Measles mortality, state of nutrition, and family structure: a community study from Guinea-Bissau

In an urban area of Guinea-Bissau where the general state of nutrition seemed fairly good, the case fatality rate for measles among children less than three years of age who were examined clinically during an epidemic was 25.0%. Nutritional indicators (weight-for-age, height-for-age, and weight-for-height ratios) measured a few months before the epidemic were about equal both for the group of 60 children who subsequently died of measles and for the general child population. Because no community study has demonstrated that the nutritional state influences the outcome of measles, the assumed importance of the state of nutrition for measles fatality rates is questioned. Children in monogamous households had a lower risk of dying of measles. It is suggested that measles may be more severe in polygamous families because several children can have the disease simultaneously.