Evaluation of epidemiological data on measles among children under-five years of age in Mogadishu hospitals during the period from 2020-2022 in Mogadishu, Somalia

Abstract

Measles remains a significant public health issue globally, particularly in children under five years in low-resource settings. Somalia experienced massive measles outbreaks, and the estimated 19,000 probable cases in 2017 were primarily among children under the age of five years. The study was undertaken to determine epidemiological data regarding measles among children aged under five years attending Mogadishu hospitals between 2020-2022, including case distribution, vaccination status, mortality, and how vaccination coverage relates to outcome. A retrospective descriptive cross-sectional study was conducted based on medical records of four central hospitals in Mogadishu: Banadir, SOS, Hamar-jajab District, and Daynile hospitals. Study populations comprised children under five years with a confirmed measles diagnosis and hospitalized within the provided time frame. Inclusion criteria were all children under five years with confirmed measles diagnosis and complete medical records, but incomplete record cases and lack of vaccination status were excluded. Sample size computation utilized Slovin's formula and provided 400 participants enrolled by purposive sampling. Data collection was by a line list structured to capture demographic characteristics, history of vaccination, admission dates, and clinical outcomes. Statistical analysis was by SPSS version 20 with descriptive statistics and chi-square tests used to establish the association of vaccination status with mortality outcomes. There were 212 (53%) males and 188 (47%) females, as indicated by the results. Age distribution indicated 120 (30%) children aged 1-2 years, being the highest proportion, followed by 93 (23.3%) aged less than one year. Vaccination was significantly low as 18 (4.5%) of the children were vaccinated and 382 (95.5%) were not vaccinated. Clinical outcomes were 390 (97.5%) that recovered and 10 (2.5%) that died. Chi-square analysis found no statistically significant correlation between vaccination and mortality (χ² = 0.524, p = 0.469), primarily due to small sample size limitations. However, that so many more unvaccinated than vaccinated children were hospital cases is proof enough that vaccines are extremely effective against serious measles that contributed to hospitalization. These findings underscore the urgent necessity for intensified vaccination activities and community mobilization in an effort to increase measles immunization coverage among at-risk populations in Mogadishu, thereby truncating morbidity and mortality rates among children under the age of five years. Keywords: Measles, Vaccination status, vaccination, Hospitals, Mogadishu, Somalia