Measles in infants: a review of studies on incidence, vaccine efficacy and mortality in east Africa.

Control of measles in developing countries is complicated by high incidence and mortality among infants. Hospital-based and community-based studies from East Africa were reviewed with respect to the reported incidence and mortality of measles and vaccine efficacy/seroconversion rates after the administration of measles vaccine to infants. The studies reviewed confirm that measles is particularly severe in infants, and some indicate that vaccination before 9 months with standard vaccine could be effective and have beneficial effects for children aged 6-9 months, while other studies refute this finding. Due to the high incidence and mortality of measles in infants, alternative control strategies are essential to reduce measles mortality. Further studies are needed on the effects of a two-dose schedule vaccinating at 6 and 9 months, which in mathematical modelling shows considerable benefit. Improved management of measles cases, including the administration of vitamin A could be considered as a complementary strategy for reducing measles mortality, especially in infants.