Borus P K, Cumberland P, Sonoiya S, Kombich J, Tukei P M, Cutts F T
Centre for Virus Research, Kenya Medical Research Institute, P.O. Box 54628, Nairobi, Kenya.
East Afr Med J. 2003 Jul;80(7):361-4. doi: 10.4314/eamj.v80i7.8719.
To determine morbidity and mortality from measles and to estimate measles vaccine effectiveness among children hospitalised with measles in two hospitals in Nairobi.
A review of hospital records (index cards).
Kenyatta National Hospital and Mbagathi District Hospitals covering the years 1996-2000.
A review of index cards for measles morbility and mortality was undertaken in the two hospitals. Measles data at the Kenya Expanded Programme on Immunisation covering both hospitals was analysed for vaccine effectiveness.
The incidence of measles was unusually high in 1998 between July and November (monthly range 130-305), reflecting on the occurrence of an outbreak at that time. There was no definite monthly incidence trend of measles in 1996,1997, 1999 and 2000. The median age of cases was 13 months (range 0-420 months) for Kenyatta hospital and 18 months (range 1-336 months) for Mbagathi Hospital. Significantly, 29.8% of all cases were aged below nine months when routine immunisation for measles had not begun. The median number of days spent in hospital were five days (range 0-87 days) for Kenyatta and four days (range 1-13 days) for Mbagathi. The overall case fatality rate was 5.6% and was similar for both males and females. The overall measles vaccine effectiveness among measles cases admitted to Kenyatta and Mbagathi Hospitals was 84.1%.
The case admissions in Kenyatta and Mbagathi Hospitals suggest measles was prevalent in Nairobi over the latter half decade of the 1990's. Apart from 1998 when there was an outbreak, the seasonality of measles was dampened. The 1998 outbreak suggests a build up of susceptible children the majority of whom were born in the last quarter of 1996. The high mortality may have had to do with the majority of cases presenting late when symptoms were already complicated and severe.
确定麻疹的发病率和死亡率，并评估内罗毕两家医院中患麻疹住院儿童的麻疹疫苗效力。
对医院记录（索引卡）进行回顾。
肯尼亚国家医院和姆巴加蒂区医院，涵盖1996 - 2000年。
对两家医院的麻疹发病率和死亡率索引卡进行回顾。分析肯尼亚扩大免疫规划中涵盖两家医院的麻疹数据以评估疫苗效力。
1998年7月至11月期间麻疹发病率异常高（每月范围为130 - 305例），反映出当时爆发了疫情。1996年、1997年、1999年和2000年麻疹没有明确的月发病率趋势。肯尼亚医院病例的中位年龄为13个月（范围0 - 420个月），姆巴加蒂医院为18个月（范围1 - 336个月）。值得注意的是，在所有病例中，29.8%的患儿年龄在9个月以下，此时尚未开始常规麻疹免疫接种。肯尼亚医院住院天数的中位数为5天（范围0 - 87天），姆巴加蒂医院为4天（范围1 - 13天）。总体病死率为5.6%，男性和女性相似。肯尼亚医院和姆巴加蒂医院收治的麻疹病例中，麻疹疫苗的总体效力为84.1%。
肯尼亚医院和姆巴加蒂医院的病例收治情况表明，20世纪90年代后半期麻疹在内罗毕流行。除了1998年爆发疫情外，麻疹的季节性减弱。1998年的疫情表明易感儿童数量增加，其中大多数出生于1996年最后一个季度。高死亡率可能与大多数病例就诊时症状已复杂严重有关。
