Synergistic impact of measles and diarrhoea on nutrition and mortality in Bangladesh
Koster, F.T.; Curlin, G.C.; Aziz, K.M.; Haque, A.
Bulletin of the World Health Organization 59(6): 901-908
1981
ISSN/ISBN: 0042-9686 PMID: 6978197 Document Number: 424513
The efficacy of recent efforts to improve the delivery of available vaccines, especially in the developing countries, can be aided by surveys that identify populations suffering from unduly high morbidity and mortality as a result of a particular disease. The results of a prospective household surveillance of 5775 children in 12 villages in Bangladesh, in which the occurrence of measles and diarrhea, changes in nutritional status, and the causes of all deaths during a 12 mo. period were monitored, is presented. The measles case-fatality rate was 3.7% among all children. Prolonged diarrhea was the most common complication in fatal cases. The greatest weight loss was seen in children with measles complicated by prolonged diarrhea, and children < 4 yr of age in this group failed to achieve catchup growth. Thus, measles and diarrhea appeared to interact synergistically to increase mortality and the irreversible effects of nutritional deprivation. This information should provide further impetus to an extensive measles vaccination program in Bangladesh. Until then, nutrition intervention programs should be aimed at children < 4 yr of age, convalescing from measles.