Clinical Profiles and Outcome of Children Admitted with Measles During 2009 Outbreak


ABSTRACT:BACKGROUND: Measles is a highly contagious acute viral infection. It is a common cause of morbidity and mortality constituting half of vaccine preventable diseases.OBJECTIVE:The study was designed to describe the demographic, vaccination status, clinical profiles, and outcome of children admitted with measles during outbreak.PATIENTS AND METHODS: A cross sectional hospital based study was conducted on 137 children admitted with measles in Children Welfare Teaching Hospital/Medical City /Baghdad during the outbreak of measles in the period from 1st January- 31st May 2009. Patients below the age of 14 years who were clinically diagnosed as cases of measles were treated and followed.RESULTS: The median age was 17 months with a range of 3 months-14 years. Male /female ratio of 1.14:1. 86.86 % patients were admitted in March. Sixty eight (49.63%) children were not vaccinated. Twenty four (55.81%) children of vaccinated group had one dose of measles vaccine only and 19(44.19%) children had two doses. Complications of measles were detected in 120(87.59%) of patients. The most frequent complication of measles was pneumonia which was encountered in 72(52.55%) cases. Gastroenteritis was recorded in 44(32.12%) of patients. Six patients (4.38%) died after developing complications in the form of pneumonia in five and encephalitis in one. Forty four (32.12%) cases were malnourished and majority of them 26 (59 %) cases were in the >15 months age group. Two thirds of deaths were among malnourished children. The case fatality was 4.38%.CONCLUSION:One third of measles infections occurred before the age of 9 months. Half of measles cases were not vaccinated. The majority of the complicated cases had occurred in the unvaccinated children. Pneumonia was found to be the most frequent complication of measles that necessitated admission. Young age, pneumonia, malnutrition, immune deficiency and non-vaccination status were significant factors related to mortality..