Morbidity and Mortality from Measles in Cameroonian Children: Implications for Measles Control

Objective: To investigate the epidemiological trends of measles in the Littoral, North-west, South-west and Western regions of Cameroon in order to improve measles control. Design and Methods: Cross-sectional study of retrolective data collected on cases of measles from January 1997 to April 2003 and stored in registers at regional levels. Child age, immunization and disease status, complications and outcomes were recorded. Results: 33,268 cases of measles were registered. The trend was endemo-epidemic with outbreaks occurring between Feb- ruary and April. The average incidence rate was 4.8‰ per year with 4.1‰ reported in 1998, 5.8‰ in 2001, and 0.9‰ in 2002. Complete data sets for 16,637 cases indicate that 47.4% were children aged 9 to 59 months. Those less than 9 months represented 15.2% of the cases. More than half (415 cases) of the 766 cases with known immunization status (54.2%) representing 2.5% of the 16,637 total cases had received the measles vaccine. Complications were frequent in the Western (53.7%) and the Littoral (33.7%) regions and 53.3% of all complications were bronchopulmonary infections. The global case fatality rate was 1.6%, and 2.1% in children less than 9 months with a significant tendency to decrease with age (p<10 -4 ). The most frequent cause-related disorders of death were malnutrition (34.4%), neurological (35.3%) and di- gestive (26.2%). Conclusion: measles was a public health problem in Cameroon with vaccinated and unvaccinated children both affected within the period of study. Those less than 9 months old, carried the highest burden of the disease in terms of mortality.