences" ], [ "heading", "Computer and Information Sciences" ], [ "heading", "Disease Surveillance" ], [ "heading", "Earth Sciences" ], [ "heading", "Epidemiology" ], [ "heading", "Geographical Locations" ], [ "heading", "Geography" ], [ "heading", "Geoinformatics" ], [ "heading", "Immunity" ], [ "heading", "Immunology" ], [ "heading", "Infectious Diseases" ], [ "heading", "Measles" ], [ "heading", "Medical Conditions" ], [ "heading", "Medical Risk Factors" ], [ "heading", "Medicine and Health Sciences" ], [ "heading", "Nigeria" ], [ "heading", "People and Places" ], [ "heading", "Preventive Medicine" ], [ "heading", "Public and Occupational Health" ], [ "heading", "Research Article" ], [ "heading", "Spatial Autocorrelation" ], [ "heading", "Vaccination and Immunization" ], [ "heading", "Viral Diseases" ], [ "openalex", "2713|Virology and Viral Diseases" ], [ "plos", "/Biology and life sciences/Immunology/Immunity" ], [ "plos", "/Biology and life sciences/Immunology/Vaccination and immunization" ], [ "plos", "/Computer and information sciences/Geoinformatics/Spatial autocorrelation" ], [ "plos", "/Earth sciences/Geography/Geoinformatics/Spatial autocorrelation" ], [ "plos", "/Medicine and health sciences/Epidemiology" ], [ "plos", "/Medicine and health sciences/Epidemiology/Disease surveillance" ], [ "plos", "/Medicine and health sciences/Epidemiology/Medical risk factors" ], [ "plos", "/Medicine and health sciences/Immunology/Immunity" ], [ "plos", "/Medicine and health sciences/Immunology/Vaccination and immunization" ], [ "plos", "/Medicine and health sciences/Medical conditions/Infectious diseases/Viral diseases/Measles" ], [ "plos", "/Medicine and health sciences/Public and occupational health/Preventive medicine/Vaccination and immunization" ], [ "plos", "/People and places/Geographical locations/Africa/Nigeria" ] ], "openalex": "W7223995544", "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0359837&type=printable", "pmcid": "PMC13712523", "pmid": "42945220", "published": "2026-10-27", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/29mzd9ga6dh6r.ris", "sources": [ { "first_seen": "2026-10-30T12:17:17Z", "native_id": "10.1371/journal.pone.0359837", "source": "plos", "url": "https://doi.org/10.1371/journal.pone.0359837" }, { "first_seen": "2026-10-31T12:23:05Z", "native_id": "PMC13712523", "source": "pmc", "url": "https://doi.org/10.1371/journal.pone.0359837" } ], "subjects": [ { "field": "biology", "origin": "plos:immunology", "subfield": "immunology" }, { "field": "earth", "origin": "heading:Earth Sciences", "subfield": "general" }, { "field": "medicine", "origin": "plos:epidemiology", "subfield": "epidemiology-public-health" }, { "field": "medicine", "origin": "heading:Infectious Diseases", "subfield": "infectious-disease" } ], "title": "Spatio-temporal dynamics, transmission hotspots, and vaccination gaps driving measles persistence in Nigeria, 2006–2025", "title_text": "Spatio-temporal dynamics, transmission hotspots, and vaccination gaps driving measles persistence in Nigeria, 2006–2025", "type": "peer-reviewed", "updated_at": "2026-10-31T12:23:05Z", "url": "https://research.draconitic.com/paper/29mzd9ga6dh6r", "venue": "PLOS One", "versions": [] }