TY - JOUR
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
N1 - Funding Information:
This work is funded by the Fogarty International Center of the US National Institutes of Health (Grant R01 TW05991-01 ), Canadian Institute of Health Research (CIHR; IEG-53506 ), International Development Research Center (Grant 102172 ), and the Li Ka Shing Knowledge Institute and Keenan Research Center at St Michael's Hospital, University of Toronto . This paper was also prepared with partial support from the Disease Control Priorities Network Project funded by the Bill & Melinda Gates Foundation . PJ is supported by a University of Toronto Endowed Chair . Part of this work was conducted while SKM was a Fellow of the Pediatric Scientist Development Program and was supported by grants from Sick Kids Foundation , Pediatric Chairs of Canada , and the March of Dimes . The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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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U2 - 10.1016/j.vaccine.2013.07.012
DO - 10.1016/j.vaccine.2013.07.012
M3 - Article
C2 - 23876496
AN - SCOPUS:84883599326
SN - 0264-410X
VL - 31
SP - 4655
EP - 4661
JO - Vaccine
JF - Vaccine
IS - 41
ER -