Measles Mortality in High and Low Burden Districts of India: Estimates of a Nationally Representative Study of Over 12,000 Child Deaths

Authors: Shaun K. Morris, Shally Awasthi, Rajesh Kumar, Anita Shet, Ajay Khera, Maryam Nakhaee, Usha Ram, Jose R.M. Brandao, Prabhat Jha



Direct estimates of measles mortality in India are unavailable. Our objective is, to use a nationally-representative study of mortality to estimate the number and distribution of, measles deaths in India with a focus on 264 high burden districts.


We used physician coded verbal autopsy data from the Million Death Study which surveyed, over 12,000 deaths in children aged 1 month to under 15 years from 1.1 million nationally, representative households in 2001–2003.


We estimate there were 92,000 (99% CI 63,000–137,000) measles deaths in children 1–59, months of age in India in 2005, representing a mortality rate of 3.3 (99% CI 2.3–5.0) per 1000 live, births and about 6% of all 1–59 month deaths. In children under 15 years of age, there were 107,000, (99% CI 74,000–158,000) measles deaths. The measles mortality rate was nearly 70% greater in girls, than in boys, and 60% of the deaths were in three populous states Uttar Pradesh, Bihar, and Madhya, Pradesh. The 1–59 month measles mortality rate in high burden districts was 4.48 (99% CI 3.94–5.02) compared to 2.40 (99% CI 2.28–2.52) per 1000 live births in other districts.


Measles killed over 100,000 children in India in 2005 and girls were at higher risk than boys. The majority of measles deaths occurred in a few states and high burden districts. The results of this study highlight the importance of focusing measles supplementary immunization activities in high burden districts. More


Morris, S.K. et al. 2013. Measles mortality in high and low burden districts of India: Estimates from a nationally representative study of over 12,000 child deaths. Vaccine. Availble online.