Measles mortality in high and low burden districts of India: Estimates from a nationally representative study of over 12,000 child deaths

Shaun K. Morris, Shally Awasthi, Rajesh Kumar, Anita Shet, Ajay Khera, Fatemeh Nakhaee, Usha Ram, Jose R M Brandao, Prabhat Jha

Research output: Contribution to journalArticle

Abstract

Background: Direct estimates of measles mortality in India are unavailable. Our objective is, to use a nationally-representative study of mortality to estimate the number and distribution of, measles deaths in India with a focus on 264 high burden districts. Methods: We used physician coded verbal autopsy data from the Million Death Study which surveyed, over 12,000 deaths in children aged 1 month to under 15 years from 1.1 million nationally, representative households in 2001-2003. Results: We estimate there were 92,000 (99% CI 63,000-137,000) measles deaths in children 1-59, months of age in India in 2005, representing a mortality rate of 3.3 (99% CI 2.3-5.0) per 1000 live, births and about 6% of all 1-59 month deaths. In children under 15 years of age, there were 107,000, (99% CI 74,000-158,000) measles deaths. The measles mortality rate was nearly 70% greater in girls, than in boys, and 60% of the deaths were in three populous states Uttar Pradesh, Bihar, and Madhya, Pradesh. The 1-59 month measles mortality rate in high burden districts was 4.48 (99% CI 3.94-5.02) compared to 2.40 (99% CI 2.28-2.52) per 1000 live births in other districts. Conclusion: Measles killed over 100,000 children in India in 2005 and girls were at higher risk than boys. The majority of measles deaths occurred in a few states and high burden districts. The results of this study highlight the importance of focusing measles supplementary immunization activities in high burden districts.

Original languageEnglish (US)
Pages (from-to)4655-4661
Number of pages7
JournalVaccine
Volume31
Issue number41
DOIs
StatePublished - Sep 23 2013
Externally publishedYes

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Measles
India
death
Mortality
Live Birth
physicians
households
necropsy
immunization
Autopsy
Immunization
Physicians

Keywords

  • Childhood
  • Immunization
  • India
  • Measles
  • Mortality
  • Vaccine

ASJC Scopus subject areas

  • Immunology and Microbiology(all)
  • Infectious Diseases
  • Public Health, Environmental and Occupational Health
  • veterinary(all)
  • Molecular Medicine

Cite this

Measles mortality in high and low burden districts of India : Estimates from a nationally representative study of over 12,000 child deaths. / Morris, Shaun K.; Awasthi, Shally; Kumar, Rajesh; Shet, Anita; Khera, Ajay; Nakhaee, Fatemeh; Ram, Usha; Brandao, Jose R M; Jha, Prabhat.

In: Vaccine, Vol. 31, No. 41, 23.09.2013, p. 4655-4661.

Research output: Contribution to journalArticle

Morris, Shaun K. ; Awasthi, Shally ; Kumar, Rajesh ; Shet, Anita ; Khera, Ajay ; Nakhaee, Fatemeh ; Ram, Usha ; Brandao, Jose R M ; Jha, Prabhat. / Measles mortality in high and low burden districts of India : Estimates from a nationally representative study of over 12,000 child deaths. In: Vaccine. 2013 ; Vol. 31, No. 41. pp. 4655-4661.
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T1 - Measles mortality in high and low burden districts of India

T2 - Estimates from a nationally representative study of over 12,000 child deaths

AU - Morris, Shaun K.

AU - Awasthi, Shally

AU - Kumar, Rajesh

AU - Shet, Anita

AU - Khera, Ajay

AU - Nakhaee, Fatemeh

AU - Ram, Usha

AU - Brandao, Jose R M

AU - Jha, Prabhat

PY - 2013/9/23

Y1 - 2013/9/23

N2 - Background: Direct estimates of measles mortality in India are unavailable. Our objective is, to use a nationally-representative study of mortality to estimate the number and distribution of, measles deaths in India with a focus on 264 high burden districts. Methods: We used physician coded verbal autopsy data from the Million Death Study which surveyed, over 12,000 deaths in children aged 1 month to under 15 years from 1.1 million nationally, representative households in 2001-2003. Results: We estimate there were 92,000 (99% CI 63,000-137,000) measles deaths in children 1-59, months of age in India in 2005, representing a mortality rate of 3.3 (99% CI 2.3-5.0) per 1000 live, births and about 6% of all 1-59 month deaths. In children under 15 years of age, there were 107,000, (99% CI 74,000-158,000) measles deaths. The measles mortality rate was nearly 70% greater in girls, than in boys, and 60% of the deaths were in three populous states Uttar Pradesh, Bihar, and Madhya, Pradesh. The 1-59 month measles mortality rate in high burden districts was 4.48 (99% CI 3.94-5.02) compared to 2.40 (99% CI 2.28-2.52) per 1000 live births in other districts. Conclusion: Measles killed over 100,000 children in India in 2005 and girls were at higher risk than boys. The majority of measles deaths occurred in a few states and high burden districts. The results of this study highlight the importance of focusing measles supplementary immunization activities in high burden districts.

AB - Background: Direct estimates of measles mortality in India are unavailable. Our objective is, to use a nationally-representative study of mortality to estimate the number and distribution of, measles deaths in India with a focus on 264 high burden districts. Methods: We used physician coded verbal autopsy data from the Million Death Study which surveyed, over 12,000 deaths in children aged 1 month to under 15 years from 1.1 million nationally, representative households in 2001-2003. Results: We estimate there were 92,000 (99% CI 63,000-137,000) measles deaths in children 1-59, months of age in India in 2005, representing a mortality rate of 3.3 (99% CI 2.3-5.0) per 1000 live, births and about 6% of all 1-59 month deaths. In children under 15 years of age, there were 107,000, (99% CI 74,000-158,000) measles deaths. The measles mortality rate was nearly 70% greater in girls, than in boys, and 60% of the deaths were in three populous states Uttar Pradesh, Bihar, and Madhya, Pradesh. The 1-59 month measles mortality rate in high burden districts was 4.48 (99% CI 3.94-5.02) compared to 2.40 (99% CI 2.28-2.52) per 1000 live births in other districts. Conclusion: Measles killed over 100,000 children in India in 2005 and girls were at higher risk than boys. The majority of measles deaths occurred in a few states and high burden districts. The results of this study highlight the importance of focusing measles supplementary immunization activities in high burden districts.

KW - Childhood

KW - Immunization

KW - India

KW - Measles

KW - Mortality

KW - Vaccine

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