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Nutritional status and delayed mortality following early exposure to measles

Published online by Cambridge University Press:  15 May 2009

P. Aaby ,
M. Andersen  and
K. Knudsen
P. Aaby
Affiliation:
Department of Epidemiology Research, Danish Epidemiology Science Centre, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
M. Andersen
Affiliation:
Department of Epidemiology Research, Danish Epidemiology Science Centre, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark Statistical Research Unit, University of Copenhagen, Copenhagen, Denmark
K. Knudsen
Affiliation:
Department of Epidemiology Research, Danish Epidemiology Science Centre, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
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Community studies in Guinea-Bissau have found that exposure to measles prior to 6 months of age is associated with delayed mortality later in childhood. In an attempt to understand the underlying mechanism, we examined the role of pre-exposure nutritional status and the impact of exposure to measles on growth and subsequent mortality in these outbreaks. Though exposed children were lighter than controls, there was no association between pre-exposure weight-for-age and subsequent mortality adjusting for age. Although exposure was strongly associated with excess mortality, it did not have a negative impact on growth. Adjustment for state of nutrition did not alter the mortality ratio (MR) between 6 and 59 months of age for exposed children and controls; exposed children examined anthropometrically between 6–17 months had a MR of 3·70 compared with controls. This trend was the same for anthropometric measurements obtained at 18–59 months of age. Among the controls, there was a significant association between weight-for-age and subsequent mortality to the age of 5 years. However, for exposed children there was no association; the relation between weight-for-age and subsequent mortality was significantly different for exposed children compared with controls (tests for interaction between exposure and anthropometric measurements at 6–17 months: P = 0·05). Growth faltering as a consequence of early exposure to measles does not explain the marked excess mortality among these children. Further studies of the process underlying delayed mortality after early exposure to measles are warranted.

Type
Research Article
Information
Epidemiology & Infection , Volume 117 , Issue 3 , December 1996 , pp. 525 - 531
Copyright
Copyright © Cambridge University Press 1996

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