An evaluation of the clinical features of measles virus infection for diagnosis in children within a limited resources setting

Abstract

Background: Measles is a recurrent health problem in both advanced and developed countries. The World Health Organization (WHO) recommends anti-measles immunoglobulin M (Ig M) as the standard method of detecting the virus; however, many areas still present the inability to perform a serology test of anti-measles IgM. Therefore, a typical clinical feature is necessary to establish the diagnosis of measles. The objective of this study was to evaluate hyperpigmented rash and other clinical features as the diagnostic tools with respect to measles, especially in an outbreak setting. Methods: In this observational diagnostic study, the inclusion criteria were as follows: between 6 and 144 months of age, fever, maculopapular rash for 3 days or more, accompanied by a cough, or coryza, or conjunctivitis. Those with a prior history of measles vaccination (1-6 weeks) were excluded, in addition to those with histories of corticosteroid for 2 weeks or more and immunocompromised conditions. The samples were taken from Dr. Soetomo General Academic Hospital in Surabaya, Indonesia. We evaluated the sensitivity, specificity, the positive predictive value, and the negative predictive value of such clinical features. Hyperpigmented rash was validated using Kappa and Mc Nemar tests. Anti-measles Ig M was considered as the gold standard. Results: This study gathered 82 participants. The clinical manifestations of all subjects included fever, cough, coryza, conjunctivitis, Koplik spots, and maculopapular rash (which turns into hyperpigmented rash along the course of the illness). Most maculopapular rashes turn out to be hyperpigmented (89%). Sensitivity, specificity, positive predictive value, and negative predictive values of the combination of fever, maculopapular rash, and hyperpigmented rash were found to be at 90.7, 28.6, 93.2, and 22.2%, respectively. The Mc Nemar and Kappa tests showed p values of 0.774 and 0.119, respectively. Conclusion: The combination of fever, maculopapular rash, and hyperpigmented rash can be used as a screening tool regarding measles infection in an outbreak setting, which can then be confirmed by anti-measles Ig M. Cough, coryza, and Koplik's spot can be added to this combination, albeit with a slight reduction of sensitivity value.

Respiratory Complications of Measles in the Pediatric Ward of the Regional Hospital of Kindia/Guinea

“…They were present in all of our patients. Husada D et al in their study conducted in Indonesia in 2019 also noted the same reasons in all of their patients [12]. This could be explained by the fact that the virus has a tropism for the respiratory epithelium, and our results align with the clinical picture of measles outlined by the WHO.…”

Avaliaçâo Da Satisfação Dos Pacientes Atendidos Na Clínica De Prótese Dental Ii Do Curso De Odontologia Da Universidade Estadual De Ponta Grossa No Paraná

“…Em alguns casos, as manchas podem aparecer no palato mole e persistem por 2 ou 3 dias. Uma maior tendência da presença das lesões de Kloplik em crianças mais novas tem sido reportada(HUSADA et al, 2020). Não há tratamento específico, apenas formas de aliviar a sintomatologia.…”