65pc children with measles suffer from malnutrition

Malnourished children are at greater risk of contracting measles. A study has found that 65 per cent of children with measles are suffering from moderate to severe malnutrition. Tests of samples from children who came for treatment with symptoms of measles found that 95 per cent of them had measles.

The study was jointly conducted by Bangladesh Shishu Hospital and Institute and the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). The findings of the study were released at an event held at the hospital auditorium on Wednesday.

State Minister for Health and Family Welfare MA Muhit, senior officials of the health department, scientists, researchers and physicians attended the event.

Speaking as the chief guest at the end of the event organised to share the research findings, State Minister MA Muhit said the country has been caught in a measles epidemic. It is difficult to stop the current measles outbreak. There is no known way to stop measles other than vaccination.

There are 40,000 posts for field workers to administer vaccines. Of these, 25,000 are filled. It is not possible to vaccinate all children while leaving nearly 40 per cent of the posts vacant, he said.

The state minister further said the current situation had emerged due to multifaceted failures. It cannot be fixed with a magic bullet. If everything goes well, it will take at least two to three months to bring measles under control.

The study was conducted on 354 children under the age of 14 who sought treatment at Bangladesh Shishu Hospital and Institute between March and July this year. Researchers analysed the children’s demographic and medical information, tested their samples and conducted genetic analysis of pathogens collected from the samples.

The sample testing and genetic analysis were conducted at the icddr,b laboratory. Twelve scientists, researchers and officials from the two institutions were involved in the study.

Professor Mirza Md Ziaul Islam, director of Bangladesh Shishu Hospital and Institute, presented the first part of the research at the event.

He said 71 per cent of children with measles came directly to Bangladesh Shishu Hospital for treatment. The remaining 29 per cent were referred after receiving treatment at various hospitals in or outside Dhaka. Slightly more than 5 per cent of the children who sought treatment required ICU (intensive care unit) services.

The researchers sought to assess the nutritional status of children under five. There were 308 children in this age group.

The study found that 12 per cent of them were suffering from severe malnutrition, while 53 per cent had moderate malnutrition. In other words, 65 per cent of the children with measles were suffering from moderate to severe malnutrition. The nutritional status of 34 per cent of the children was normal. The remaining 1 per cent were overweight for their age.

There is a close relationship between breastfeeding and a child’s nutrition. Experts also say breast milk helps build a child’s immunity against measles and various other diseases.

The study found that 38 per cent of the children were not regularly breastfed. Colostrum and exclusive breastfeeding during the first six months after birth act as a vaccine for children. No other food is needed during this period.

It was found that nine of the 11 children who died of measles, or 82 per cent, had not been exclusively breastfed.

Vaccination protects against measles. In Bangladesh, the first dose of the measles vaccine is given at nine months of age and the second dose at 15 months.

The researchers reviewed vaccination information for 342 children. They found that 43 per cent of children with measles were not yet old enough to receive the vaccine, meaning they were under nine months old.

On the other hand, 37 per cent of children were not given any vaccine even after reaching the eligible age. Fourteen per cent had received one dose of the measles vaccine, while 6 per cent had received two doses.

It appears that some children contracted measles even after receiving two doses of the vaccine. Researchers said scientific investigation is needed to determine why children contracted measles despite receiving two doses.

Md Mostafizur Rahman, senior director of icddr,b, presented the findings of the genetic analysis of the measles virus at the event.

He said there are 28 types of measles virus worldwide. In Bangladesh and this region, people are mostly infected with the B3 type of measles virus.

There has been very little mutation in this type. The mutation has not made the virus more infectious. This means that the widespread transmission of measles in the country is not due to the virus itself.

Citing another study conducted by icddr,b, Md Mostafizur Rahman said the immunity that children receive from their mothers at birth gradually declines over time.

That study was conducted on 200 mothers and 200 children in Kamalapur, Dhaka.

The study found that 85 per cent of mothers had measles antibodies in their blood during pregnancy. In the first month after birth, 60 per cent of children had antibodies in their bodies. However, antibodies received from the mother’s body decline rapidly. By six months of age, children no longer have any measles antibodies. They have none by nine months either.

Mostafizur Rahman said the measles vaccine does not work well when given at six months of age. Vaccination at nine months produces better results, and the results are even better at a slightly older age.

The researchers made several recommendations, including ensuring vaccination for children, developing effective vaccination strategies, increasing medical and epidemiological research, and using research findings to help eliminate measles.

At the event, the welcome address was delivered by Professor Md Riaz Mobarak, head of the Epidemiology and Research Department of Bangladesh Shishu Hospital and Institute.

Following the presentation of the research findings, Professor Md Monir Hossain, a member of the governing board of Bangladesh Shishu Hospital and Institute, former director Md Mahbubul Haque, and Professor Md Atikul Islam of the Department of Paediatrics took part in a scientific discussion.

Director General of the Directorate General of Health Services Professor Prabhat Chandra Biswas, Director (Hospitals) of the DGHS Md Nurul Islam, and Director of the Institute of Epidemiology, Disease Control and Research (IEDCR) Kazi Ahmed Zaki also spoke at the event.

The event was chaired by AKM Azizul Haque, chairman of the governing board of Bangladesh Shishu Hospital and Institute.