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American Journal of Epidemiology Vol. 151, No. 7: 723-735
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health

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Increased Childhood Morbidity After Measles Is Short-term in Urban Bangladesh

Syed M. Akramuzzaman1, Felicity T. Cutts2, Jeremy G. Wheeler2 and Mohammed J. Hossain1

1Clinical Sciences Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
2Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine London, United Kingdom

In a 1995–1996 cohort study in the city of Dhaka, Bangladesh, morbidity in 117 hospitalized and 137 acute measles cases compared with age-matched children without measles (unexposed) was determined by weekly interview for 6 months. Compared with unexposed children, there were higher incidences of hospitalization (adjusted rate ratio (RR) = 3.1, 95% confidence interval (CI): 1.3, 7.6) and bloody diarrhea (adjusted RR = 2.7, 95% CI: 1.4, 5.1) in hospital measles cases during the 6 weeks after recruitment. Among community cohorts, there were higher incidences of bloody diarrhea (adjusted RR = 4.1, 95% CI: 1.1, 14.6), watery diarrhea (adjusted RR = 1.6, 95% CI: 0.9, 2.7), fast breathing (adjusted RR = 3.8, 95% CI: 2.1, 6.9), and the weekly point prevalence of pneumonia (adjusted prevalence ratio = 3.1, 95% CI: 1.0, 9.8) in measles cases during the same period. All measles cases regained lost weight within about 6 weeks. The prevalence of anergy to seven recall antigens 6 weeks after recruitment was higher in both hospital (adjusted odds ratio = 2.8, 95% CI: 1.2, 6.4) and communrty (adjusted odds ratio = 3.1, 95% CI: 1.1, 8.9) measles cases. Morbidity increased during the first 6–8 weeks after measles, but the authors found no consistent evidence of longer-term morbidity or wasting. The results support recent findings that measles is not associated with increased delayed mortality. Am J Epidemiol 2000;151:723–35.

cohort studies; diarrhea; immunity; cellular; measles; pneumonia


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