Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-19T02:10:03.962Z Has data issue: false hasContentIssue false
  • English
  • Français

Nutritional status and delayed mortality following early exposure to measles

Published online by Cambridge University Press:  15 May 2009

P. Aaby ,
M. Andersen  and
K. Knudsen
P. Aaby
Affiliation:
Department of Epidemiology Research, Danish Epidemiology Science Centre, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
M. Andersen
Affiliation:
Department of Epidemiology Research, Danish Epidemiology Science Centre, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark Statistical Research Unit, University of Copenhagen, Copenhagen, Denmark
K. Knudsen
Affiliation:
Department of Epidemiology Research, Danish Epidemiology Science Centre, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Community studies in Guinea-Bissau have found that exposure to measles prior to 6 months of age is associated with delayed mortality later in childhood. In an attempt to understand the underlying mechanism, we examined the role of pre-exposure nutritional status and the impact of exposure to measles on growth and subsequent mortality in these outbreaks. Though exposed children were lighter than controls, there was no association between pre-exposure weight-for-age and subsequent mortality adjusting for age. Although exposure was strongly associated with excess mortality, it did not have a negative impact on growth. Adjustment for state of nutrition did not alter the mortality ratio (MR) between 6 and 59 months of age for exposed children and controls; exposed children examined anthropometrically between 6–17 months had a MR of 3·70 compared with controls. This trend was the same for anthropometric measurements obtained at 18–59 months of age. Among the controls, there was a significant association between weight-for-age and subsequent mortality to the age of 5 years. However, for exposed children there was no association; the relation between weight-for-age and subsequent mortality was significantly different for exposed children compared with controls (tests for interaction between exposure and anthropometric measurements at 6–17 months: P = 0·05). Growth faltering as a consequence of early exposure to measles does not explain the marked excess mortality among these children. Further studies of the process underlying delayed mortality after early exposure to measles are warranted.

Type
Research Article
Information
Epidemiology & Infection , Volume 117 , Issue 3 , December 1996 , pp. 525 - 531
Copyright
Copyright © Cambridge University Press 1996

References

1.Aaby, P, Bukh, J, Kronborg, D, Lisse, IM, da Silva, MC. Delayed excess mortality after exposure to measles during the first six months of life. Am J Epidemiol 1990; 132: 211–9.CrossRefGoogle ScholarPubMed
2.Hull, HF, Williams, PJ, Oldfield, F. Measles mortality and vaccine efficacy in rural West Africa. Lancet 1983; 1: 972–5.CrossRefGoogle ScholarPubMed
3.Aaby, P, Andersen, M, Knudsen, K. Excess mortality after early exposure to measles. Int J Epidemiol 1993; 22: 156–62.CrossRefGoogle ScholarPubMed
4.Aaby, P, Bukh, J, Hoff, G et al. , High measles mortality in infancy related to intensity of exposure. J Pediatr 1986; 109: 40–4.CrossRefGoogle ScholarPubMed
5.Knudsen, K, Aaby, P, Whittle, H et al. , Child mortality following low, medium and high litre measles vaccination in West Africa. Int J Epidemiol 1996; 25: 665–73.CrossRefGoogle Scholar
6.Aaby, P, Knudsen, K, Whittle, H et al. , Long-term survival after Edmonston–Zagreb measles vaccination: Increased female mortality. J Pediatr 1993; 122: 904–8.CrossRefGoogle ScholarPubMed
7.Aaby, P, Samb, B, Simondon, F et al. , Sex specific mortality after high litre measles vaccines in rural Senegal. Bull WHO 1994; 72: 761–70.Google Scholar
8.Aaby, P, Bukh, J, Lisse, IM et al. , Overcrowding and intensive exposure as determinants of measles mortality. Am J Epidemiol 1984; 120: 49–63.CrossRefGoogle ScholarPubMed
9.Aaby, P, Pedersen, IR, Knudsen, K et al. , Child mortality related to seroconversion or lack of seroconversion after measles vaccination. Pediatr Infect Dis J 1989; 8: 197–200.Google ScholarPubMed
10.Aaby, P, Knudsen, K, Jensen, TG et al. , Measles incidence, vaccine efficacy and mortality in two urban African areas with high vaccination coverage. J Infect Dis 1990; 162: 1043–8.CrossRefGoogle ScholarPubMed
11.Aaby, P, Bukh, J, Lisse, IM et al. , Measles mortality, state of nutrition, and family structure: A community sludy from Guinea-Bissau. J Infect Dis 1983; 147: 693–701.CrossRefGoogle Scholar
12.Aaby, P, Bukh, J, Lisse, IM et al. , Measles vaccination and reduction in child mortalily: a community study from Guinea-Bissau. J Infect 1984; 8: 13–21.CrossRefGoogle Scholar
13.Sullivan, KM, Gorstein, J. Anthro. Software for calculating pediatric anthropomelry. Atlanta: CDC and Geneva: WHO, 1990.Google Scholar
14.Cox, DR. Regression models and life tables (with discussion). J R Slat Soc B 1972; 34: 187–220.Google Scholar
15.Beau, JP, Garenne, M, Diop, B, Briend, A, Diop, Mar I. Diarrhoea and nutritional slalus as risk faclors of child mortality in a Dakar hospital (Senegal). J Trop Pediatr 1987; 33: 4–9.CrossRefGoogle Scholar
16.Murray, J, Murray, A. Suppression of infection by famine and its activation by refeeding–A paradox? Perspect Biol Med 1977; 20: 471–83.CrossRefGoogle ScholarPubMed
17.Aaby, P, Samb, B, Andersen, M, Simondon, F. No long-term excess mortality after measles infection: A com-munity study from Senegal. Am J Epidemiol 1996; 143: 1035–41.CrossRefGoogle Scholar