Evaluation of Demographic, Clinical, and Paraclinical Profile of Hospitalized Children with Measles

Abstract

Background: Despite widespread vaccination, measles remains a substantial public health threat, with variable epidemiological characteristics. Objectives: This study aimed to describe the characteristics of children hospitalized with measles in Zahedan, southeastern Iran. Methods: In this descriptive cross-sectional study, we reviewed the medical records of 210 children younger than 18 years with laboratory-confirmed measles, defined by either a positive anti-measles IgM test or RT-PCR, who were admitted to a major teaching hospital from March 2022 to March 2023. Data on demographics, vaccination status, clinical features, complications, and laboratory findings were collected and analyzed using descriptive and inferential statistics. Continuous variables were assessed for normality using the Shapiro-Wilk test. Results: The mean age of the patients was 18.6 ± 12.4 months (range, 1 - 86 months), and 54.3% were male. Overall, 54.8% had a history of complete measles vaccination, whereas 40% were unvaccinated. Of the 210 cases, 182 (86.7%) were confirmed by IgM ELISA and 28 (13.3%) by RT-PCR. Most children were Iranian (85.7%) and resided in urban areas (74.8%). Pneumonia was the most common complication (43.8%), followed by diarrhea (30%) and otitis media (11.9%). Encephalitis and blindness were rare. Elevated liver enzymes were detected in 79.5% of patients, with no significant association with pneumonia or a prolonged hospital stay. Nearly all patients presented with fever and rash (99%), followed by cough (73.8%), coryza (64.8%), and conjunctivitis (40%). Conclusions: This study highlights a substantial burden of measles among young children in Zahedan, including a notable subset of vaccinated individuals, suggesting possible vaccine failure. The high prevalence of complications, such as pneumonia, underscores the need for early diagnosis and supportive care. Strengthening routine immunization, ensuring equitable access for migrant populations, and maintaining robust surveillance are crucial for measles control in this region. Future studies should investigate the duration of maternal antibody protection and the feasibility of an early vaccination schedule in high-risk populations.