Measles-associated diarrhoea in the Infectious Diseases Hospital, Rangoon

A study was conducted in the Infectious Diseases Hospital in Rangoon (Burma) to determine the magnitude of measles-associated diarrhoea morbidity and mortality in children under 6 years of age contributing to the overall diarrhoeal morbidity and mortality, and to determine the bacterial pathogens of measles-associated diarrhoea cases. Measles-associated diarrhoea cases occur most frequently in younger age groups (12-23 and 0-11 months). Although not directly comparable, their contribution to the total diarrhoeal cases (8%) was high but the proportion of measles-associated diarrhoeal deaths contributing to total diarrhoeal deaths was lower than the theoretical estimates. A low fatality rate (2%) among the measles-associated diarrhoea cases was found and this suggests a much lower rate in the community. This implies that measles-associated diarrhoeal mortality is probably not a major public health problem in Burma. Chest infection was the most common complication (32%) and was found in the majority of deaths resulting from complicated measles. A definite seasonal distribution of measles and measles-associated diarrhoea cases was found. Only 10% of the stool samples examined were positive for bacterial pathogens and all were shigellae. We found that a significant number of measles-associated diarrhoeal cases were malnourished.