A ten-year study of measles admissions in a Nigerian teaching hospital.

BACKGROUND: Measles remains a major cause of childhood morbidity and mortality in Nigeria despite the availability of safe and effective vaccines. The last report on measles from our center was about 15 years ago. A review of the current status is necessary in order to strengthen interventional strategies.
OBJECTIVES: To study the burden and epidemiological correlates of measles admissions in a Nigerian teaching hospital.
DESIGN: Retrospective.
SUBJECTS: Children admitted with measles infection and/or complications.
METHODS: A review of medical records of measles admissions over the 10-year period, May 1994 and April 2004.
RESULTS: One hundred and sixty four children (6.1% of paediatric admissions) aged 4 months to 12 years (28.4 + 28.82 months) were admitted with measles. Sixty-three infants (< or = 12 months old) accounted for 39.4% of patients with about half of them younger than nine months. History of vaccination against measles was obtained in 43 (29.5%) subjects. Forty- eight (32.9%) children were underweight weighing between 60-80% of the expected weight for age and six (4.1%) of them were marasmic weighing below 60% of expected weight for age. None of the patients had oedema. The commonest complication was bronchopneumonia (55.5%). Major complications were less commonly associated with children who weighed more than 80% of expected weight (p = 0.011). The case fatality rate was 7.5 % accounting for 0.4% of childhood mortality. Children without prior measles vaccination, those of low socio-economic status and those weighing less than 80% of expected for age all had significantly higher mortality rates. (p< 0.05 in each case).
CONCLUSION: Measles incidence has risen in the last ten years in Sagamu and its environs but it is still largely a disease of young children. Therefore routine immunization and disease surveillance should be strengthened. Supplemental immunization activities should also be considered.