Uptake of Second Dose of Measles Vaccine Among Children in Kakamega County, Kenya

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 xv 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.