About 82% of children who died while undergoing treatment for measles had not received adequate or exclusive breastfeeding during their first 6 months of life, according to a joint study by Bangladesh Shishu Hospital and Institute and icddr,b.
The findings were presented at a dissemination meeting on the study at the auditorium of Bangladesh Shishu Hospital and Institute in Sher-e-Bangla Nagar, Dhaka, on Wednesday.
The study was conducted among 354 children hospitalized with measles and is still ongoing, researchers said.
According to the study, 40% of the affected children were aged between 3 and 9 months. Overall, 38% had not received exclusive breastfeeding during the first 6 months of life.
The proportion was significantly higher among children who died while undergoing treatment, with 82% not having received exclusive breastfeeding during their first 6 months.
Researchers also analyzed the nutritional status of the children. The study found that 65% of measles-affected children were malnourished, including 12% with severe malnutrition and 53% with moderate malnutrition.
For an analysis based on age and vaccination status, researchers divided 341 children into 4 groups.
Among 146 children under 9 months of age who were not yet eligible for routine measles vaccination, 142 tested positive for measles, representing 97.3%.
Among 126 children who were eligible for vaccination but had not received any dose, 122 tested positive, or 97%.
Of the 48 children who had received 1 dose of vaccine, 44 tested positive for measles, representing 92%. Meanwhile, 16 of the 21 children who had received the recommended 2 doses tested positive, accounting for 76%.
Researchers cautioned that the finding does not mean that 76% of children who receive 2 doses of measles vaccine contract the disease.
The study was not conducted among the general population. Instead, it focused on a specific group of children admitted to hospital with suspected measles.
Therefore, the finding that 16 of the 21 suspected cases who had received 2 doses tested positive requires further investigation, researchers said.
The study noted that several factors may contribute to infection despite vaccination, including inadequate development of immunity after vaccination, waning antibody protection over time, malnutrition and other individual health-related factors.
However, determining the extent to which each factor contributed to infection was beyond the scope of the current study.
Researchers also analyzed the measles virus detected among the affected children. All the viruses identified belonged to the B3 subclade and showed similarities with B3 viruses detected in other countries.
The researchers also identified 4 changes or mutations in the epitope region of the virus's H protein, which can be recognized by antibodies.
The research was conducted under the Epidemiology and Research Department of Bangladesh Shishu Hospital and Institute.
The main research paper was presented by the institute's Director Professor Dr Mirza Mohammad Ziaul Islam and icddr,b Senior Director Dr Mustafizur Rahman.
State Minister for Health and Family Welfare Dr MA Muhit attended the dissemination meeting as the chief guest, while Professor Dr AKM Azizul Haque, chairman of the governing board of Bangladesh Shishu Hospital and Institute, chaired the event.
Director General of the Directorate General of Health Services Professor Dr Prabhat Chandra Biswas, DGHS Director Dr Md Nurul Islam and IEDCR Director Dr Kazi Ahmed Zaki attended the meeting as special guests.
