A STUDY TO FIND OUT THE EFFECTIVENESS OF MEASLES VACCINE AND ITS IMPLICATIONS ON POSTMEASLES COMPLIC

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A STUDY TO FIND OUT THE EFFECTIVENESS OF
MEASLES VACCINE AND ITS IMPLICATIONS ON
POST-MEASLES COMPLICATIONS

• 
  
• By
• Ms. Farha Vora
• Mr. Dhwanil Vyas
  Ms.Anuja Waghela
  (7th
  sem, Batch 2002)

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RATIONALE

• Measles is a major cause of morbidity and a
  significant contributor to childhood mortality.
  Approximately 30 of reported measles cases have
  one or more complications, the major being
  pneumonia and diarrhea.
• Case Fatality Rate in hospitalized cases of
  measles, according to a 1991 study was 4 with a
  range of 1.8 to 7.6. Thus measles is a leading
  killer among vaccine preventable diseases.
• With the implementation of the Universal
  Immunization Programme, which includes measles
  vaccination, the scenario is gradually changing.
• However, inspite of measles immunization being an
  effective strategy to prevent cases, outbreaks
  can continue to occur, especially in densely
  populated areas such as urban slums, even with
  good coverage. This is because vaccine efficacy
  is only 85 and because there are pockets of
  poorly immunized children.
• So our study is basically aimed at studying the
  beneficial effects of measles vaccination.

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AIMS AND OBJECTIVES

• To find out the number of measles cases
  admitted in the pediatric ward no. 13 of V.S.
  General Hospital from April 2000 to April 2005.
• To find out the proportion of previously
  immunized measles cases admitted in the pediatric
  ward no. 13 of V.S. general hospital.
• To find out the relative proportion of various
  complications occurring in these cases.

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METHODOLOGY

• SUBJECTS
• Cases of measles admitted to the pediatric ward
  no. 13 of the V.S. General Hospital during the
  time period of April 2000 to April 2005.
• DESIGN OF THE STUDY
• Record-based study
• SAMPLING METHOD
• Purposive Sampling
• SETTING
• V.S. General Hospital
• SEQUENCE OF EVENTS
• Initially, the record-numbers of the Measles
  cases were obtained from the Pediatric ward. This
  information was given to the record-section of
  the hospital and the case papers were obtained.
  The relevant data was collected from these and it
  was compiled together. Thereafter, analysis of
  the data was done followed by proof-reading.

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LIMITATIONS

• Small sample size.
• Since the patients were analyzed on the basis of
  hospital records, all the variables needed in all
  the cases were not available.
• As only the indoor patients were assessed, most
  of the cases were with complications.
• As all the registers and the individual records
  could not be retrieved, there is a possibility of
  selection bias.

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INFORMATION COLLECTED

• NAME
• AGE
• SEX
• MONTH AND YEAR OF ADMISSION
• COMPLICATIONS
• OTHER ASSOCIATED DISEASES
• ANEMIA AND MALNUTRITION

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ANALYSIS

• The following analysis is done by the method of
  ratio, proportions and by applying Z test.
• 60 cases having measles were selected from the VS
  Hospital Pediatrics ward no. 13.
• They belonged to the age group, 6 to 96 months.

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The age and sex distribution of occurrence of
measles cases

• Thus, maximum numbers of cases i.e. 63.33 were
  seen in 0 to 24 months age group, while the
  occurrence was comparatively less in the age
  group of 37 to 96 months.
• Females were comparatively more susceptible to
  measles.

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The month-wise distribution of occurrence of
measles cases is as follows

• 58.3 of the cases were seen in Spring i.e.
  between March to May.

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VACCINATION STATUS

• Out of the 60 cases, 40 i.e. 66.7 cases were
  unvaccinated and 20 i.e. 33.3 cases were
  vaccinated.

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GASTROINTESTINAL COMPLICATIONS

• Thus, Gastrointestinal complications were seen in
  20 of both vaccinated as well as unvaccinated
  cases.

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RESPIRATORY COMPLICATIONS

• Thus respiratory complications were seen in 85
  of unvaccinated cases and 90 of vaccinated cases.

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EAR,NOSE AND THROAT COMPLICATIONS

• Thus, 20 of the unvaccinated and 30 of the
  vaccinated cases suffered from ENT complications.

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CENTRAL NERVOUS SYSTEM COMPLICATIONS

• Thus, while CNS complications were seen in 20 of
  unvaccinated cases, these were found to be
  present in only 15 of vaccinated cases.

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ASSOCIATED CONDITIONS
PROTEIN ENERGY MALNUTRITION
ANEMIA
60
63
37

• Thus, anemia was found to be co-existent in 63
  of measles cases observed

• Thus, PEM was found to be co-existent in 40 of
  measles cases observed.

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Comparison of the complications seen in
Vaccinated and Unvaccinated cases
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Comparison of the complications seen in
Vaccinated and Unvaccinated cases

• Gastrointestinal Tract GIT complications were
  seen in 20 of vaccinated as well as 20 of
  unvaccinated cases.
• Respiratory system 90 of vaccinated cases and
  85 of unvaccinated cases had respiratory
  complaints.
• Central Nervous System While 20 of unvaccinated
  cases suffered from CNS complications, these were
  found to be present in only 15 of vaccinated
  measles cases.
• Ear, Nose and Throat 30 of vaccinated and 20
  of unvaccinated cases had ENT complaints.

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Z - Test

• Thus, the Z values are significant for-
• Vitamin Def.
• Cough/Cold
• Rash.
• So, it can be said that complications like
  vitamin def., cough, cold and rash are more
  common among the unvaccinated children than those
  who are vaccinated.

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SUMMARY AND CONCLUSION

• 60 cases of Measles admitted in the Paediatric
  ward no 13, V.S. General Hospital during the
  period of April 2000 to April 2005 were
  evaluated.
• Out of the 60 cases, 40 i.e. 66.7 cases were
  unvaccinated and 20 i.e. 33.3 cases were
  vaccinated.
• Maximum number of cases i.e. 63.33 were seen in
  0 to 24 months age group, while the occurrence
  was comparatively less in the age group of 37 to
  96 months.
• Females are comparatively more susceptible to
  measles.
• 58.3 of the cases were seen in Spring i.e.
  between March to May.

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SUMMARY AND CONCLUSION (Contd.)

• Gastrointestinal complications were seen in 20
  of both vaccinated as well as unvaccinated cases.
• Respiratory complications were seen in 85 of
  unvaccinated cases and 90 of vaccinated cases.
• 20 of the unvaccinated and 30 of the vaccinated
  cases suffered from ENT complications.
• While CNS complications were seen in 20 of
  unvaccinated cases, these were found to be
  present in only 15 of vaccinated cases.
• Anemia was found to be co-existent in 63 of
  measles cases observed
• PEM was found to be co-existent in 40 of measles
  cases observed.

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Resources
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TIME-LINE CHART
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