A 2-year hospital-based survey of measles infections were carried out at the University Teaching Hospital (UTH) in Lusaka, Zambia from January 1992 to December 1993. During this period, a total of 1066 children with a clinical diagnosis of measles were admitted to the paediatric isolation ward at UTH. Measles cases were seen throughout both 1992 and 1993. However, there was a peak from September to December, 1992. The number of cases decreased with age, and 370 (34.7%) were under 1 year old. It is noteworthy that 203 (19.0%) were less than the 9 months of age which is the recommended time for measles vaccination in Zambia. The overall case fatality rate was 12.6%, and was higher in children aged 0-3 years (14.3%) than in those aged 4 years and above (6.7%). Measles vaccination status could be checked from the child's immunization card for 343 measles cases over 9 months of age, 118 (34.4%) of these having previously received measles vaccine. Vaccinated children had a significantly lower case fatality rate (6.4%) than the unvaccinated group (17.0%). This suggests that while measles vaccine cannot prevent infection, it can reduce the severity of infection.
PIP: During January 1992-December 1993, in Zambia, 1066 children aged 0-15 were admitted to the pediatric isolation ward with measles at the University Teaching Hospital in Lusaka. Measles cases peaked during September-December 1992, which comprised all of the 1992 hot dry season and the beginning of the hot rainy season. There were more measles cases in 1992 than in 1993 (831 vs. 235). 86.9% of all measles cases were 0-5 years old. The overall case fatality rate was 12.6%. Measles cases aged less than 3 were more likely to die than older children (14.3% vs. 6.4%; p = 0.025). The researchers had access to immunization cards in 330 measles cases aged 10 months or older. 34.4% had received measles vaccine earlier. The vaccine efficacy in this group was 44.3%. Vaccinated cases were less likely to die than unvaccinated cases (6.8% vs. 17%; p = 0.009). These findings indicate that the measles vaccine used had a low efficacy, but it minimized the severity of measles and protected against death.