How urbanization affects the epidemiology of emerging infectious diseases

Neiderud, Carl-Johan

Immunization status between residents in urban centres and rural areas can differ. Coverage of measles vaccination in Indonesia have shown to be 68.5% in rural areas, compared with 80.1% in urban regions (72) . Studies in Nigeria have shown that sometimes the coverage can actually be better in more rural areas, and it might be explained by better mobilization and participation in the delivery of immunization services (73) . In a study in Uganda, 58% of the urban group compared to 53% in the rural areas were fully immunized, but polio vaccine was given to 51% in the urban group and 52% in the rural group (74) . Immunization coverage can also vary considerably among different settings, not only between rural and urban surroundings, but also between urban, rural, and slum settlements. In Changdigarh, a union territory of India, full immunization of children at the age of 2 was 30% in slums, 74% in urban, and 62.5% in rural settings (75) . It shows that there can be a wide variety of reasons for immunization status among the population in different regions and countries of the world. Effective immunization can be a cost-effective measure in poorer countries. High coverage can prevent epidemics in large cities and save many lives; however, immunization needs to be available both for the rural and urban population to achieve the greatest benefit.