Bangladesh gets first institutional measles treatment guideline

Bangladesh has taken a significant step towards strengthening measles management, as Holy Family Red Crescent Medical College (HFRCMC) today (16 June) launched the country's first-ever institutional Measles Treatment Guideline, a comprehensive, evidence-based protocol aimed at standardising the diagnosis and treatment of the disease.

According to a press release, the guideline was unveiled at a programme held at the college auditorium in Dhaka at 9am today.

While disease-specific institutional treatment guidelines are widely used in many countries, Bangladesh has lacked such structured frameworks at the institutional level. Healthcare professionals say the initiative marks a milestone in improving the clinical management of measles and its complications.

The event was chaired by Prof Dr K M Mozibul Haque, principal of HFRCMC. Health and Family Welfare Minister Sardar Md Shahadat Hossain attended as chief guest and described the initiative as an important contribution to the country's healthcare system.

Speaking at the event, the minister also pledged support for expanding hostel facilities, accommodation and other infrastructure for the medical college and hospital.

Special guests included Prof Dr Harun-Al-Rashid, president of the Doctors Association of Bangladesh (DAB); Dr Zahirul Islam Shakil, secretary general of DAB; Prof Dr Shahin Rahman Chowdhury, acting director of Holy Family Red Crescent Medical College Hospital; and Prof Dr Meherun Nessa, vice-principal of HFRCMC.

Assistant Professor of Community Medicine Dr Farhana Haque presented an overview of the institution, while Dr Sayem Mohammad, associate professor of medicine at HFRCMC, delivered the keynote presentation on the newly introduced guideline.

The 50-page document, comprising 14 clinical modules, was developed under the leadership of Dr Sayem Mohammad, FCPS Gold Medallist and MRCP (UK), who served as editor-in-chief.

According to the organisers, no hospital or medical institution in Bangladesh previously had a standardised, evidence-based protocol dedicated to the treatment of measles and its complications.

In his keynote presentation, Dr Sayem highlighted the resurgence of measles worldwide. Citing World Health Organization data, he said an estimated 10.3 million measles cases were recorded globally in 2023, resulting in around 107,500 deaths, 95% of which involved children under the age of five.

He noted that measles remains one of the most contagious infectious diseases, with a basic reproduction number (R₀) ranging between 12 and 18. According to the presentation, around 22 million children missed their first measles vaccine dose last year, while 46 million children have never received any vaccination.

Dr Sayem said measles cases continue to be reported across several divisions in Bangladesh, with urban slums and areas with low immunisation coverage among the most affected.

He added that, in the absence of a standardised treatment protocol, clinicians have often had to manage serious complications such as pneumonia, encephalitis and severe dehydration without uniform guidance.

The guideline introduces a three-tier clinical triage system, allowing patients to be categorised at hospital entry points for home management, isolation ward admission or emergency and intensive care treatment based on defined clinical criteria.

It also recommends immediate administration of Vitamin A at triage without waiting for laboratory confirmation and includes detailed protocols for managing measles-related pneumonia, encephalitis, seizures, eye complications and severe dehydration.

The document sets out infection prevention standards for isolation facilities, including the mandatory use of N95 respirators by healthcare workers, recognising that measles is an airborne disease.

The guideline further identifies several practices that should be avoided, including the use of corticosteroids in measles pneumonia, steroid eye drops in measles-related eye complications and plain dextrose infusions for severe dehydration.

HFRCMC has called on the government to consider adopting the guideline as a national measles treatment protocol. The institution also recommended incorporating isolation room requirements and infection control standards into hospital accreditation systems.

Among other recommendations, the guideline advocates expanding paediatric intensive care facilities at district-level hospitals, introducing routine immunity screening for frontline healthcare workers and establishing a real-time electronic disease surveillance system to accelerate outbreak reporting.

"Every measles death in Bangladesh is preventable. This guideline is our institution's commitment, we call on the government to make it the nation's," Dr Sayem said.

HFRCMC said the initiative reflects its broader commitment to improving medical practice, clinical training and patient care in Bangladesh.