Measles complications in a Nigerian hospital setting

Abstract

In spite of active measles vaccination efforts in 2005 in southern Nigeria, re-emergence continues to occur. This study was carried out to ascertain the incidence of measles, severity, mortality and its complications, in order to enhance treatment and reduce under-five child mortality. Secondary data from the records in the measles ward of Oni Memorial Children's Hospital, Ibadan was used. The period under investigation was 2005 to 2008, following the catch-up and follow-up measles vaccination exercise. Four hundred children between the ages of 5 months and 14 years were clinically diagnosed with measles from 2005 to 2008, of which 124 (31%) had complications. Among those with complications, 70 (56.5%) mortalities were observed, and as the children approached 14 years of age, incidence of measles reduced to 0%. Measles is still a major childhood problem in the southern part of Nigeria, even as the burden is more in northern Nigeria. This will invariably hamper global measles mortality reduction initiatives and the attainment of the fourth millennium development goal of reduction of under-five child mortality by 2015, hence the need for a coordinated and strategic mass vaccination effort to target unimmunized children.

Evaluation of the Measles Surveillance System in Kaduna State, Nigeria (2010-2012)

“…In 2008, there was a further increase to 9,510 cases (AIR: 13.4 cases/100,000 children). By 2011, the number of measles cases had risen to 17,248 (AIR: 18.2 cases/100,000 children) [8]. Most of the cases occurred predominantly among younger children [6].…”

“…About 30, 194, 254 and 169 measles outbreaks were reported in 2006, 2007, 2008 and 2009 respectively [11]. Furthermore, between epidemiological week 1 to 43 of 2013, 643 outbreaks were confirmed in 83% of the 774 LGAs of this country [15] with Kebbi and Kaduna States in northern Nigeria recording a significant proportion of these outbreaks [8,10].…”

“…In 2010, the estimated annual measles incidence aggregated across all countries was 1.6 cases per 1000, resulting in about 139,000 deaths globally [6]. In Africa, about 13 million cases, 650,000 deaths occur annually, with sub-Saharan Africa having the highest morbidity and mortality [7,8].…”

“…Despite high administrative estimates of measles vaccine coverage (>99%) at first (routine) dose and during SIAs in Nigeria, outbreaks continue to occur [6,8,14]. About 30, 194, 254 and 169 measles outbreaks were reported in 2006, 2007, 2008 and 2009 respectively [11].…”

Evaluation of the Measles Case-Based Surveillance System in Kaduna State (2010-2012)

“…Measles infection is endemic in Nigeria and has been documented to occur all year round despite high measles routine and supplemental immunisation coverage (2,3). The frequent outbreaks of Measles in Kaduna State prompted the need for the reevaluation of the Measles case-based surveillance system…”