Measles in African children

Measles, also known as “rubeola” is an acute, highly communicable viral exanthematous disease caused by “Morbillivirus” a member of the Paramyxovirus family, which is transmitted to a susceptible person through aerosol or by direct contact. The mucous membranes of an exposed individual have been Infected by the virus and then tends to spread to other parts of the body. According to series of experiment carried out, it can be concluded that the measles infect only humans with no known animal occurrence. Measles has an incubation period of about 10 days (with a range of 7 to 18 days).
Generally in Africa, Measles remains a leading cause of death and disabilities among children in most countries. Globally, measles mortality fell 60% from an estimated 873,000 deaths in 1999 to 345,000 in 2005. Estimates for 2008 indicate deaths fell further to 164,000, with 77% of the remaining measles deaths in 2008 occurring within the Southeast Asian region In 2015, there were about 134 200 deaths, translating to about 367 deaths every day or 15 deaths every hour, most of them in children under the age of 5. In Ethiopia in 2000, measles was responsible for 22% of deaths in children less than five years of age and 17% of deaths in children aged 5-14 years. Nigeria is among the 45 countries that account for 94% of the deaths due to measles worldwide. In Nigeria, measles transmission occurs through all months of the year, but peaks in the dry season (February, March and April). Among the leading causes of childhood mortality, Measles has also been rated as the fifth leading cause. Although, measles has a low mortality rate ranging from (3% — 5&) it could however rise up to 10% of the cases during an epidemic
Factors that predispose to burden of measles morbidity and mortality in African and other developing countries are due to a poor immunisation coverage, malnutrition, poor shelter and overcrowding, underlying immune deficiency disorders due to malnutrition, vitamin A deficiency and lack of access to medical care, cultural habits that influence health-seeking behaviour and early age of occurrence of infection, while Other predisposing factors, especially in the developing nations are political instability, cultural and religious objections to immunisation and cultural habits that influence health-seeking behaviour. In Africa, about 125 million preschool-aged children have vitamin A deficiency, placing them at high risk of death, severe infection, or blindness as a result of measles.

Generally, the symptoms of measles appears initially within the first 10 to 20 days of exposure to the virus. These symptoms include: cough, fever, runny nose, red eyes, sore throat, white spots inside the mouth. One of the classic signs of measles is a wide spread of skin rash. The rash can last up to 7 days and mostly appears with 14 days of viral exposure. The most common development occurs in the head and spreads slowly to the other parts of the body

Measles is followed by at least one complication caused by the disruption of epithelial surfaces and immuno-suppression. These include pneumonia, ear and sinus infections, persistent diarrhea, upper airway obstruction from croup (laryngotracheo- bronchitis), and mouth ulcers. Less common complications include corneal drying that could progress to ulceration (keratomalacia) and blindness, protein energy malnutrition, convulsions and brain damage. Children do not die directly from measles, but from its complications when not properly manage which may lead to death within the first month after the onset of rash. Children under the age of 5 years or adults over the age of 20 years are usually more susceptible to the complications of measles.

There’s no specific antiviral treatment exists for measles virus. Severe complications from measles can be reduced through supportive care that ensures good nutrition, adequate fluid intake (a humidifier to ease a cough and sore throat), adequate rest to boost your immune system and treatment of dehydration with WHO-recommended oral rehydration solution. This solution replaces fluids and other essential elements that are lost through diarrhea or vomiting. Antibiotics should be prescribed to treat eye and ear infections, and pneumonia, acetaminophen or ibuprofen should be prescribed to reduce fever. All children diagnosed with measles should receive two doses of vitamin A supplements, given 24 hours apart. This treatment restores low vitamin A levels during measles that occur even in well-nourished children and can help prevent eye damage and blindness.
Various interventions are available for people that might have been exposed to the virus. These can help in lessening its severity or preventing an infection. This measure includes: A measles vaccine, which should be administered within 72 hours of exposure, a dose of immune proteins called immunoglobulin, should be used within 6 days of exposure

Measles vaccination prevented about 20.3 million deaths. This implies that vaccination is actually effective against measles infection. Despite the availability of a safe and effective vaccine for over 50 years, measles remains a leading cause of death among young children in Africa and developed countries, especially among non-immunised children. Efforts have been made for mass vaccination against measles, especially for children; however, in sub-Saharan Africa, measles still ranks high among the burden of vaccine-preventable diseases

Kindly like and share

Leave a Comment