INCREASING TREND OF MEASLES IN CHILDREN: INVESTIGATING THE CORRELATION OF INCIDENCE WITH IMMUNIZATION STATUS, SEROLOGY, ACQUIRED PROTECTION FROM MOTHER
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Keywords
Measles, Serology, Measles Vaccination, Expanded Program on Immunization, Mumps, Rubella (MMR), Immunization Coverage
Abstract
Background: Measles is a highly contagious viral infection and remains a leading cause of morbidity and mortality in children worldwide. Despite the availability of an effective vaccine, the goal of measles elimination faces setbacks, particularly in regions like Pakistan where vaccination coverage is notably low. According to the Expanded Program on Immunization (EPI) schedule, children should receive a "0 dose" of measles vaccine at 9 months and the first dose at 15 months, with a second dose at 4-5 years. However, actual vaccination coverage remains inadequate in Pakistan.
Objective: This study aims to explore the correlation between measles incidence and immunization status, evaluate serological markers of recent infection, and assess maternal antibody protection in infants.
Methodology: A cross-sectional observational study was conducted at the Department of Pediatrics, Ittefaq Trust Hospital, Lahore, from January 2023 to May 2024. Fifty children aged 0-12 years, diagnosed with measles, were enrolled. A detailed vaccination history was collected, and blood samples were tested for measles-specific IgM and IgG antibodies using ELISA. Data were analyzed using SPSS version 25.
Results: The mean age of participants was 13.02 ± 10.05 months. The age distribution included 30 children (60%) under 9 months, 7 (14%) aged 10-15 months, and 13 (26%) over 15 months. Male children constituted 72% of the sample. Only 2% had received the measles "0 dose," and none had received the measles "1" dose. Serological analysis revealed positive IgM in 82% of cases, while all tested children were negative for IgG, with 96% showing no evidence of past infection. A sample was not taken for IgG testing in one child. Correlation analysis showed a significant positive relationship between age and IgM positivity (r = 0.42, p = 0.008), while no significant correlations were found between age or gender and IgG levels or between gender and IgM levels.
Conclusion: The study highlights alarmingly low measles vaccination coverage, correlating with high incidence and positive serology for recent infection. The findings underscore the critical need for timely vaccination, especially since even infants as young as 3 months exhibited measles infection, indicating insufficient maternal antibody protection. Enhanced vaccination efforts are crucial to control measles effectively.
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Dr. Sabah Yasir
Postgraduate Resident, Department of Pediatrics, Ittefaq Hospital Trust, Lahore, Pakistan
Dr Amna Siddique
Senior Registrar, Department of Pediatrics, Ittefaq Hospital Trust, Lahore, Pakistan
Dr Areeba Abid
Postgraduate Resident, Ittefaq Hospital Trust, Lahore, Pakistan
Dr Shahid Hamid
Head of Department of Paediatrics, Ittefaq Hospital Trust, Lahore, Pakistan