Organ complication, CRP value predict severe outcome in paediatric measles
The risk of severe outcome in children with measles, while independent of age, increases in the presence of encephalitis or pancreatitis and elevated C-reactive protein (CRP) values, a study has found.
Researchers reviewed the medical records of 249 children (median age 14.5 months; 51 percent male) hospitalized for measles to investigate the risk factors for severe outcome defined by the presence of long-lasting sequelae, need of intensive care or death.
Of the children, 207 (83 percent) developed any complication and three (1 percent) died. Organ complications, such as in the respiratory tract, liver, pancreas, central nervous system and myocardium, were reported in 135 of the 207 children.
Meanwhile, blood cytopaenia occurred in 120 children, with neutropaenia being more common in those with the B3-genotype vs other genotypes (29.5 percent vs 7.7 percent; p=0.01).
On multivariable regression analysis, the risk of severe outcome was significantly associated with pancreatitis (adjusted odds ratio [aOR], 9.19; p=0.01), encephalitis (aOR, 7.02; p=0.04) and CRP value (aOR, 1.1; p=0.028).
CRP was a significant predictor of complications and severe outcome, with an area under the receiver operating characteristic curve of 0.67 (95 percent CI, 0.52–0.82). CRP values >2 mg/dL were associated with a higher risk of complications (OR, 2.0; 1.15–3.7; p=0.01) or severe outcome (OR, 4.13; 1.43–11.8; p<0.01).
According to current knowledge and World Health Organization indications, measles-related complications and death occur with greater frequency in children aged <5 years and in those with malnutrition, micronutrient deficiency or immunodeficiency. Researchers noted that while the potential effect of bacterial coinfection on CRP is unclear, point-of-care CRP testing might be useful in identifying children requiring hospital management.