Clinical Presentation, Complications and Outcome of Measles in Pediatric Population at Tertiary Care Hospital

Measles in Pediatric Population

Authors

  • Shazia Kulsoom National Institute of Child Health, Karachi, Pakistan
  • Shazia Soomro National Institute of Child Health, Karachi, Pakistan
  • Sadaf Junejo National Institute of Child Health, Karachi, Pakistan
  • Misbah Anjum National Institute of Child Health, Karachi, Pakistan
  • Hira Waseem National Institute of Child Health, Karachi, Pakistan
  • Marium Akram National Institute of Child Health, Karachi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v4i03.624

Keywords:

Measles, Bronchopneumonia, Encephalitis

Abstract

Measles is highly contagious infection with person-to-person transmission through droplet infection in developing countries, which can lead to death in complicated cases. Bronchopneumonia, encephalitis, gastroenteritis with renal failure and electrolyte imbalance are common complications in pediatric age group. Objective: To determine complications of measles in hospitalized children at Tertiary Care Children Hospital. Methods: This cross-sectional study conducted at inpatient medical wards of National Institute of Child Health from July-Dec 2022. All patients hospitalized in study duration with the diagnosis of measles from 6 months till 12 years of age were enrolled. History, examination, laboratory tests, treatment and outcome were recorded and analyzed. Results: Children enrolled were 185, the mean age ± SD of presentation was 26.7 ± 27.1 months, with 56.8% males. Mean weight of patients was 10.48 ± 9.7kg. Common measles complications were bronchopneumonia 160(86.5%), acute diarrhea 64(34.6%) encephalitis 24(13%), myocarditis 16(8.6%), acute kidney injury 11(5.9%), and otitis media 18(9.7%). Conclusions: Most common clinical features were fever, maculopapular rash, cough and coryza.  Bronchopneumonia was the main reason of hospitalization in majority of patients and leading cause of death in 13.5% of patients along with encephalitis and myocarditis. Additional strategies are required by government for elimination of vaccine preventable measles from Pakistan. 

References

Orsoo O, Saw YM, Sereenen E, Yadamsuren B, Byambaa A, Kariya T, et al. Epidemiological characteristics and trends of a Nationwide measles outbreak in Mongolia, 2015–2016. BMC Public Health. 2019 Dec; 19: 1-0. doi: 10.1186/s12889-019-6511-0.

Donadel M, Stanescu A, Pistol A, Stewart B, Butu C, Jankovic D, et al. Risk factors for measles deaths among children during a Nationwide measles outbreak–Romania, 2016–2018. BMC Infectious Diseases. 2021 Dec; 21(1): 1-0. doi: 10.1186/s12879-021-05966-3.

Ben-Chetrit E, Oster Y, Jarjou'i A, Megged O, Lachish T, Cohen MJ, et al. Measles-related hospitalizations and associated complications in Jerusalem, 2018–2019. Clinical Microbiology and Infection. 2020 May; 26(5): 637-42. doi: 10.1016/j.cmi.2019.08.022.

Pacheco FC, França GV, Elidio GA, Oliveira CM, Guilhem DB. Decrease in the coverage of measles-containing vaccines and the risk of reestablishing endemic transmission of measles in Brazil. International Journal of Infectious Diseases. 2019 May; 82: 51-3. doi: 10.1016/j.ijid.2019.03.014.

Siani A. Measles outbreaks in Italy: A paradigm of the re-emergence of vaccine-preventable diseases in developed countries. Preventive Medicine. 2019 Apr; 121: 99-104. doi: 10.1016/j.ypmed.2019.02.011.

Mehmood M, Setayesh H, Siddiqi DA, Siddique M, Iftikhar S, Soundardjee R, et al. Prevalence, geographical distribution and factors associated with pentavalent vaccine zero dose status among children in Sindh, Pakistan: analysis of data from the 2017 and 2018 birth cohorts enrolled in the provincial electronic immunisation registry. BMJ Open. 2022 May; 12(5): e058985. doi: 10.1136/bmjopen-2021-058985.

Ödemiş İ, Köse Ş, Akbulut İ, Albayrak H. Seroprevalence of measles, mumps, rubella, and varicella zoster virus antibodies among healthcare students: analysis of vaccine efficacy and cost-effectiveness. Revista Española de Quimioterapia. 2019; 32(6): 525.

Hall V, Banerjee E, Kenyon C, Strain A, Griffith J, Como-Sabetti K, et al. Measles Outbreak—Minnesota April–May 2017. Morbidity and Mortality Weekly Report. 2017 Jul; 66(27): 713–7. doi: 10.15585/mmwr.mm6627a1.

