CLINICAL AND DEMOGRAPHIC PROFILE OF CHILDREN HOSPITALIZED WITH MEASLES INFECTION IN PESHAWAR

Main Article Content

FaheemUllah Khan
Amin Jan Gandapur
Iftikhar Ali
Rifaq Zeb
Wiqar Ahmad

Abstract

OBJECTIVE: To record the clinical and demographic characteristics of measles in patients hospitalized with measles infection in Peshawar, Pakistan.


METHODS: A retrospective review of medical records from December 2017 to January 2016 was conducted at Northwest General Hospital and Research Centre, Peshawar. A total of 182 measles patients’ data was retrieved and recorded in predesigned format which include information on demographics, clinical features, complications and outcome. Both descriptive and inferential statistics was used for data analysis.


RESULTS: Out of 182 patients, 118(64.8%) were males. The mean age was 24.1±2.5 months. The average length of hospital stay was 3.09±2.58 days. The most common complication was pneumonia 99 (54.4%), followed by diarrhea 54 (29.7%) and encephalitis 11 (6.0%). The patients were categorized in to two age groups, pre-vaccination group (≤9 months age) and post-vaccination group (>9 months age). Significant number of cases 54 (30%) were seen in age group <9 months. Only 45 (35%) cases in age group >9 months received the scheduled measles vaccination. Multivariate regression analysis revealed that Koplik spots [AOR=0.251, Cl; 0.074-0.853, p=0.027], lymphocyte count (normal/high) [AOR=0.205, Cl; 0.092-0.453, p<0.001] and vaccination in general [AOR= 2.546, Cl; 1.185-5.469, p=0.017] were found to be significantly associated with age group >9 months.


CONCLUSION: Pneumonia was the commonest complication followed by diarrhea. Vaccination history was very poor and significant number of patients were seen in age group <9 months of age.

Article Details

How to Cite
Khan, FaheemUllah, et al. “CLINICAL AND DEMOGRAPHIC PROFILE OF CHILDREN HOSPITALIZED WITH MEASLES INFECTION IN PESHAWAR”. KHYBER MEDICAL UNIVERSITY JOURNAL, vol. 11, no. 2, June 2019, pp. 79-84, doi:10.35845/kmuj.2019.18662.
Section
Original Articles
Author Biographies

FaheemUllah Khan, Northwest General Hospital & Research Center

Pediatric medicine

Amin Jan Gandapur, Northwest General Hospital & Research Center

Pediatric medicine

Iftikhar Ali, Northwest General Hospital & Research Center

Pharmacy services

Rifaq Zeb, Khyber Teaching Hospital

Pediatric medicine

Wiqar Ahmad, Northwest General Hospital & Research Center

Internal medicine

References

Caldararo S. Measles. Pediatr Rev 2007;28(9):352-4. DOI:10.1542/pir.28-9-352.

Fields BN, Knipe DM, Howley PM. Fields virology. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2007.

World Health Organization. Measles 2018. [Cited on 2019, March 18]. Available from: https://www.who.int/news-room/fact-sheets/detail/measles.

World Health Organization. Measles 2009. [Cited on September 17, 2018]. Available from: http://www.who.int/mediacentre/factsheets/fs286/en/.

World Health Organization. Measles 2013 (updated 2013 Feb 20) [Cited on September 17, 2018]. Available from: http://www.who.int/mediacentre/factsheets/fs286/en/index.html.

Grais R, Dubray C, Gerstl S, Guthmann J, Djibo A, Nargaye K, et al. Unacceptably high mortality related to measles epidemics in Niger, Nigeria, and Chad. PLoS Med 007;4(1):e16. DOI:10.1371/journal.pmed.0040016.

World Health Organization. Measles 2015. [Cited on September 17, 2018]. Available from: http://www.who.int/mediacentre/factsheets/fs286/e(1)n/; 2015.

World Health Organization. Measles vaccination has saved an estimated 17.1 million lives since 2000, 2015. [Cited on September 17, 2018]. Available from: http://www.who.int/mediacentre/news/releases/2015/measles-vaccination/en/; 2015.

Gaafar T, Moshni E, Lievano F. The challenge of achieving measles elimination in the Eastern Mediterranean Region by 2010. J Infect Dis 2003;187(Supplement_1):S164-S71.DOI:10.1086/368035.

