| Popis: |
In a study of 7,631 cases referred to the infectious diseases hospital, Nairobi with a diagnosis of measles, 7,447 cases had the diagnosis confirmed. The overall mortality was 17.5 per 1000 cases with 43.51 of all the deaths occurring in all children less than 12 months of age. A nutritional analysis revealed that children whose weight were below 80 of the Harvard median of weight for age stayed in hospital longest and had the highest mortality rate. Measles continues to offer increasing challenge in spite of the intensive vaccination programme presently being carried out.In a study of 7631 children referred to the infectious diseases hospital in Nairobi, Kenya, between April 1982 and April 1985 with a diagnosis of measles, 7447 cases had the diagnosis confirmed clinically. Only children with some secondary complications were admitted. An attempt was made to record the age, weight, and sex of every patient. Children were then divided into age groups and their nutritional status was rated according to the Wellcome classification. The youngest child was a 2-week old neonate whose 20-year old mother had measles. The peak age was 7-12 months accounting for 39% of all children, while 9.8% were aged under 6 months. The highest morality was recorded in children aged 12 months and below who accounted for 43.5% of the deaths. The weight of 5961 (80%) children were obtained. 4872 (82%) had weight for age less than 80% of the Harvard median. 46% of 2697 children were actually marasmic (they had weight for age less than 60% of the Harvard median) and 2175 (36%) children were underweight with some having overt kwashiorkor. Patients whose weight for age was less than 60% of the Harvard median had the highest duration of hospital stay with total patient days of 4997 and a mean duration of stay of 4.0 days. The overall mortality rate was 17.5/1000 admissions. The mortality rate was highest among marasmic children with 39.6/1000 admissions. Children who were underweight had an overall mortality of 14.3/1000 admissions, while those whose weight for age was normal had a mortality rate of only 7.4/1000. The incidence of measles is still very frequent, and overcrowding in developing countries only worsens the severity of this disease. There is a need for revision of vaccination programs to provide early protection and equally as great a need to eliminate protein energy malnutrition. |
