A comprehensive new study has revealed that sixty-five per cent of children hospitalised with measles suffer from moderate to severe malnutrition. Conducted jointly by the Bangladesh Shishu Hospital and Institute and the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), the research highlights a compounding public health crisis among young patients.

The findings were unveiled on Wednesday at an official event hosted within the Shishu Hospital auditorium. The gathering brought together senior health officials, medical researchers, scientists, and clinicians, alongside State Minister for Health M A Muhit, who attended as the chief guest.

The research examined three hundred and fifty-four children under the age of fourteen who sought medical treatment at the institution between March and July. Investigators conducted detailed clinical assessments, demographic analyses, and laboratory evaluations of biological samples. Genetic sequencing of the viral specimens was carried out at the icddr,b laboratories, with a team of twelve scientists, researchers, and institutional officials leading the project.

Among the cohort, seventy-one per cent of the children arrived directly at the Shishu Hospital for care, while the remaining twenty-nine per cent were referred after receiving initial treatment at other medical facilities in Dhaka and surrounding districts. Furthermore, slightly over five per cent of the admitted patients required critical care in intensive care units.

The nutritional assessment, which focused on three hundred and eight children under five years of age, revealed alarming vulnerabilities. Twelve per cent of these young patients suffered from severe acute malnutrition, while fifty-three per cent experienced moderate malnutrition, bringing the total proportion of undernourished children to sixty-five per cent. Only thirty-four per cent maintained a normal nutritional status, and roughly one per cent presented with weight above the age-appropriate median.

Breastfeeding practices also emerged as a critical factor in patient outcomes. Researchers noted that thirty-eight per cent of the affected children did not receive regular breast milk. Among the eleven children who tragically succumbed to measles during the study period, nine—representing eighty-two per cent—had not been exclusively breastfed during infancy.

The analysis of vaccination histories across three hundred and forty-two children showed that forty-three per cent of infected patients were under nine months of age, meaning they had not yet reached the eligible age for the first dose under the national immunisation schedule. However, thirty-seven per cent of children who had surpassed the eligible age remained entirely unvaccinated. Only fourteen per cent had received a single dose, and a mere six per cent had completed the recommended two-dose schedule. Notably, a small fraction of children contracted the virus despite completing both doses, prompting researchers to call for further scientific inquiry into breakthrough infections.

Addressing the genetic characteristics of the virus, Dr Mohammad Mustafizur Rahman, senior director at icddr,b, explained that global measles strains comprise twenty-eight distinct genotypes, with genotype B3 predominating in Bangladesh. Genetic sequencing revealed only minor mutations, confirming that the virus has not evolved into a hyper-transmissible form. Consequently, the surge is driven by immunisation gaps and nutritional vulnerabilities rather than a novel viral variant.

Dr Rahman also referenced complementary data on maternal antibody transfer, noting that while eighty-5 per cent of expectant mothers possess measles antibodies, these defenses deplete rapidly, vanishing entirely by the sixth month of life and leaving infants unprotected before the nine-month vaccination threshold.

State Minister M A Muhit acknowledged the gravity of the outbreak, stating that containment will take at least two to three months under optimal conditions. He highlighted a severe structural challenge within the primary healthcare delivery system, noting that out of forty thousand sanctioned field worker positions for immunisation, approximately fifteen thousand remain vacant.

The study concluded with key recommendations, including reinforcing routine immunisation outreach, expanding clinical epidemiology research, and integrating nutritional support into infectious disease management frameworks.

Study Findings at a Glance

What specific interventions do health experts recommend to address the high vacancy rates among frontline immunisation field workers?