Relationship Between Serum Igm Levels And Liver Function In Rubella And Measles Virus Infection In Children Below Five Years Attending Maternal Child Health Clinics In Selected Hospitals In Nairobi County

Abstract

Rubella and measles virus are important diseases of children under five years of age which are preventable through immunization. Despite intervention through immunization, outbreaks of rubella and measles in Kenya are still common. The main objective of current study was to determine the correlation between liver function and IgM levels in children under five years of age in Nairobi County. The study involved 235 subjects and was carried out at Kenyatta National Hospital, Mbagathi District Hospital and Mama Lucy Kibaki Hospital. Out of the 235 study subject who were qualitatively tested for both measles and rubella using IgM assay, only three (1.28%) were positive for measles and five (2.13%) positive for rubella.It was noted that these study subjects had not been vaccinated before for the studied viruses.Liver function tests were analyzed for all the two hundred and thirty five study subjects. Among the liver function parameters, total protein and albumin showed a very strong negative correlation (r=-0.932 and r=-1.000 respectively) with measles IgM concentration; this was statistically significant at p=0.035 and p= 0.007 respectively. Positive correlation was shown between measles IgM concentration and AST(r=0.247), ALT(r=0.637), ALP(r=0.935), TBILI(r=0.719) and DBILI (r=0.654). This positive correlation was statistically significant for AST (p=0.032) and ALT (p=0.021). TP, ALB, ALP, TBILI and DBILI showed a negative correlation (r=-0.316, r=-0.872, r=-0.804, r= -0.550 and r= -0.404 respectively) with rubella IgM concentration which was statistically significant for TP and ALB at p=0.015 and p= 0.031 respectively. Positive correlation was shown between rubella IgM concentration and AST(r=0.333) and ALT(r=0.360). This positive correlation was statistically significant for AST (p=0.044) and ALT (p=0.028). The study has established that the two diseases still affect children below the age of five years in Nairobi County. The metabolic and excretion functions of the liver for the studied population xiv were affected by these viral infections as expressed by an increase in the mean levels of transaminases (AST=206 iu/L, ALT=202 iu/L) and bilirubin (TBILI=43μmol/L and DBILI=30μmol/L) in blood. Similar studies should be undertaken in all the counties in Kenya to establish the status of rubella and measles in children below five years of age since the current study worked on point prevalence of Rubella and measles in Nairobi County. Liver function tests should be included during the baseline study of the suspected cases of rubella or measles infection.