Measles revisited: across-sectional descriptive study of factors associated with clinically diagnosed measles infection in children admitted to Kenyatta National Hospital.

Abstract

Measles incidence has been reported to be significantly high with outbreaks being reported in several Kenyan districts despite continued measles immunization. Measles vaccine failure remains a significant problem. Measles cases in the under 9 months old children are frequently being reported. Factors that may be contributing to the persistent occurrence of high numbers of measles cases require evaluation to enable control and planned eradication of the disease. A cross-sectional descriptive study was carried out from January to July 2002 to determine the prevalence of measles vaccine failure, unimmunized under 9 months old, missed measles immunization opportunities and malnutrition states among children presenting to KNH with acute measles. A total of 92 children with measles were evaluated. The key informants were the parents or guardians and available hospital records. The results were as follows: Regarding immunization status, 61/92 (66%) had not been vaccinated against measles, 29/92 (32%) had received measles vaccine regarded as vaccine failure and immunization status was unknown for 2 (2%) of the children. Among the 61 unimmunized children, 30(49%) were under 9 months old while 27(44%) were 9 months or older constituting missed measles immunization opportunities. The missed immunization opportunities included 13 children

with nosocomial measles and 14 cases who had their measles immunization deferred by health workers. Malnutrition was prevalent among children with measles, 48(52%). We conclude that contraction of measles before the age of 9 months, measles vaccine failure and missed measles immunization opportunities were frequent contributing factors to occurrence of measles in children hospitalized at KNH with acute measles. There is need for consideration of introduction of immunization facilities in PFC, establishment of infectious disease isolation units to limit nosocomial measles, continued education of health workers and further research to evaluate causes of vaccine failure.