Clinical outcome in children hospitalized with complicated measles.

OBJECTIVE

To determine the association of clinical outcome of measles in children with demographic profile and complications.

DESIGN

A cross-sectional analytical study.

PLACE AND DURATION OF STUDY

Isolation ward, The Children's Hospital, Pakistan Institute of Medical Sciences (PIMS), from January 2003 to August 2004.

PATIENTS AND METHODS

Detailed history and physical examination of all the hospitalized patients with complications of measles was filled in case report form. Immunization cards were assessed for measles vaccination status. Data was analyzed by using SPSS version 10 software. The clinical outcome of measles was compared with demographic profile and complications by using Chi-square test and p-values were obtained.

RESULTS

Two hundred and five hospitalized patients with complications of measles were studied. There were 61.5% males. Mean age was 46.1 months and 57% patients were vaccinated against measles. Malnourished patients were 71.2% and had a longer hospital stay (p=0.010). Pneumonia (40.0%) and diarrhoea (38.5%) were the commonest complications. Seven children died. Mortality was significantly associated with younger age (p=0.04), unvaccinated status (p=0.04) and presence of encephalitis (p=0.00001).

CONCLUSION

The most common complications of measles are pneumonia and diarrhoea with dehydration requiring hospitalization. Malnourished children experience more complications and have longer hospital stay. Mortality is significantly associated with infancy, unvaccinated status and encephalitis. A second dose of measles should be introduced at 15 months of age.