Immunisation is one of the most cost effective public health interventions
that provide protection against infectious diseases. The purpose of this
study was to assess and describe the measles immunisation status and
vaccine management in the Engela district.
A descriptive, cross-sectional study was conducted using a proportionate
and systematic sampling technique. A structured administered interview
to participants, supplemented with an observational checklist to assess
measles coverage, vaccine and cold chain management. The data was
analysed using Epi Info.7 software and setting p-values of 0.05 for
statistical significance.
A total of 162 parents/caregivers of the children aged between 9-59
months were interviewed and 17 public health facilities were assessed.
The median age of children was 24.5 months and 88 (54.3%) were males.
The majority of children 155 (95.7%) had been vaccinated against
measles, with a 95% confidence interval of (91.3% - 98.3%). More
unvaccinated children were diagnosed with measles compared to the
vaccinated (28.6% vs 6.5%, p=0.029), and this could be attributed to
vaccine failure or improper management of vaccines and the cold chain.
Receiving information on immunization was associated with vaccination
(p = 0.0001).
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Fifteen (88%) of the health facilities had functional cold chain equipment
and vaccines that were stored at temperatures ranging between +2°C and
+8°C. The storage management of the vaccines however did not meet the
minimum storage requirements as backup systems were flawed in the
sense that gas cylinders or generators were not available for the
refrigerators in case of power outages. The coverage was also suboptimum
as 13 (76%) of the health facilities had a measles coverage of
less than 80%, and 8 (47.1%) had a dropout rate of more than 10%.
Recommendations were submitted to the Ministry of Health and Social
Services. The more important recommendations focused on reviving the
health education sessions, increasing the routine measles coverage and
reducing the dropout rate as well as improving the vaccine and cold chain
management.