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Measles in southern Ghana: 1985-1993
1Department of Child Health, University of Ghana Medical School Accra.
Abstract:
Measles continues to be a significant cause of morbidity and mortality among children in Southern Ghana although at a much lower level than a decade earlier. The major indications for measles admissions and the mortality associated factors of pneumonia, malnutrition, and diarrhea complicated by dehydration, however remain the same. The majority of measles admissions were in children without primary immunization resident in the more densely populated inner city of Accra and the peri-urban areas inhabited by lower-income recent immigrants. Our data show uncomfortable increases in the number of children aged 3-8 months as well as school age children (> or = 60 months), thus reopening the perennial discussion on the measles immunization programme i.e. what to do with younger infants with doubtful maternally-derived protection as well as the children who have missed their primary immunization at 9 months or those with immunization failure. The advantages of the 2-dose measles immunization programme need urgent consideration by national programme directors in African countries. The second dose is especially advocated to address the attendant problems of the cold chain system, vaccine efficacy, vaccine failure and diagnostic errors as older school-going age children.
Insights
Measles remains a threat to children in Southern Ghana, particularly those unvaccinated. A two-dose measles immunization program is crucial to address protection gaps in infants and older children.
Area of Science:
- Pediatrics
- Public Health
- Infectious Diseases
Background:
- Measles continues to cause significant illness and death in children in Southern Ghana, though less than previously.
- Key factors for measles admissions and mortality, such as pneumonia, malnutrition, and dehydration, persist.
Purpose of the Study:
- To analyze measles admissions and mortality factors in Southern Ghana.
- To evaluate the current measles immunization program's effectiveness and identify areas for improvement, especially concerning younger infants and older children.
Main Methods:
- Retrospective analysis of measles cases admitted to hospitals in Southern Ghana.
- Examination of demographic data, immunization status, and clinical outcomes of pediatric measles patients.
Main Results:
- Most measles admissions were unvaccinated children in densely populated urban and peri-urban areas.
- Increases in measles cases were observed in infants aged 3-8 months and school-aged children (≥60 months).
- Pneumonia, malnutrition, and dehydration remained significant mortality factors.
Conclusions:
- The study highlights gaps in measles vaccination coverage, particularly in vulnerable populations.
- A two-dose measles immunization strategy should be urgently considered to improve protection, especially for infants and older children potentially experiencing vaccine failure or missed primary immunization.