Measles mortality in India: a review of community based studies.

This paper reviews the measles Case Fatality Ratios (CFRs) reported in the community based studies from India. Measles mortality varied considerably in outbreaks, prospective and retrospective studies. A median CFR of 2.5 per cent (0.2-3.7), 0.1 per cent (0-2.2) and 3.7 per cent (0-23.9) was recorded in prospective, retrospective and outbreak studies respectively. The retrospective studies seem to underestimate the measles mortality in Indian setting. Most of the outbreaks recording CFRs equal to or less than the median, 3.7 per cent, occurred in the areas where health care facilities were available for treatment of measles associated complications. Virtually in all studies, the age specific CFRs wherever recorded, were found to be the highest among infants and thereafter the ratios declined progressively. Although suggestive of, the studies did not provide sufficient data to establish an association between malnourishment and the risk of dying from measles. Measles mortality was not consistently high in any particular sex. The study makes a strong case for measles immunization at the earliest recommended age and the provision of better health services as the important public health measures for reducing the measles CFRs.