Shaun K Morris1, Shally Awasthi, Rajesh Kumar, Anita Shet, Ajay Khera, Fatemeh Nakhaee, Usha Ram, Jose R M Brandao, Prabhat Jha. 1. Centre for Global Heath Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada; Division of Infectious Diseases, Hospital for Sick Children, Toronto, Ontario, Canada and Department of Pediatrics, University of Toronto, 555 University Avenue, Toronto, Ontario, M5G1X8, Canada. Electronic address: shaun.morris@sickkids.ca.
Abstract
BACKGROUND: Direct estimates of measles mortality in India are unavailable. Our objective is, to use a nationally-representative study of mortality to estimate the number and distribution of, measles deaths in India with a focus on 264 high burden districts. METHODS: We used physician coded verbal autopsy data from the Million Death Study which surveyed, over 12,000 deaths in children aged 1 month to under 15 years from 1.1 million nationally, representative households in 2001-2003. RESULTS: We estimate there were 92,000 (99% CI 63,000-137,000) measles deaths in children 1-59, months of age in India in 2005, representing a mortality rate of 3.3 (99% CI 2.3-5.0) per 1000 live, births and about 6% of all 1-59 month deaths. In children under 15 years of age, there were 107,000, (99% CI 74,000-158,000) measles deaths. The measles mortality rate was nearly 70% greater in girls, than in boys, and 60% of the deaths were in three populous states Uttar Pradesh, Bihar, and Madhya, Pradesh. The 1-59 month measles mortality rate in high burden districts was 4.48 (99% CI 3.94-5.02) compared to 2.40 (99% CI 2.28-2.52) per 1000 live births in other districts. CONCLUSION: Measles killed over 100,000 children in India in 2005 and girls were at higher risk than boys. The majority of measles deaths occurred in a few states and high burden districts. The results of this study highlight the importance of focusing measles supplementary immunization activities in high burden districts.
BACKGROUND: Direct estimates of measles mortality in India are unavailable. Our objective is, to use a nationally-representative study of mortality to estimate the number and distribution of, measles deaths in India with a focus on 264 high burden districts. METHODS: We used physician coded verbal autopsy data from the Million Death Study which surveyed, over 12,000 deaths in children aged 1 month to under 15 years from 1.1 million nationally, representative households in 2001-2003. RESULTS: We estimate there were 92,000 (99% CI 63,000-137,000) measles deaths in children 1-59, months of age in India in 2005, representing a mortality rate of 3.3 (99% CI 2.3-5.0) per 1000 live, births and about 6% of all 1-59 month deaths. In children under 15 years of age, there were 107,000, (99% CI 74,000-158,000) measles deaths. The measles mortality rate was nearly 70% greater in girls, than in boys, and 60% of the deaths were in three populous states Uttar Pradesh, Bihar, and Madhya, Pradesh. The 1-59 month measles mortality rate in high burden districts was 4.48 (99% CI 3.94-5.02) compared to 2.40 (99% CI 2.28-2.52) per 1000 live births in other districts. CONCLUSION: Measles killed over 100,000 children in India in 2005 and girls were at higher risk than boys. The majority of measles deaths occurred in a few states and high burden districts. The results of this study highlight the importance of focusing measles supplementary immunization activities in high burden districts.
Authors: Katherine Ellicott Colson; Laura Dwyer-Lindgren; Tom Achoki; Nancy Fullman; Matthew Schneider; Peter Mulenga; Peter Hangoma; Marie Ng; Felix Masiye; Emmanuela Gakidou Journal: BMC Med Date: 2015-04-02 Impact factor: 8.775
Authors: Mira Johri; Stéphane Verguet; Shaun K Morris; Jitendar K Sharma; Usha Ram; Cindy Gauvreau; Edward Jones; Prabhat Jha; Mark Jit Journal: Bull World Health Organ Date: 2016-07-05 Impact factor: 9.408
Authors: Stéphane Verguet; Edward O Jones; Mira Johri; Shaun K Morris; Wilson Suraweera; Cindy L Gauvreau; Prabhat Jha; Mark Jit Journal: BMC Med Date: 2017-08-10 Impact factor: 8.775