Abstract
BackgroundIn recent years Pakistan has faced frequent measles outbreaks killing hundreds of children despite the availability of vaccine for decades. This study was undertaken to determine the persistence of maternal transferred measles antibody levels in infants before measles vaccination with relation to their feeding practices.MethodsA cross sectional study was conducted at district Islamabad over 1 year between 1st October 2013 to 30th Sept. 2016. Any infant less than 9 months of age, not suffering from an acute or debilitating illness and not vaccinated was enrolled in the study. After taking written informed consent from parents / guardians, information was collected on a pretested questionnaire. About 3 cc venous blood was taken to quantify any measles IgG antibodies. Data was analyzed by using Epi Info 7.2 version.ResultsThree hundred eighty-four infants were enrolled and were divided into three age groups, 1–90, 91–180 and 181–270 days age groups. Mean age of infants was 4.4 months ±3.2 SD. Male to female ratio was 1.2:1. A level of maternal measles IgG antibodies ≥12 U/ml was taken as protective. Of total 384 infants, 91(24%) had protective measles antibody titters (> 12 U/ml). and 65 (73%) of them were on breast milk. Highest antibody levels were found in 1–90 days age group. Analysis showed that 181–270 days aged infants had 3.1875 more odds of having unprotected/ low levels of antibodies against measles than children aged less than 180 days. Age group < 180 days found to be statistically significant with protective IgG levels (OR: 3.1875, P value: < 0.000063).ConclusionMeasles protective antibodies were found in infants < 180 days age group. Breast feeding provides early protection against measles. Levels drop down to low levels immediately after birth and then after 06 months. It is, therefore, recommended that measles vaccination should be considered for administration at 6 months or even earlier if measles immunity is desired.
Highlights
In recent years Pakistan has faced frequent measles outbreaks killing hundreds of children despite the availability of vaccine for decades
Of total 384 infants, 91(24%) were found to have protective measles antibody titers (> 12 U/ml), remaining 293 (76%) infants had lower levels
Out of 91infants who had protective measles antibodies, 65 (73%) infants were on breast milk, (Table 1)
Summary
In recent years Pakistan has faced frequent measles outbreaks killing hundreds of children despite the availability of vaccine for decades. This study was undertaken to determine the persistence of maternal transferred measles antibody levels in infants before measles vaccination with relation to their feeding practices. In Pakistan measles vaccination coverage has increased and its reported first dose coverage reached 88% in 2012 [5]. According to WHO, this coverage is not sufficient to prevent outbreaks [6, 7]. In December 2012, measles outbreaks started in Sind province and lasted until August, 2013 and killed 321. Primary protection against infectious diseases at birth is provided mainly by maternal antibodies [9]. A number of factors affect maternal antibody concentration in young infants. Duration of gestation determines the placental transfer of antibodies to the newborn: that is the reason, preterm babies receive significantly fewer antibodies [10]
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