Content area
Abstract
Measles afflicts practically all children and causes considerable mortality in the high-mortality populations of West Africa. It has been argued that the elimation of measles in such contexts has the potential to reduce overall death rates well beyond the actual number of measles deaths saved. This argument is based on the tendency for measles to be associated with many other diseases which may cause death after apparent recovery from measles.
This study examines the level and pattern of measles morbidity and mortality among children aged 0 to 14 years in Ngayokheme--a rural zone of Senegal, West Africa. The relationships between individual-level factors including age, sex, weaning and vaccination of children and their risks of contracting and dying from measles and other causes are examined. The extent to which reductions in measles incidence influence the overall death rate is also examined.
The data for the study are from the Sine-Saloum survey which was conducted in Ngayokheme between 1963 and 1982. The data consist of information on all events occurring to individuals in the study area. Of specific interest to this study are data on measles incidence and the vaccination of children during three mass-immunization programs in 1966, 1969 and 1979.
Life table and multivariate methods, including Ordinary Least Squares and logit regressions, are used to analyze the data.
Among the most striking results of the study is the finding that the vaccination of children against measles reduces their risks not only of measles incidence and mortality but also of mortality from other causes. Macro-level analyses reinforce this result by showing that a reduction in measles incidence among children aged 0 to 4 years by one per thousand would result in a reduction in the total death rate in this age group by 1.07 per thousand. The study also shows that female children are more at risk of contracting and dying from measles than males and children who have been weaned are subject to lower measles risks than children still breastfeeding.
It is suggested, given the efficacy of vaccination against measles, that marked reduction in overall mortality may be achieved by implementing a well-targeted vaccination program in the study area.
