Muhammad Siddiq, Muddassir Saeed.
A study of measles cases reported to District Head-quarter Hospital, Bahawalnagar.
Pak Paed J Jan ;30(1):16-22.

Objective: to study the measles cases reported to the hospital and measles associated diarrhea and pneumonia in children less than 15 years of age over a period of one year. Study design: Hospital-based Prospective Study was conducted at children out patient department of District Head Quarter Hospital, Bahawalnagar, which is the main secondary health care facility of the district. The study period was from March, 2005, to February, 2006. Data collection and analysis: Data collecting procedures were based on the questionnaires designed for clinical diagnosis of measles and complications were also recorded. Standard case definitions were used for the diagnosis of Probable Measles, Clinically Confirmed Measles, Measles Associated Diarrhea (MAD) and Measles Related Pneumonia (MRP). Informed verbal consent was taken from the respondents. Pediatricians filled the questionnaires. All cases of measles were included and the cases that did not meet clinical case definition were excluded from the study. Results: A total of 140 cases of measles were enrolled during the study period of one year. The maximum number of patients, (86) 61.43%, were in the months of April, May, June, July and August. Out of 140 patients, 38 were clinically confirmed of having measles while 62 were grouped as probable measles. There were more females (88) than males (52).The most affected age group was under the age of 3-years with 76 patients (54.28 %), 37 (26.43%) cases in 3 to 5 years age group and 27 cases (19.28%) were above 5 years of age, while 17 cases (12.14%) were reported in 6 to 9 months of age. Only 60 cases (42.86%) were immunized against measles while 80 cases (57.14%) were not immunized. Non-immunized children were more likely to suffer from complicated measles (75 (93.75%)) than immunized children (29 (48.33%)). Diarrhea was the most frequent complication (53.57 %, n=75), followed by pneumonia (20.71%, n=29). The largest proportion (53.33%, n=40) of cases with diarrhea occurred in June, July and August while most Pneumonia with measles cases were reported in February, May and November (55.17%, n=16). During follow up of the identified cases of measles, 3 children died due to its complications, two with pneumonia and one with diarrhea giving a fatality rate of 2.14 %. Conclusion: Measles is still under reported and its complications are a problem in the region. Occurrence of measles in immunized children reflects partial immunity and / or vaccine failure.

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