World Health Organization. Progress towards reducing measles mortality and eliminating measles, WHO Eastern Mediterranean Region, 1997-2007. Wkly Epidemiol Rec 2008;83(11):97-104

Khan T, Qazi J. Measles outbreaks in Pakistan: causes of the tragedy and future implications. Epidemiol Rep 2014;2(1):1-5. DOI:10.7243/2054-9911-2-1.

Riaz H. Public health failings behind Pakistan's measles surge. The Lancet 2013;381(9862):189. DOI: 10.1016/s0140-6736(13)60072-0.

Chaudhry A. WHO reports 94 measles outbreaks across Pakistan in January. Daily DAWN. 2013. [Cited on September 17, 2018]. Available from: https://www.dawn.com/news/781120.

Masud T, Navaratne KV. The expanded program on immunization in Pakistan: recommendations for improving performance 2012. [Cited on September 17, 2018]. Available from: http://siteresources.worldbank.org/HEALTHNUTRITIONANDPOPULATION/Resources/281627-1095698140167/EPIinPakistan.pdf.

World Health Organization. Reported measles cases and incidence rates by WHO Member States 2013, 2014 as of 11 February 2015. 2015 [Cited on September 17, 2018]. Available from: http://www.who.int/immunization/monitoring_surveillance/burden/vpd/surveillance_type/active/measlesreportedcasesbycountry.pdf.

Siddiqui S, Akbar M, Mehtab A, Zafar M, Shahid S, Ahmed S, et al. Frequency of immunisation of children upto five years of age according to vaccination card in Karachi-A multicentre study. Ann Abbasi Shaheed Hosp Karachi Med Dent Coll 2017;22(1):12-9.

Ahsan MR, Al Mamun A, Alam HSK, Sarker PK, Makbul S, Kabir R, et al. Occurrence of Measles among Children Admitted in Tertiary Care Hospital. Bangladesh J Child Health 2018;42(1):15-8.

Khan M, Khan K, Ahmed A. Audit of measles cases in a tertiary care hospital. Pak Paed J 2013;37(3):143-8.

Saleem AF, Zaidi A, Ahmed A, Warraich H, Mir F. Measles in children younger than 9 months in Pakistan. Indian Pediatr 2009;46(11):1009-12.

Tariq P. Assessment of coverage levels of single dose measles vaccine. J Coll Physicians Surg Pak 2003;13(9):507-10.

Furrukh M, Jalil A, Anwar S, Aslam Z, Javed T. Measles-Demographics and vaccination status. J Rawalpindi Med Coll Students Suppl 2015:19(S-1):21-3.

Akramuzzaman SM, Cutts FT, Hossain MJ, Wahedi OK, Nahar N, Islam D, et al. Measles vaccine effectiveness and risk factors for measles in Dhaka, Bangladesh. Bull World Health Organ 2002;80(10):776-82.

Zahidie A, Wasim S, Fatmi Z. Vaccine effectiveness and risk factors associated with measles among children presenting to the hospitals of Karachi, Pakistan. J Coll Physicians Surg Pak 2014;24(12):882-8.

Silfverdal SA, Ehlin A, Montgomery SM. Breast‐feeding and a subsequent diagnosis of measles. Acta Paediatr 2009;98(4):715-9. DOI:10.1111/j.1651-2227.2008.01180.x.

Indwar P, Debnath F, Sinha A. Reporting measles case fatality due to complications from a tertiary care hospital of Kolkata, West Bengal 2011-2013. J Family Med Prim Care 2016;5(4):777-9. DOI:10.4103/2249-4863.201161.

Ali S. Health for all in Pakistan: achievements, strategies and challenges. East Mediterr Health J 2000;6(4):832-7.

Orenstein WA, Cairns L, Hinman A, Nkowane B, Olivé J-M, Reingold AL. Measles and Rubella Global Strategic Plan 2012–2020 midterm review report: Background and summary. Vaccine 2018;36:A35-A42. DOI: 10.1016/j.vaccine.2017.10.065.

Rahim F, Rehman H, Afridi J. Measles-demographic profile and complications in children. J Med Sci 2011;19(4):174-6.

Onyiriuka AN. Clinical profile of children presenting with measles in a Nigerian secondary health-care institution. J Infect Dis Immun 2011;3(6):112-6.

Bugvi AS, Rahat R, Zakar R, Zakar MZ, Fischer F, Nasrullah M, et al. Factors associated with non-utilization of child immunization in Pakistan: evidence from the Demographic and Health Survey 2006-07. BMC Public Health 2014;14(1):232.DOI:10.1186/1471-2458-14-232.

Similar Articles

1 > >> 

You may also start an advanced similarity search for this article.