title: Does Measles Vaccination Reduce the Risk of Acute Respiratory Infection (ARI) and Diarrhea in Children: A Multi-Country Study?
abstract: BACKGROUND
  Pneumonia and diarrhea occur either as complications or secondary infections in measles affected children. So, the integrated Global Action Plan for Pneumonia and Diarrhea (GAPPD) by WHO and UNICEF includes measles vaccination as preventive measure in children. The objective of the study is to examine the effect of measles vaccination on Acute Respiratory Infection (ARI) and diarrhea in children in the Democratic Republic of Congo, Ethiopia, India, Nigeria, and Pakistan.
  
  
  METHODS
  We analyzed data from the most recent rounds of Demographic and Health Surveys (DHS) in the selected countries. We included children age 12-59 months in the analysis. We used multivariable binary logistic regression to examine the effect of measles vaccination on ARI and diarrhea in children. We also estimated Vaccination Effectiveness (VE).
  
  
  RESULTS
  More than 60 percent of the children age 12-59 months were given measles vaccine before the survey in the Democratic Republic of Congo, Ethiopia, India and Pakistan. Children who were given the measles vaccine were less likely to suffer from ARI than unvaccinated children in India and Pakistan. Children who were given the measles vaccine had a lower risk of diarrhea than those who did not receive it in all the selected countries except Ethiopia. Measles vaccination was associated with reduction in ARI cases by 15-30 percent in India and Pakistan, and diarrhea cases by 12-22 percent in the Democratic Republic of Congo, India, Nigeria and Pakistan.
  
  
  CONCLUSIONS
  The receipt of the measles vaccine was associated with decrease in ARI and diarrhea in children. The immunization program must ensure that each child gets the recommended doses of measles vaccine at the appropriate age. The measles vaccination should be given more attention as a preventive intervention under the Global Action Plan for Pneumonia and Diarrhea (GAPPD) in all low and middle-income countries.
authors.affiliation: International Institute for Population Sciences, Mumbai, India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Bawankule
authors.affiliation: Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Singh
authors.affiliation: Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India.
authors.forename: Kaushalendra
authors.initials: K
authors.lastname: Kumar
authors.affiliation: B K L Walawalkar Rural Medical College, Derwan, India.
authors.forename: Sadanand
authors.initials: S
authors.lastname: Shetye
mesh_terms: D000349:Africa; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D008297:Male; D032541:Mass Vaccination / Q000009:adverse effects / Q000706:statistics & numerical data*; D008458:Measles Vaccine / Q000009:adverse effects / Q000627:therapeutic use*; D010154:Pakistan; D012141:Respiratory Tract Infections / Q000453:epidemiology*
chemical_list: D008458:Measles Vaccine