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Measles infection in hospitalized children in Lusaka, Zambia
H Oshitani1, M Mpabalwani, F Kasolo
1Virology Laboratory, University Teaching Hospital, Lusaka, Zambia.
Insights
Measles vaccination in Zambia significantly reduces child mortality. Vaccinated children had a 6.4% case fatality rate compared to 17.0% in unvaccinated children, indicating vaccine effectiveness in reducing disease severity.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Measles remains a significant public health concern, particularly in developing countries.
- Understanding measles epidemiology and the impact of vaccination is crucial for disease control.
Purpose of the Study:
- To assess measles infection patterns and case fatality rates in children admitted to the University Teaching Hospital (UTH) in Lusaka, Zambia.
- To evaluate the effectiveness of measles vaccination in reducing disease severity and mortality.
Main Methods:
- A 2-year hospital-based survey (January 1992-December 1993) of measles cases admitted to UTH.
- Analysis of patient demographics, age distribution, vaccination status, and case fatality rates.
- Comparison of outcomes between vaccinated and unvaccinated children.
Main Results:
- A total of 1066 children were admitted with measles, with a peak incidence from September to December 1992.
- Children under 1 year old constituted 34.7% of cases, with 19.0% being under 9 months (recommended vaccination age).
- The overall case fatality rate was 12.6%, higher in younger children (0-3 years). Vaccinated children had a significantly lower case fatality rate (6.4%) than unvaccinated children (17.0%).
Conclusions:
- Measles vaccination in Zambia, while not preventing infection, significantly reduces the severity of the disease and lowers case fatality rates.
- The findings underscore the importance of timely measles vaccination to mitigate severe outcomes.
- Targeted vaccination strategies are essential, especially for infants below the recommended age for vaccination.
Abstract:
A 2-year hospital-based survey of measles infections were carried out at the University Teaching Hospital (UTH) in Lusaka, Zambia from January 1992 to December 1993. During this period, a total of 1066 children with a clinical diagnosis of measles were admitted to the paediatric isolation ward at UTH. Measles cases were seen throughout both 1992 and 1993. However, there was a peak from September to December, 1992. The number of cases decreased with age, and 370 (34.7%) were under 1 year old. It is noteworthy that 203 (19.0%) were less than the 9 months of age which is the recommended time for measles vaccination in Zambia. The overall case fatality rate was 12.6%, and was higher in children aged 0-3 years (14.3%) than in those aged 4 years and above (6.7%). Measles vaccination status could be checked from the child's immunization card for 343 measles cases over 9 months of age, 118 (34.4%) of these having previously received measles vaccine. Vaccinated children had a significantly lower case fatality rate (6.4%) than the unvaccinated group (17.0%). This suggests that while measles vaccine cannot prevent infection, it can reduce the severity of infection.