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Measles associated diarrhea and pneumonia in south India
N Deivanayagam1, N Mala, S S Ahamed
1Advanced Centre for Clinical Epidemiological Research and Training (ACCERT), Institute of Child Health, Madras.
Abstract:
A prospective study was undertaken from April 1988 to April 1989, to assess the diarrheal and respiratory complications of measles. Standard definitions were used for the cases, Measles Associated Diarrhea (MAD) and Measles Related Pneumonia (MRP). Children with diarrhea not related to measles were recruited for comparison for MAD. There was a total of 454 cases, measles 53 (11.7%), measles associated diarrhea (MAD) 113 (24.9%), measles related pneumonia (MRP) 186 (41.0%) and MAD with MRP 102 (22.5%). Children under 10 months and 24 months were 11% and 51.5%, respectively. Altogether 215/401 (53.6%) and 288/401 (71.8%) had diarrhea and pneumonia. Children who had been measles vaccinated were 8.4%. The overall case fatality was 4.2%. Case fatality in pneumonia was 1.1%. There was no statistically significant difference between the MAD and diarrhea in relation to religion, water supply, the method of excreta disposal, nutritional status and immunization status other than measles vaccination. There was significant difference in the nature of stools between the two groups, the stools of MAD were more of dysenteric in nature (p < 0.005). Vitamin A deficiency as evidenced by eye signs, was significantly more in MAD than in diarrhea (p < 0.001). It is recommended that Vitamin-A be given to all children with measles, complication due to diarrhea be promptly and adequately treated and to consider measles vaccination earlier than 9 months.
Insights
Measles complications like diarrhea and pneumonia are common, especially in young children. Early measles vaccination and Vitamin A supplementation are recommended to reduce severity and fatality.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Measles is a significant cause of childhood morbidity and mortality globally.
- Diarrheal and respiratory complications frequently arise during measles infection.
- Understanding these complications is crucial for effective management and prevention strategies.
Purpose of the Study:
- To assess the incidence and characteristics of diarrheal and respiratory complications in measles patients.
- To compare Measles Associated Diarrhea (MAD) with non-measles diarrhea.
- To identify risk factors and outcomes associated with measles complications.
Main Methods:
- Prospective study conducted from April 1988 to April 1989.
- Inclusion of 454 cases, with standard definitions for Measles Associated Diarrhea (MAD) and Measles Related Pneumonia (MRP).
- Comparison group of children with diarrhea unrelated to measles.
Main Results:
- Diarrhea and pneumonia were prevalent in 53.6% and 71.8% of measles cases, respectively.
- Measles Associated Diarrhea presented with more dysenteric stools (p < 0.005) and higher rates of Vitamin A deficiency (p < 0.001).
- Overall case fatality was 4.2%, with pneumonia case fatality at 1.1%.
Conclusions:
- Measles vaccination coverage was low (8.4%) in the study population.
- Prompt treatment of diarrhea and Vitamin A supplementation for measles patients are recommended.
- Consideration for earlier measles vaccination (before 9 months) is advised.