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Studies of Diarrheal Disease in Central America^*

VIII. Measles, Diarrhea, and Nutritional Deficiency in Rural Guatemala

Nevin S. Scrimshaw, Joao B. Salomon, Hans A. Bruch AND John E. Gordon^||

Measles in rural populations of Guatemala is a serious disease, mainly affecting children in the first three years of life. The most frequent complication was acute diarrhea, which occurred in half of patients less than five years old. In other communities of the same region, the ratio was as high as two-thirds. Diarrhea contributed to deaths and disability, and the more malnourished the child the more likely the association. Children with measles usually required several weeks to regain their preceding weight. Kwashiorkor was an occasional aftermath.

Within the limitations of small numbers, the age-specific death rate for measles of children under five years in a village where a daily food supplement of 15 grams of protein and 450 calories was offered, declined from 973 per 100,000 during May, 1950–April, 1959, to 286 per 100,000 during the test period, May, 1959–April, 1964. No measles deaths occurred among children receiving the food supplement at least 25% of the time. Death rates in a control village of a similar high order did not change. Neither village population had local medical service.

During the study period, case fatality among preschool children was 6.8% in the control village and 4.3% in the feeding village, despite an earlier average age at attack, and with 22% of eligible children not participating.

^* This work was supported by the Pan American Health Organization and Grant AM-4827 from the National Institutes of Health (U. S. A.). INCAP Publication I-366.

Professor of Nutrition and Head, Department of Nutrition and Food Science, Massachusetts Institute of Technology, Cambridge, Massachusetts.

Medical Epidemiologist, Division of Statistics, INCAP.

Acting Chief, Division of Statistics, INCAP.

^|| Senior Lecturer (Epidemiology), Clinical Research Center, Department of Nutrition and Food Science, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139.