ASSESSMENT OF FACTORS ASSOCIATED WITH MEASLES OUTBREAKS IN ZARIA LOCAL GOVERNMENT AREA (LGA) KADUNA STATE, NIGERIA

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dc.contributor.authorDALHAT, MAHMOOD MUAZU
dc.date.accessioned2014-02-18T11:03:10Z
dc.date.available2014-02-18T11:03:10Z
dc.date.issued2012-09
dc.descriptionA THESIS SUBMITTED TO THE POSTGRADUATE SCHOOL, AHMADU BELLO UNIVERSITY, ZARIA, NIGERIA IN PARTIAL FULFILLMENT FOR THE AWARD OF MPH – FIELD EPIDEMIOLOGY DEPARTMENT OF COMMUNITY MEDICINE, FACULTY OF MEDICINE, AHMADU BELLO UNIVERSITY, ZARIA, NIGERIA SEPTEMBER, 2012.en_US
dc.description.abstractMeasles is a highly contagious vaccine preventable viral infection. Immunisation coverage as low as 20% were reported in Nigeria. Consequently, 30, 194 and 256 outbreaks of measles were reported in 2006, 2007 and 2008, respectively. Identifying socio-demographic factors predisposing to measles could provide strategies for measles control at community level. We conducted a community survey to determine factors related to measles disease in households in Zaria LGA. An unmatched, case-control study was conducted. A case was defined as any child who was diagnosed by a health worker in a health centre, between June, 2006 and June, 2011. Controls were children from the same neighborhood who did not have a child with past history of illness suggestive of measles (fever and rash). A multi-stage sampling technique was used to select 140 cases and 140 controls. An interviewer-administered questionnaire was used to collect demographic information and risk factors for measles. Anthropometric measurements of assenting children were taken. Malnutrition was defined as ≤ 2 standard deviation away from the WHO recommended Z-score table of weight for height. Independent risk factors for measles was determined by bivariate and multivariate analyses. The study was complemented with a KII with the persons in charge of routine immunization (RI) in all the 12 health care facilities in Zaria LGA that received RI antigens from local authorities. An observation checklist was completed by interviewers to assess availability of required facilities for RI delivery. A total of 72 cases (51%) and 60 controls (43%) were females. Median ages for cases and controls were 42 months (range: 10 – 156) and 36 months (range: 9 – 108), respectively. Of the 216 children assessed, 95(44%) were malnourished. Malnourished children [OR =1.9; 95% CI: 1.1 - 3.3)], failure to achieve DPT3 coverage [OR =2.3; (95% CI: 1.4 - 3.7)], lack of formal education [OR =1.9; (95% CI: 1.1- 3.1)], maternal age >35yrs [OR =1.9; (95% CI: 1.1 XIII - 3.2)], spending <150 naira on transport per vaccination visit [OR =2.3; (95% CI: 1.3- 4.1)] and mother’s income <1000 naira ($7.0) per month [OR =2.1; (95% CI: 1.3 - 3.5)] were statistically significant risk factors for measles disease on bivariate analysis. Multivariate analysis revealed failure to vaccinate for measles [AOR =2.3; (95% CI: 1.1 – 4.7)], failure to achieve DPT3 coverage [AOR =3.3; (95% CI: 1.7 – 6.4)], mothers earning <1000 naira ($7.0) per month [AOR =2.1; (95% CI: 1.3 – 3.5)], spending <150 naira ($1.0) per vaccination visit [AOR =2.4; (95% CI: 1.2 - 4.6)] as independent risk factors for measles disease. A total of 12 KII were conducted. At least 7 respondents agreed that measles outbreaks were frequent (≥1/year). All health facilities reported stock outs within the previous 6 months prior to the study. Measles vaccine was among the vaccines unavailable during stock out in 4 of the facilities. No measles vaccine was available in half the facilities during the evaluation. All the facilities cited as major challenges to RI frequent stock outs of vaccine and poor parents’ awareness on importance of vaccination. Other challenges cited were poor facilities for cold chain maintenance, absence of feedback from reports sent to local authorities, and lack of staff training on RI delivery. All the respondents recommended maintaining a consistent supply of RI antigens, improving public awareness on importance of immunization, provision of cold chain maintenance facilities and regular training of staff. Poor public health infrastructures, financial limitations among mothers and lack of awareness by parents in the study area could lead to poor RI delivery. Effective RI delivery, improved Health education and improving the socio-economic status of women could prevent measles outbreaks. Key words: Case-control, Measles, Nigeria, Risk factors, Vaccination.en_US
dc.identifier.urihttp://hdl.handle.net/123456789/1927
dc.language.isoenen_US
dc.subjectASSESSMENT,en_US
dc.subjectFACTORS,en_US
dc.subjectMEASLES,en_US
dc.subjectZARIA LOCAL GOVERNMENT,en_US
dc.subjectKADUNA STATE,en_US
dc.subjectNIGERIA.en_US
dc.titleASSESSMENT OF FACTORS ASSOCIATED WITH MEASLES OUTBREAKS IN ZARIA LOCAL GOVERNMENT AREA (LGA) KADUNA STATE, NIGERIAen_US
dc.typeThesisen_US
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