Increased Childhood Morbidity After Measles Is Short-term in Urban Bangladesh

• Published in: American journal of epidemiology Vol. 151; no. 7; pp. 723 - 735
• Main Authors: Akramuzzaman, Syed M., Cutts, Felicity T., Wheeler, Jeremy G., Hossain, Mohammed J.
• Format: Journal Article
• Language: English
• Published: Cary, NC Oxford University Press 01.04.2000
• Subjects: Acute Disease; Antigens - blood; Bangladesh - epidemiology; Biological and medical sciences; cellular; Child; Child, Preschool; cohort studies; diarrhea; Female; Human viral diseases; Humans; immunity; Incidence; Infant; Infection - epidemiology; Infection - immunology; Infectious diseases; Male; measles; Measles - complications; Measles - epidemiology; Medical sciences; Miscellaneous; Odds Ratio; pneumonia; Socioeconomic Factors; Urban Health - statistics & numerical data; Viral diseases; Weight Loss; Asia; Bangladesh; Human; Infection; Viral disease; Measles; Risk factor; Urban area; Child; Epidemiology; Morbidity; Public health
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/oxfordjournals.aje.a010267

In a 1995–1996 cohort study in the city of Dhaka, Bangladesh, morbidity in 117 hospitalized and 137 acute measles cases compared with age-matched children without measles (unexposed) was determined by weekly interview for 6 months. Compared with unexposed children, there were higher incidences of hospitalization (adjusted rate ratio (RR) = 3.1, 95% confidence interval (CI): 1.3, 7.6) and bloody diarrhea (adjusted RR = 2.7, 95% CI: 1.4, 5.1) in hospital measles cases during the 6 weeks after recruitment. Among community cohorts, there were higher incidences of bloody diarrhea (adjusted RR = 4.1, 95% CI: 1.1, 14.6), watery diarrhea (adjusted RR = 1.6, 95% CI: 0.9, 2.7), fast breathing (adjusted RR = 3.8, 95% CI: 2.1, 6.9), and the weekly point prevalence of pneumonia (adjusted prevalence ratio = 3.1, 95% CI: 1.0, 9.8) in measles cases during the same period. All measles cases regained lost weight within about 6 weeks. The prevalence of anergy to seven recall antigens 6 weeks after recruitment was higher in both hospital (adjusted odds ratio = 2.8, 95% CI: 1.2, 6.4) and communrty (adjusted odds ratio = 3.1, 95% CI: 1.1, 8.9) measles cases. Morbidity increased during the first 6–8 weeks after measles, but the authors found no consistent evidence of longer-term morbidity or wasting. The results support recent findings that measles is not associated with increased delayed mortality. Am J Epidemiol 2000;151:723–35.