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Measles outbreak in the Philippines: epidemiological and clinical characteristics of hospitalized children, 2016-2019

Authors :
Fleurette M. Domai
Kristal An Agrupis
Su Myat Han
Ana Ria Sayo
Janine S. Ramirez
Raphael Nepomuceno
Shuichi Suzuki
Annavi Marie G Villanueva
Eumelia P. Salva
Jose Benito Villarama
Koya Ariyoshi
Kim Mulholland
Luigi Palla
Kensuke Takahashi
Chris Smith
Edna Miranda
Source :
The Lancet Regional Health. Western Pacific, Vol 19, Iss , Pp 100334- (2022)
Publication Year :
2022
Publisher :
Elsevier, 2022.

Abstract

Summary: Background: Measles outbreaks increased worldwide during 2017-19. The largest outbreak in the World Health Organisation Western Pacific region occurred in the Philippines where first-dose measles-containing vaccine (MCV1) coverage had reduced to 75% in 2018. The aim of this study was to summarise paediatric measles admissions to the national infectious diseases referral hospital in Manila during 2016 to 2019. Methods: A retrospective single-centre observational study including 5,562 children aged under five years admitted with measles from January 2016 to December 2019. We summarised sociodemographic and clinical characteristics, vaccine status, reported exposures, and outcomes. Univariable and multivariable logistic regression analyses were undertaken to assess associations between different characteristics of hospitalised children and death. Findings: The median age of children hospitalised with measles was 11 months (interquartile range: 7-28). 84·5% of cases were reported not to have received any MCV. The risk of mortality was 3·2%, with 41% of deaths occurring among children aged less than 9 months. No children died who had received two MCV. The following characteristics were significantly associated with mortality in the multivariable analysis: age group, residence outside of the national capital region, not having received any MCV, duration between onset of fever and hospital admission of 7-14 days compared with 0-3 days, not receiving vitamin A supplementation, having pneumonia, and gastroenteritis. Interpretation: The Philippines remains at risk of future measles epidemics. Routine immunization needs to be strengthened and earlier timing of MCV1 requires further evaluation to reduce measles incidence and mortality. Funding: This work is in part funded by Nagasaki University (salary support for CS, KAA, RN, SS, KA, KT).

Details

Language :
English
ISSN :
26666065
Volume :
19
Issue :
100334-
Database :
Directory of Open Access Journals
Journal :
The Lancet Regional Health. Western Pacific
Publication Type :
Academic Journal
Accession number :
edsdoj.b800e476b2334ee6af64893f3cfb9653
Document Type :
article
Full Text :
https://doi.org/10.1016/j.lanwpc.2021.100334