Measles related complications and the role of vitamin A supplementation.
OBJECTIVE
Measles is associated with high rate of complications and contributes to a major proportion of childhood morbidity and mortality. The role of vit A supplementation (VAS) in the case management of measles and prevention of complications is partially understood and not sufficiently supported by epidemiological data. This paper analyses the possible role of vit A supplementation in prevention of measles related complications and associated fatality.


METHODS
A cross sectional study was carried out during an outbreak of measles in Shivpuri, India. A total population of 193,000 was covered by house to house visit and, the caregivers of total 1204 measles cases, including 214 cases with complications, were interviewed using a semi structured interview schedule. The analysis of data was done using Epi Info.


RESULTS
The attack rate of 6.7% and rate of complications at 17.8% were found in this investigation. The coverage with routine measles vaccine and the vit A supplementation was 18.3% and 28.9% respectively. The management of measles cases was poor with only 15.8% cases receiving therapeutic doses of vit A. Both complications and case fatality rate was higher amongst children who had not received vit A supplementation in previous 6 months (p<0.05). Measles vaccine also found to have preventive effect on development of complications (p<0.05).


CONCLUSIONS
Routine vit A supplementation and measles vaccination reduce the chances of complications amongst cases of measles. The role of VAS becomes more important when the case management is poor. While, measles is frequently associated with complications in the Indian setting, there is a need of enhancing the efforts to improve the delivery of vit A supplementation and measles vaccine to the children in rural areas.
Department of Community Medicine, Gajara Raja Medical College and Associated JA Group of Hospitals, Gwalior, 474009, India.
Ashok
A
Mishra
Subodh
S
Mishra
Pankaj
P
Jain
Rahul Singh
RS
Bhadoriya
Rakesh
R
Mishra
Chandrakant
C
Lahariya
D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D008457:Measles / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control; D008458:Measles Vaccine / Q000008:administration & dosage; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014801:Vitamin A / Q000008:administration & dosage / Q000627:therapeutic use*; D014802:Vitamin A Deficiency / Q000453:epidemiology*
D008458:Measles Vaccine; D014801:Vitamin A