Comparative Analysis of Measles Morbidity and Mortality in Calabar during the Expanded Programme on Immunization and the National Programme on Immunization Eras

Abstract

Background: In an apparent desire to improve the routine immunization coverage in the country, the Nigerian Government in 1997, launched the National Programme on Immunization (NPI) in place of the existing Expanded Programme on Immunization (EPI).

Aim: The aim of the present retrospective study was to determine whether the desired goal was achieved, by comparing the hospital incidences, morbidities and mortalities from measles infection during the EPI (January 1992 to December 1996) and NPI (January 1997 to December 2001) eras.

Subjects and Methods: The subjects were children admitted with measles infection to the University of Calabar Teaching Hospital, Calabar, during the period. Data were extracted from the relevant case files.

Results: One hundred and twenty cases (representing 24 cases per year), and 36 cases (representing 7.2 cases per year) were admitted during the NPI and EPI eras, respectively (P<0.001). Measles contributed 5.1 percent of the total paediatric admissions during the NPI period and 1.5 percent in the EPI period. The incidence of complications (86.6 percent) was significantly higher in the NPI era than that recorded (52.8 percent) in the EPI era (P<0.001), with bronchopneumonia being the most common. Measles contributed 5.5 percent to the total mortality during the NPI period with a case fatality rate of 6.7 percent; these were significantly higher (P<0.05) than the 0.83 percent and 2.8 percent respectively, obtained in the EPI period.

Conclusion: There was an upsurge in the incidence, morbidity and mortality from measles during the NPI era. Adequate health education, intensification of the National Programme on Immunization, and house-to-house contact for measles vaccination are advocated.