Spectrum of complications of measles in Afghanistan: a study of 784 cases.

Seven hundred and eight-four patients with measles admitted to the Institute of Child Health, Kabul (Afghanistan) between April 1980 and March 1982 were studied. Almost three-quarters (73.6%) of children (4 months to 12 years) with measles were below the age of 3 years. The maximum number of cases occurred in the 1 to 2 years age group (43.1%). Eighty-nine patients (11.3%) contracted the disease before 1 year of age whereas only 13 infants had developed measles before the age of 7 months. Measles occurred throughout the year and there was no significant seasonal variation. Bronchopneumonia was the commonest complication (85.4%) followed by enteritis (30.2%) and laryngotracheobronchitis (22%). The overall mortality was 10.8%. Respiratory complications including bronchopneumonia and laryngotracheobronchitis were the commonest causes of death followed by encephalitis and gastroenteritis. However, the case fatality rate was highest among patients who suffered from encephalitis and laryngotracheobronchitis. In our study, there was no significant difference in the incidence of mortality between well-nourished and moderately undernourished children. It is recommended that in developing countries measles vaccination should be given around 8-9 months of age and must be completed before the age of 1 year.