Risk factors for increased mortality in children with complications of measles

ABSTRACT

Measles is a common infectious disease of children, which may be associated with complications. This study was conducted to determine the risk factors that predispose children suffering from complications of measles to increased mortality. This was conducted in the Department of Paediatrics, Mayo Hospital, Lahore from 1st January 1998 to 31st August 1998. Eighty-four children having various complications of measles were included. Thirteen children left against medical advice leaving 71 evaluable cases. Fifty-eight cases improved and were discharged and 13 died. Mortality was proportionate in all age groups. Mortality in the girls as compared to the boys was 9 vs 4 which was not statistically significant. Mortality rate was higher in those with weight < 5th centile [P=0.12]. Measles vaccination was received by 32 percent cases but it had no impact on the case fatality. Fifty-three children had a positive history of contact with a measles patient out of which 60.36 percent had a close contact at home. This also did not have any prognostic significance. Pneumonia was the most common [67.86 percent] complication followed by encephalitis [38.1 percent], diarrhoea, febrile fits, meningitis and tuberculosis. Case fatality of measles was 18.31 percent, however all cases who expired had pneumonia either alone or with another complication. Hence severe malnutrition [weight < 5[th] centile] and pneumonia were two risk factors for increased mortality in this series of patients