Measles case fatality ratio in India a review of community based studies.

Abstract:

CONTEXT:Measles remains a major cause of child mortality in India. Measles case fatality ratios (CFRs) vary substantially between countries and even within the same community over time. We present a review of Indian community-based measles CFR studies conducted from 1975 to 2008. EVIDENCE ACQUISITION:PubMed, Cochrane Libraries, and all WHO databases were searched using a combination of terms. All community-based studies were abstracted into a database. RESULTS:We identified 25 studies with data on 27 communities. The median CFR was 1.63 per 100 cases (Q1= 0.00 and Q3= 5.06). Studies conducted after 1994 had significantly lower CFRs (P=0.031). Studies in rural settings had significantly higher CFRs compared to urban studies (P=0.015). No differences were found by study design or outbreak/endemic setting. CONCLUSIONS:This review suggests measles CFR may be declining in India. We hypothesize that increased measles vaccination coverage is the main factor contributing to the decline. Widespread vaccination increases both the average age of infection and the proportion of total measles cases previously vaccinated. Vitamin A treatment/supplementation is also likely to have contributed. In order to further reduce measles burden in India, vaccination and vitamin A treatment/supplementation coverage should be increased and a two dose vaccine strategy should be implemented in all areas.

journal_name

Indian Pediatr

journal_title

Indian pediatrics

authors

Sudfeld CR,Halsey NA

subject

Has Abstract

pub_date

2009-11-01 00:00:00

pages

983-9

issue

11

eissn

0019-6061

issn

0974-7559

journal_volume

46

pub_type

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