Risk Factors and Complications in Measles Mortalities

Abstract

Abstract: To determine the risk factors and complications in patients expired due to measles. Background: Measles is one of the vaccine-preventable diseases. Mortality and morbidity due to it has been decreased in many countries with preventive measures. However, epidemics occur off and on in some communities. Pakistan has faced an epidemic in 2012-13. Started from one province and affected others. Due to some risk factors, Pakistani children suffered from many complications. Place & Duration: Measles ward, the Children`s Hospital, Lahore form February to June 2013. Methodology: All patients who were admitted and expired in measles ward were included in the study. A Performa was filled for each patient to document the risk factors and complications in affected patients. Results: 1075 patients were admitted. 44 expired. 27 were males. Minimum age of patients who expired was 3 months and maximum was 7 years. Maximum deaths were in group 4: 27% (12/44), followed by group 2: 23% (10/44). 30 (68%) were malnourished having weight less than 5th centile. 70% of the patients died within 24 hours (31/44) because of severity of illness. 82% (36/44) patients had contacts in families or society. 86% (38/44) patients were unvaccinated and only one patient received two doses (2%). 17 patients had co-morbid conditions. These were; cystic fibrosis, dilated cardiomyopathy, complex cyanotic heart disease, Gaucher`s disease, hypothyroidism, chronic renal failure, hepatitis (3), seizures disorders, pulmonary tuberculosis, hydrocephalus, Aplastic anemia and severe nutritional anemia (3). Complications documented were; pneumonia (measles pneumonia with superadded bacterial infection) 100% (n=44), Encephalitis 47% (n=21), Enteritis 9% (n=4) and respiratory failure 4.5 % (n=2). Conclusion: Lack of vaccination is the most important risk factor for mortality, followed by malnutrition and co-morbid illness.