Determinants of Measles outbreak Among Under-five Children in Sewena District of East Bale Zone, Oromia Region, Ethiopia: unmatched Case-Control Study

Abstract

Background: Measles is a serious contagious, vaccine-preventable viral disease that primarily affects children under the age of five. In July 2022, a measles infection was detected in the Sewena districts of the East Bale zone. Objective: The aim of this study was to identify determinants of the measles outbreak in the Sewena district of East Bale Zone, Oromia region, Ethiopia, in March 2023. Method: Community-based unmatched case-control study was conducted among 360 under-five children with a 1:2 (case-to-control) ratio. Sample from each kebele allocated proportionally to the cases they reported and collected randomly, the cases from the line list, and the control from nearby households. Mothers/caregivers were interviewed using a structured questionnaire online data collection tool CSPro Data Entry 7.2.1, which was used to collect the data and stored it on the central server. It was then exported to Microsoft Excel and then imported into Stata version 14.0 for both data cleaning and analysis. Model fitness and multicollinearity were assessed accordingly. Variables with a p-value <0.25 in the bivariable analysis were entered into the multivariable analysis and those with a P-value <0.05 were considered statistically significant. The adjusted odds ratio with a 95% CI was used to measure the strength of the association. Result: The response rate was 342(95%). Male participants were 59(51.8%) among cases and 116(50.9%) of controls. The Mean age of the Cases and the controls were 26.9 (SD± 11.5) and 29.9 (SD±12.5) months respectively. A high proportion, of cases 87.7% and controls 98.2% caregivers responded as they knew about measles. The proportion of vaccinated cases and controls was 67 (59%) and 176 (77%) respectively. The odds of measles infection were higher unvaccinated children (AOR=7.31,95%CI=2.94-18.21), malnourished (AOR=9.93,95%CI=2.79- 35.35), who had contact with measles case (AOR=4.31, 95%CI=1.48-12.52) and who had travel history (AOR=6.8, 95%CI=2.44-19.24), were determinants of measles infection. Conclusion: Being un-vaccinated with the measles vaccine, having visible signs of malnutrition, having contact with measles cases, and travel history are determinants of measles infection. Strengthening routine immunization and continuous screening for malnutrition is very essential to minimize the effect of measles infection in children