Mawlood SK, Al-Ani MM, Al-Ani RM, Alshibib A. Impact of measles vaccination on clinical characteristics and outcomes in children in Ramadi, Iraq. World J Clin Pediatr 2025; 14(3): 107253 [DOI: 10.5409/wjcp.v14.i3.107253]
Corresponding Author of This Article
Raid M Al-Ani, Department of Surgery/Otolaryngology, College of Medicine, University of Anbar, Al-Thaela, Ramadi City 31001, Anbar, Iraq. med.raed.alani2003@uoanbar.edu.iq
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Prospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Pediatr. Sep 9, 2025; 14(3): 107253 Published online Sep 9, 2025. doi: 10.5409/wjcp.v14.i3.107253
Impact of measles vaccination on clinical characteristics and outcomes in children in Ramadi, Iraq
Sou’dad Khaled Mawlood, Mohammed Maher Al-Ani, Raid M Al-Ani, Asfar Alshibib
Sou’dad Khaled Mawlood, Department of Pediatrics, Al-Ramadi Teaching Hospital for Maternity and Children, Anbar Health Directorate, Ramadi City 31001, Anbar, Iraq
Mohammed Maher Al-Ani, Department of Pediatrics, College of Medicine, University of Anbar, Ramadi City 31001, Anbar, Iraq
Raid M Al-Ani, Department of Surgery/Otolaryngology, College of Medicine, University of Anbar, Ramadi City 31001, Anbar, Iraq
Asfar Alshibib, Department of Medical Microbiology, Cmlto Canadian College of Medical Technologist, Toronto M1 L-M9N, Canada
Author contributions: Mawlood SK collected the data and prepared the initial draft; Al-Ani MM designed the project and supervised the study; Al-Ani RM co-designed the project, wrote the final draft, and formatted the tables and references; Alshibib A conducted the data analysis, wrote the discussion section, and revised the initial draft; All authors have read and approved the final version of the manuscript.
Institutional review board statement: The study was approved by the Ethical Approval Committee of the University of Anbar (Reference number 88, on 23-5-2023).
Informed consent statement: Informed consent was obtained from the parents of every participant.
Conflict-of-interest statement: All authors declare that there is no conflict of interest.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Data sharing statement: The data generated and analyzed during this study are available from the authors upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Raid M Al-Ani, Department of Surgery/Otolaryngology, College of Medicine, University of Anbar, Al-Thaela, Ramadi City 31001, Anbar, Iraq. med.raed.alani2003@uoanbar.edu.iq
Received: March 19, 2025 Revised: April 15, 2025 Accepted: May 24, 2025 Published online: September 9, 2025 Processing time: 89 Days and 19.5 Hours
Abstract
BACKGROUND
Measles is a highly contagious disease that caused by a measles virus. While measles vaccination is highly effective in preventing the disease, those who are unvaccinated or have not completed the vaccine series are at significant risk.
AIM
To assess the clinical characteristics and outcomes of measles in vaccinated vs unvaccinated children in Ramadi city.
METHODS
Clinically confirmed cases of measles at Al-Ramadi Teaching Hospital for Maternity and Children, identified between June and December 2023, were enrolled in this prospective cohort study. The cases were divided into two groups (vaccinated and unvaccinated). The clinical characteristics and outcomes were compared between unvaccinated and vaccinated children.
RESULTS
Of 289 kids, there were 222 (76.8%) children under 5 years old, and 161 (55.7%) boys. Around 2/3rd children were unvaccinated. Besides, only 5 (4.9%) kids from the vaccinated group received three doses. Fever, maculopapular rashes, and cough were the most common manifestations. Unvaccinated children had higher rate of developing complications (pneumonia and diarrhea with P values 0.001 and 0.01 respectively), longer hospital admission period (P value = 0.008), and the need for respiratory care unit (RCU) admission comparing with the vaccinated children (4 cases for unvaccinated group vs 1 case for vaccinated group).
CONCLUSION
Unvaccinated kids were associated with more complications, longer admission hospital stays, and RCU admission. We recommend that public health directors utilize artificial intelligence tools to help control future measles epidemics.
Core Tip: Measles is a preventive disease by vaccine. Outbreak of measles can occur due to decrement in vaccination coverage rate. We aimed to compare vaccinated vs unvaccinated children with measles regarding disease severity and outcomes. The most affected children are in the age group < 5 years (222/289) and boys (161/289). The majority of affected children are either non-vaccinated or incomplete vaccination. Children with unvaccinated status are more prone to develop complications, respiratory care unit admission, and longer hospital stay.