Thomas S, Hiebert J, Gubbay JB, Gournis E, Sharron J, Severini A, et al. Measles outbreak with unique virus genotyping, Ontario, Canada, 2015. Emerging Infectious Diseases. 2017 Jul; 23(7): 1063. doi: 10.3201/eid2307.161145.

Patel MK, Goodson JL, Alexander Jr JP, Kretsinger K, Sodha SV, Steulet C, et al. Progress toward regional measles elimination—worldwide, 2000–2019. Morbidity and Mortality Weekly Report. 2020 Nov; 69(45): 1700. doi: 10.15585/mmwr.mm6945a6.

Karimi Sr AS. Evaluation of Routine Immunization Coverage in 12-to 23-Month Children in Sarepol Province, 2018: Descriptive Cross-sectional Study. Iproceedings. 2022 Feb; 8(1): e36536. doi: 10.2196/36536.

Li H, Zhang M, Lao Q, Ding Y, Zhao K, Xu R. Risk Factors for Different Grades of Lower Respiratory Tract Infections in Children Under Five Years Old with Measles: Based on Chest Radiography. Current Medical Imaging. 2020 Feb; 16(2): 149-55. doi: 10.2174/1573405614666181012141452.

Shah SJ, Dero AA, Hayat N, Khan MJ, Ahmad S, Ahmad H. Frequency of Complications of Measles in Hospitalized Children of Pakistan. Journal of Pharmaceutical Negative Results. 2022 Dec: 3757-62.

Sindhu TG, Geeta MG, Krishnakumar P, Sabitha S, Ajina KK. Clinical profile of measles in children with special reference to infants. Tropical Doctor. 2019 Jan; 49(1): 20-3. doi: 10.1177/0049475518804695.

Hester G, Nickel A, LeBlanc J, Carlson R, Spaulding AB, Kalaskar A, et al. Measles hospitalizations at a United States children’s hospital 2011–2017. The Pediatric Infectious Disease Journal. 2019 Jun; 38(6): 547-52. doi: 10.1097/INF.0000000000002221.

Aurangzeb B, Fatmee A, Waris R, Haider N, Berjees A, Raza SH. Risk factors for mortality among admitted children with complications of measles in Pakistan: An observational study. JPMA. The Journal of the Pakistan Medical Association. 2021 Feb; 71(2 (A)): 497-501.

Khan F, Gandapur AJ, Ali I, Zeb R, Ahmad W. Clinical and demographic profile of children hospitalized with measles infection in Peshawar. Khyber Medical University Journal. 2019 Jun; 11(2): 79-84.

Khan S, Iqbal J, Tayyeb M, Fahad S, Ullah A, Khan H. 13 Prevalence of pneumonia associated with measles among infants and children hospitalized in Khyber Teaching Hospital Peshawar, KPK, Pakistan. Pure and Applied Biology (PAB). 2021 Jul; 10(3): 703-12. doi: 10.19045/bspab.2021.100072.

Asghar RM, Sharif M, Khan IY, Syed AH, Ashraf RR, Hussain M. Complications of Measles in Malnourished Children, a Descriptive Cross-Sectional Study at a Tertiary Care Hospital Rawalpindi. Journal of Rawalpindi Medical College. 2022 Mar; 26(1): 107-11. doi: 10.37939/jrmc.v26i1.1803.

Nezhoda II, Havryliuk AO, Asaulenko AA, Kholod LP. Measles pneumonia in children: clinical and morphological features of the course. Мир медицины и биологии. 2020; 16(1 (71)): 88-93. doi: 10.26724/2079-8334-2020-1-71-88-93.

Cozzi D, Bicci E, Bindi A, Cavigli E, Danti G, Galluzzo M, et al. Role of chest imaging in viral lung diseases. International Journal of Environmental Research and Public Health. 2021 Jun; 18(12): 6434. doi: 10.3390/ijerph18126434

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Published

2023-03-31
CITATION
DOI: 10.54393/pjhs.v4i03.624
Published: 2023-03-31

How to Cite

Kulsoom, S. ., Soomro, S. ., Junejo, S. ., Anjum, M. ., Waseem, H. ., & Akram, M. (2023). Clinical Presentation, Complications and Outcome of Measles in Pediatric Population at Tertiary Care Hospital: Measles in Pediatric Population. Pakistan Journal of Health Sciences, 4(03), 50–53. https://doi.org/10.54393/pjhs.v4i03.624

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