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Factors associated with the severity of measles and of delayed complications of measles

Objective

* To compare levels of IL-5, IL-10, and IFN-gamma, at recruitment, 6 weeks and 6 months post-recruitment, in children with and without complications within 6 weeks of rash onset, among those who had no complications at enrollment.
* To determine if there is an association between levels of IL-5, IL-10, and IFN-gamma at 6 weeks and 6 months post-measles, delayed-type-hypersensitivity (DTH) responses at 6 weeks and the development of complications (pneumonia, severe pneumonia, invasive diarrhoea, or hospitalisation for other reasons) 6-24 weeks after measles onset.
* To compare the risk of complications among vaccinated vs unvaccinated cases.
* To determine the association between cytokine profiles at 6 weeks and 6 months post-measles onset and early age at measles infection, sex, and vaccination status.
* To compare cytokine profiles measured by whole blood assays with results of conventional assays on PBMCs on a subsample of children.
Expected Outcome

* Information on factors associated with early and delayed complications from measles.
* Confirmation or not of the hypothesis that complicated measles cases have a bias towards a Th2 response
* Establishment of the capacity to conduct whole blood assays for cytokines at ICDDR,B
* A paper for publication in peer-reviewed journals.
This a nested case-control study within a study evaluating long-term morbidity after measles. Commercial ELISA kits will be used to measure IL-5, IL-10, and IFN-( levels in supernatant from whole blood assays at recruitment, 6 weeks and 6 months at ICDDR,B on approximately 200 measles cases. Cases and controls will be defined among measles cases with and without complications at different times after measles onset. The following factors will be investigated for a potential association with early and late complications from measles: (i) Age; (ii) Sex; (iii) Vaccination status; (iv) Interval between onset of rash and initiating treatment; (v) Primary or secondary case; (vi) Cytokine profile; (vii) DTH response 6 weeks after recruitment. We will have 80% power to detect an odds ratio of 3.5 to 4.5 for different exposures of interest at the 95% significance level.

Funding Scheme

CSC - Cost-sharing contracts

Coordinator

London School of Hygiene and TropicalMedicine
Address
Keppel Street
WC1E 7HT London
United Kingdom

Participants (2)

Bayerische Julius-Maximilians-Universität Würzburg
Germany
Address
Versbacher Straße 7
97078 Würzburg
International Centre for Diarrhoeal Disease Research
Bangladesh
Address

1000 Dhaka