Post-vaccination scenario of measles: a retrospective analysis.

ABSTRACT

BACKGROUND: Routine vaccination against measles was introduced in India during 1985-86 through the Universal Immunization Programme. Its effect on the current prevalence of measles is not known. METHODS: Information on the total number of patients admitted and deaths due to measles from January 1982 to December 1997 were obtained from the records of the Institute of Tropical Medicine, Hyderabad, the only infectious diseases hospital in the city. Details on age, sex, number of complications, duration of hospital stay, vaccination status and information on vitamin A administration in the hospital were collected from the case records. RESULTS: A total of 20,926 cases of measles were admitted from 1982 to 1997. There was a 69% reduction in hospital admissions from the pre-vaccination to the post-vaccination period, and deaths due to measles decreased by 90%. Over the years, a rise in the age of children admitted with measles was observed. Boys were admitted more frequently to the hospital (p < 0.001) than girls. All the children showed one or more complications. From 1992 onwards, vitamin A was administered to 45.4% of the children admitted. CONCLUSION: A significant reduction was observed in the number of cases admitted to the hospital as well as deaths due to measles. Apart from the effect of the vaccination programme, this could also be due to increased awareness and availability of better health care facilities in the hospital and peripheral health clinics. Administration of vitamin A to children with measles as recommended by the World Health Organization needs to be implemented. A significant increase in the number of older children (> 5 years) with no significant reduction in the infants affected by measles indicates inadequate vaccine coverage and accumulation of susceptible older children.