Measles epidemic in Harare, Zimbabwe, despite high measles immunization coverage rates

Despite rapidly increasing measles immunization coverage in Harare city, measles remains endemic, and regular outbreaks occur. The most recent occurred in 1988, when the measles immunization coverage was 83%. We have carried out a retrospective study of the clinical and epidemiological features of this outbreak to assess whether the present immunization policy needs to be changed. Of 4357 cases of measles seen at primary health care centres and hospitals in Harare during the outbreak, 1399 (32%) were severe or involved complications that required hospital admission. The peak incidence occurred among under-2-year-olds, followed by that among 5-7-year-olds. Poor nutritional status was significantly more frequent among children who were hospitalized and among those who died. A total of 59% of all cases aged 9-59 months had documented evidence of measles immunization. The most frequent complications, which occurred most often among under-5-year-olds, were diarrhoea with dehydration, pneumonia, laryngotracheobronchitis, and convulsions, which together affected 56% of hospitalized cases. The hospital case fatality rate was low (1.43%). In Harare, measles transmission remains a problem, despite high measles immunization coverage rates; the failure rate for the standard Schwarz measles vaccine also appears to be high. There is a need to reduce the number of measles cases among under-9-month-olds and young children. Further studies into alternative measles vaccines and schedules are required

Acute lower respiratory infection in paediatric wards at Harare Hospital

The report covers acute lower respiratory infection in paediatric wards at Harare Hospital; Mpilo Hospital; and Marondera for the period 1989. Trends in paediatric morbidity and mortality at Harare Hospital; Immunization at Chitungiza Hospital are also looked into

Research and intervention issue concerning infant and child mortality and health

The Harare population birthweight for gestation standards were constructed using data from 5 872 singleton livebirths. A further 18 091 births were analysed to determine the relationship; if any; between birthweight for gestation centiles and risk of perinatal mortality. The results showed an overall perinatalmortality of 41.1/1000. The least perinatal mortality occurred at a gestation of39 weeks at a birthweight of 3 500 - 3 750 gms. The lease perinatal mortality occurred when the birthweight was between the 50th and 95th centiles at any given gestation. When the perinatal mortality for each week of gestation and birthweight cell of 250g size was calculated; this showed a pattern which could be represented graphically in zones of perinatal risk. Such zones form the basis for a simple method of determining perinatal mortality risk using both birthweight and gestation