Abstract:
Measles is a major cause of death and complications among young children worldwide
despite the availability of a safe and effective vaccine. Annually over 158,000 cases of
mortality due to measles are reported globally, especially in Africa and Asia. In Kenya,
59 measles cases per a million populations were reported in 2011. Approximately 80
% of the children aged less than 5 years received a first dose of measles-containing
vaccine in Kakamega County in 2014. Second dose of measles-containing vaccine was
introduced in the routine immunization schedule in Kenya in the year 2013. A crosssectional
survey was conducted to determine the coverage, the factors associated with
uptake of second dose of measles-containing vaccine and reasons for not being
vaccinated with second dose of measles-containing vaccine among children aged 24-
35 months of age in Kakamega County. Multi-stage cluster sampling technique was
used. First, 30 clusters were selected using probability proportional to size with
replacement. Out of which 19 households were surveyed per cluster and data of the
youngest child aged between 24-35 months in a household collected. Univariate and
bivariate analysis was conducted on all variables. Prevalence odds ratios was carried
out at 95% confidence interval (CI), and two-tailed statistical significance was set at p
≤ 0.05. Variables with a p-value ≤ 0.10 were subjected to multiple logistic regression
model using backward elimination, dropping the least significant independent variable
until all the remaining predictor variables were significant (p-value ≤ 0.05). A total of
571 children were surveyed. The coverage of second dose of measles-containing
vaccine was 102 (17.9%) (95%CI = 14.9% to 21.3%). The mother’s or caretaker’s
awareness of the second dose of measles-containing vaccine, less than 30minutes taken
to immunizing health facility, uptake of Pentavalent 3 and at least two doses of
Vitamin A were significantly associated with the uptake of the second dose of measlescontaining
vaccine with the following prevalence odds ratios 14.46(6.94-30.15),
3.45(1.14-10.41), 2.73 (1.50-4.96) and 4.52 (2.69-7.58) respectively. The main
reasons cited for the children not receiving the second dose of measles-containing
vaccine were; lack of awareness of need to return for second dose of measlescontaining
vaccine 210(44.8%) and lack of awareness of need for immunization
67(14.3%). The second dose of measles-containing vaccine coverage and awareness
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of the need to return for immunization was very low in Kakamega County. Department
of Health in Kakamega Couny need to put in place strategies aimed at increasing
awareness on importance for second dose of measles-containing vaccine, conducting
outreach services in hard-to-reach areas and ensuring that there are no missed
opportunities for children who present themselves for other health services. A wider
study could be conducted to cover the whole Country.
