Factors Associated with Measles Outbreak among Children below 5 Years in Oltepesi Location in Kajiado North Sub County

Abstract

Measles is a viral illness that has been demonstrated to be extremely contagious and to cause morbidity and death in both developing and industrialized nations but also one of the top vaccine-preventable diseases in the world. Kajiado has experienced several measles disease outbreaks before 2012 despite the FIC coverage of 80% slightly below the national coverage of 83% in the same year. The objectives of this study was to find out the factors contributing to measles outbreak in Oltepesi in Kajiado North Sub County despite the good immunization coverage and an existing cold chain system. The specific objectives of the study included: establishing the role of health worker knowledge on the cold chain management, finding out the contribution of immunization coverage data accuracy, determining the socio-economic & demographic characteristics of the care givers associated with measles outbreak and to ascertain the unvaccinated population factors on measles outbreak. This was a mixed method design which involved a mixture of retrospective case control study design of caregivers, quantitative, qualitative interview of facility staff and use of secondary data from the Kenya Health Information System (KHIS) for aggregate reporting and analysis, and the health facility records including the registers, tally sheets and reporting tools. Findings: A quantitative study was conducted to identify factors affecting vaccine cold chain management related to measles outbreak. The health facilities were sampled randomly. Approximately 14.7% had indicated that their child was below 9 months compared to 1.1% of the respondents who indicated that their second child was below the same age limit. Knowledge and awareness of measles was significant [x 2=7.021, p <0.05] as there were few respondents in Oltepesi who were not aware of the measles vaccine. The results were significant [x

2=7.72, p <0.05] while on query if child was immunized against measles before the year 2012 [x 2=6.684, p <0.05] thus knowledge and awareness of measles vaccine is important in eradication of measles as well as adhering to the measles vaccination schedule. Utilization of the growth monitoring services at the two areas was significant. On the coverage of immunization in 2012 and it was established that coverage was low i.e. In January and February 15.8% and 16.7% while in the months of May, June, October and November, there were no data on immunization in Oltepesi and thus coverage was zero. Conclusion: According to the study, there is a knowledge gap and a scarcity of health professionals who work in cold chain management, and mentorship on cold chain management is urgently needed to increase understanding and practice. Recommendations: In accordance with the Kenya Expanded Program on Immunization (KEPI) objectives, the Ministry of Health should keep stepping up immunization efforts nationwide. Data cleaning and audit is necessary as the data in the KHIS might be giving false indicators to the world about health as a whole. This should be done periodically within the health systems. In order to stop any measles outbreaks and advance toward the eradication of the disease, it is imperative that the County implement enhanced ways to increase health workers' awareness of vaccine cold chain management and attain high vaccination coverage nationally.