BMJ  2006;333:1234 (16 December), doi:10.1136/bmj.39058.361620.BE

Editorials

Measles in developing countries

Vitamin A and antibiotics prevent complications, but vaccination remains the priority

The first 150 words of the full text of this article appear below.

Widespread vaccination against measles and improvements in clinical care and socioeconomic status have reduced mortality due to measles in many countries.¹ Nevertheless, measles remains an important cause of global morbidity and mortality, with case fatality rates as high as 9.7% in some African children with measles in recent years.^{1 2} Pneumonia, the most common cause of death due to measles, can be caused by the measles virus alone, secondary herpes simplex virus, adenoviruses, or bacterial infections.^{1 3} Factors contributing to increased rates of pneumonia and other complications in developing countries include young age at infection, crowding, and malnutrition, especially vitamin A deficiency.^{1 4}

Antibiotics are often given to children with measles who do not have clinically apparent secondary bacterial infections, but evidence of benefit has been largely anecdotal. In this week's BMJ, a placebo randomised trial by Garly and colleagues supports the effectiveness of co-trimoxazole for preventing pneumonia and secondary bacterial conjunctivitis . . . [Full text of this article]

¹ Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA

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