Clinical characteristics and outcomes of patients hospitalized with measles during an outbreak in Somalia

OBJECTIVES: Measles is a contagious disease associated with significant morbidity and mortality. This paper describes the clinical characteristics and outcomes of patients hospitalized with measles during an outbreak in Somalia from January 2018 to December 2021. METHODS: This retrospective study was conducted at Mogadishu Somalia Turkey Recep Tayyip Erdogan Training and Research Hospital. Children aged 6 months to 17 years who were hospitalized with clinical signs and symptoms of measles and its complications were recruited RESULTS: In total, 110 participants were enrolled. The median age was 16 [interquartile range (IQR) 12–36] years, and 87 (79.1%) were male. All participants presented with fever, typical measles rash, cough and conjunctivitis, and 43 (39.1%) had received the measles vaccine. Overall, 104 (94.6%) participants were admitted with severe respiratory symptoms, and six (5.4%) were admitted due to poor feeding and/or significant dehydration. Overall, all-cause mortality was 1.8% (n=2). The median duration of hospitalization was longer among participants who died compared with those who survived [11 (IQR 8–14) vs 4 (IQR 2–6) days; P=0.046]. Unvaccinated participants were significantly younger than vaccinated participants [36 (IQR 24–72) vs 12 (IQR 9–16) months; P<0.001]. There was a trend towards higher mortality [0/43 (0%) vs 2/67 (3%); P=0.519] and longer length of hospitalization [3 (IQR 2–6) vs 4 (IQR 3–7) days; P=0.056] among unvaccinated participants compared with vaccinated participants. Both the median total leukocyte count [5.7 (IQR 3.9–8.5) vs 11.6 (IQR 5.9–46.3) x 10(9)/L; P<0.001] and platelet count [239 (IQR 202–358) vs 308 (IQR 239–404) x 10(9)/L; P=0.032] were significantly higher among unvaccinated participants compared with vaccinated participants. However, the median haemoglobin concentration was significantly higher among vaccinated participants compared with unvaccinated participants [11.1 (IQR 9.9–12.3) vs 10.1 (IQR 9.1–11.2) g/dL; P=0.006]. CONCLUSIONS: Patients with measles in Somalia have a short hospital stay, low mortality rate and low vaccination rate. Timely vaccination and the need for improved care of patients with measles, particularly vulnerable groups including children and those with undernutrition, are encouraged.