MORBIDITY AND MORTALITY PATTERN OF HOSPITALIZED CHILDREN WITH MEASLES AT MAYO HOSPITAL, LAHORE (EPIDEMIC 2013)

Abstract

ABSTRACT

Background:

Major outbreak of measles took place in Punjab recently (2013), leading on to increase in hospitalized cases of measles in children wards, with unacceptably high morbidity and mortality. The aim of this study was to find out morbidity and mortality pattern of hospitalized cases of measles and associated factors.

Design:

Prospective case series conducted at Pediatric Department Mayo Hospital, Lahore for 7 months, i.e. from 1^st Jan to 31^st JUL 2013

Methods:

A total of 628 cases of measles were admitted in the children ward, Unit II, Mayo Hospital, Lahore from Jan-Jul 2013. The diagnosis was assigned using WHO criteria. Cases were admitted through emergency on 24 hour basis and managed in HDU and Measles isolation section. Chest X-Ray and blood complete examination was done in all cases. Complications were noted and managed along with eye consultations where necessary. Data was recorded in a predesigned proforma and entered in computer.

Results:

628 admitted cases were enrolled, with comparable sex distribution, having mean age 30.8±26.25 months and mean weight 9.69±4.14 Kg. Eighty three percent cases were below 6 years of age (33% <1 year), 71% cases were under weight and 68% were wasted (WHO classification). Sixty six percent cases had not received measles vaccination, 144 (23%) cases had received a single dose and 71 cases (12.2%) had received two doses before admission. Majority of cases belonged to Lahore city and its peri-urban areas (83%). Pneumonia (80%), diarrhea (37%), and encephalitis (7.7%) were common complications. Eye complications (corneal ulcers, keratitis, perforation and blindness) were seen in 7.3% cases. Being under weight, H/O improper measles immunization, presence of anemia, pneumonia and encephalitis were statistically significant risk factors for mortality. The case fatality rate was 8.76%.

Conclusion:

Recent Measles outbreak further highlights the importance of strengthening the need for routine and mass vaccination for all children. In a susceptible population of children with malnutrition and low vitamin A coverage, the routine EPI coverage (above 90%) is the single most important preventive factor for prevention of further epidemics in future.

Key words:

Measles, Epidemic, Measles related mortality