Clinical Report: Hospitalization Patterns by Age During a Measles Outbreak in Rwanda

Overview

This study examines age-related differences in hospitalization duration among measles cases identified during the 2026 outbreak in Nyanza District, Rwanda, with implications for clinical management and outbreak response.

Background

Measles remains a significant public health threat, particularly in low- and middle-income countries, despite the availability of a safe and effective vaccine. Persistent immunity gaps, incomplete vaccination coverage, and health system challenges continue to contribute to recurrent outbreaks. In Rwanda, high routine measles-rubella vaccination coverage has substantially strengthened measles control, although declining second-dose coverage and localized immunity gaps remain concerns.

Data Highlights

• The outbreak occurred from February 16 to April 17, 2026.

• The analysis included 56 measles cases.

• Infants younger than 9 months accounted for 44.6% of cases, while individuals older than 15 years accounted for 25%.

• Local vaccination coverage in Nyanza District was reported as 97% for the first measles-rubella dose and 90% for the second dose.

• Time to hospital discharge differed significantly across age groups (log-rank P = 0.00049).

Key Findings

• Children aged 5-15 years had the most rapid discharge, with a median time to discharge of approximately 5 days.

• Children aged 15 months to 4 years had an intermediate hospitalization course, with discharge occurring around day 10.

• Infants younger than 9 months, children aged 9-14 months, and individuals older than 15 years had more prolonged hospital stays, with a substantial proportion remaining hospitalized beyond 15 days.

• Infants younger than 9 months represented the largest proportion of cases, reflecting vulnerability before eligibility for routine measles vaccination.

• The study supports age-targeted clinical triage and resource planning during measles outbreaks.

Clinical Implications

Age should be considered when planning clinical triage and healthcare resources during measles outbreaks. The prolonged hospitalization observed among infants highlights the importance of early recognition of complications in this group, while age-specific hospitalization patterns can help guide resource allocation and outbreak response.

Conclusion

Age was the strongest determinant of measles hospitalization duration in this outbreak, with infants experiencing significantly prolonged clinical courses compared with older age groups. The findings support age-aware clinical management, early recognition of complications in infants, and age-targeted triage and resource planning during future outbreaks.

Related Resources & Content

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