Factors associated with secular trends in mortality attributed to measles in Gweru, Zimbabwe, in 1967-89

A retrospective study conducted in Gweru, Zimbabwe, investigated the trend and its associated factors in measles mortality between 1967 and 1989. Measles and malnutrition surveillance data were analysed in SPSS version 8.0 using the Forward Stepwise Linear Regression method. Measles case fatality rates ranged from zero to 48.2% (median: 4.2, Q(1) = 1.2, Q(3) = 12.9) and they significantly linearly declined [slope = -1.686; 95% confidence interval (CI) -2.327, -1.044; R(2) = 59%]. Rates of mortality among complicated measles cases (slope = 0.546, 95% CI = 0.133-0.345) and rates of mortality from malnutrition among children aged <5 years (slope = 0.459, 95% CI = 0.031-0.099) independently predicted (R(2) = 87%) measles case fatality rates. It was concluded that decline in rates of mortality among complicated measles cases, probably due to good management of such cases, and decline in rates of malnutrition among children aged <5 years may have contributed to the decline in measles case fatality rates.