Association of Previous Measles Infection With Markers of Acute Infectious Disease Among 9- to 59-Month-Old Children in the Democratic Republic of the Congo

J Pediatric Infect Dis Soc. 2019 Dec 27;8(6):531-538. doi: 10.1093/jpids/piy099.

Abstract

Background: Transient immunosuppression and increased susceptibility to other infections after measles infection is well known, but recent studies have suggested the occurrence of an "immune amnesia" that could have long-term immunosuppressive effects.

Methods: We examined the association between past measles infection and acute episodes of fever, cough, and diarrhea among 2350 children aged 9 to 59 months whose mothers were selected for interview in the 2013-2014 Democratic Republic of the Congo (DRC) Demographic and Health Survey (DHS). Classification of children who had had measles was completed using maternal recall and measles immunoglobulin G serostatus obtained via dried-blood-spot analysis with a multiplex immunoassay. The association with time since measles infection and fever, cough, and diarrhea outcomes was also examined.

Results: The odds of fever in the previous 2 weeks were 1.80 (95% confidence interval [CI], 1.25-2.60) among children for whom measles was reported compared to children with no history of measles. Measles vaccination demonstrated a protective association against selected clinical markers of acute infectious diseases.

Conclusion: Our results suggest that measles might have a long-term effect on selected clinical markers of acute infectious diseases among children aged 9 to 59 months in the DRC. These findings support the immune-amnesia hypothesis suggested by others and underscore the need for continued evaluation and improvement of the DRC's measles vaccination program.

Keywords: cough; diarrhea; fever; immunosuppression; measles.

MeSH terms

  • Biomarkers*
  • Child, Preschool
  • Democratic Republic of the Congo
  • Diarrhea
  • Humans
  • Immunization Programs
  • Immunoglobulin G
  • Immunosuppression Therapy
  • Infant
  • Infections / complications*
  • Infections / immunology*
  • Measles / complications*
  • Measles / immunology*
  • Measles / prevention & control
  • Vaccination

Substances

  • Biomarkers
  • Immunoglobulin G