title: Vaccine effectiveness and risk factors associated with measles among children presenting to the hospitals of Karachi, Pakistan.
abstract: OBJECTIVE
  To determine the risk factors regarding guardian's practices associated with development of Measles and also find out effectiveness of Measles vaccine among children less than 12 years of age presenting to the hospitals of Karachi.
  
  
  METHODS
  Matched case control study.
  
  
  METHODS
  Multicenter surveillance was conducted in 11 public and private sector hospitals of Karachi from January 2011 to September 2012 in consultation with World Health Organization Measles Surveillance Cell.
  
  
  METHODS
  Cases were children aged less than 12 years with Measles presenting to the hospitals. Controls for cases were enrolled from the same hospitals without Measles, matched for age and gender. Studied variables were analyzed by multivariate conditional logistic regression analysis adjusted for age and gender.
  
  
  RESULTS
  Measles cases were more likely to have mothers with 'lower education' [adjusted matched Odds Ratio or mOR: 3.2 (95% CI: 1.2 - 7.6), for < 5 years of schooling adjusted mOR: 2.2 (95% CI: 1.0 - 5.7) for 6 - 10 years of schooling]. Children with Measles were also more likely to be not given breast milk in initial 2 years of life [adjusted mOR: 2.6, 95% CI 1.0 - 7.0]. Cases were also more likely to have never received vaccination [adjusted mOR: 10.1, 95% CI 4.5 - 22.5] and having no other children vaccinated at home [adjusted mOR: 3, 95% CI 1.5 - 5.3]. Vaccine effectiveness for single dose was found to be 87.4 (95% CI: 76.1 - 93.4), while for two doses it was approximately 93% (95% CI: 86.2 - 96.6).
  
  
  CONCLUSIONS
  For Measles elimination, mother's education on breast feeding and appropriate weaning practices is required.
authors.affiliation: Department of Community Health Sciences, The Aga Khan University Hospital, Karachi.
authors.forename: Aysha
authors.initials: A
authors.lastname: Zahidie
authors.affiliation: Department of Community Health Sciences, The Aga Khan University Hospital, Karachi.
authors.forename: Saba
authors.initials: S
authors.lastname: Wasim
authors.affiliation: Department of Community Health Sciences, The Aga Khan University Hospital, Karachi.
authors.forename: Zafar
authors.initials: Z
authors.lastname: Fatmi
mesh_terms: D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D008297:Male; D008457:Measles / Q000453:epidemiology / Q000517:prevention & control*; D008458:Measles Vaccine / Q000008:administration & dosage*; D015999:Multivariate Analysis; D016017:Odds Ratio; D010154:Pakistan; D012307:Risk Factors; D014611:Vaccination
chemical_list: D008458:Measles Vaccine