Short term outcome of measles at Kenyatta National Hospital
Abstract
Two hundred patients aged from 4 months to 10 years
admitted with measles at the Infectious Disease Hospital
(IDH) between 15th April 1986 and 15th September 1986 were
studied. Their mean age was 23.5 months and there were no
significant sex differences. Sixty one percent of children
resided in Nairobi while 39% came from other provinces.
The ma i,n complications seen included: con junct.iv.iti s 62%
diarrhoea & vomiting 60%, bronchopneumonia 53.5%, oral thrush
20% and laryngotracheobronchitis 28.5%. There was associated
urinary tract infection in 18.8% of them with Klebsiella as
the commonest pathogen.
Fourteen percent of patients with bronchopneumonia had
unresolving pneumonia with bacterial isolation from lung puncture,
obtained in 53.3%of them. Encephalitis was observed more commonly
in this study than found in other studies, but was rarely
associated with a fatal outcome. Epistaxis and haematemesis
was an interesting complication observed exclusively in those
above 24 months of age. Age was found to be a significant
factor in the outcome of measles, as has been reported
previously, influencing both morbidity and mortality. T'ne
younger age groups tended to develop more severe measles
complications; except for conjunctivitis observed more amongat.
the older children.
Although 57.2% of patients were underweight at onset of study,
precipitation of acute kwashiorkor was seen only ln 2.5% after a
mean duration of hospitalization of 7.3 days. Malnutrition was
found to playa significant role in the complication rate, with
t.he malnourished being commonly adversely affected.
The case fatality rate was 4%, and ocourredmainly among
the infants; majority of who (7 out of 8) were malnourished.
The immunization status did not appear to affect outcome
of measles here; but those immunized were only 28.57%. Similarly
prior contact with a health facility did not appear to influence
outcome significantly except for oral thrush, which was seen more
commonly amongst those with prior contact with a health facility .
Citation
Degree of Masters in Medicine (paedetrics)Publisher
University of Nairobi College of Health Sciences
Description
A dissertation submitted in part fulfillment
for the Degree of Master of Medicine (paediatrics)
in the University of Nairobi