Measles containing vaccine coverage and factors associated with its uptake among children aged 24–59 months in Cherangany Sub County, Trans Nzoia County, Kenya

Introduction
Measles is a vaccine-preventable disease whose elimination depends on the measles-containing vaccine (MCV) coverage of ≥95% in the population. In 2020, Kenya reported 597 cases, an increase of 158 cases from those reported in 2019. This study aimed to estimate the measles vaccine coverage and factors associated with its uptake in Cherangany Sub County.

Methods
We conducted a cross-sectional study using cluster sampling in the Cherangany Sub County of Trans Nzoia County in May 2021. We enrolled eligible children aged between 24–59 months and interviewed their caregivers using a structured questionnaire. We conducted descriptive, bivariate, and multivariate analyses. We used Prevalence Odds Ratio (POR) at bivariate and adjusted POR (aPOR) at multivariate with their corresponding 95% confidence interval as the measure of association. We regarded the variables with a p-value of less <0.05 at the multivariate level as independently associated with immunization status.

Results
We recruited 536 eligible children. The median age of the participants was 39 months (Interquartile Range 31–50). The coverage was 96.6% (518/536) for MCV dose one (MCV 1), and 56.2% (301/536) MCV dose two (MCV 2). At the bivariate level, family monthly income (POR 2.32, 95% CI 1.14–4.72), child vaccination status for other scheduled vaccines (POR 0.21, 95% CI 0.07–0.66), caregiver’s level of education (POR = 1.82, 95% CI 1.29–2.57), knowledge of the vaccine-preventable diseases (POR = 0.55, 95% CI 0.38–0.80), and knowledge of the number of MCV scheduled doses (POR = 0.13, 95% CI 0.09–0.02) were significantly associated with MCV uptake. The Caregiver’s knowledge on the number of MCV scheduled doses (POR = 5.73, 95% CI 3.48–9.45) and children whose birth order was ≤5th born (POR = 0.5, 95% CI 0.22–0.95) were significantly associated with MCV uptake at the multivariate analysis.

Conclusion
The MCV 2 coverage was lower than the WHO recommended ≥ 95%. Lack of knowledge of the number of MCV scheduled doses and the child’s birth order in the family are factors associated with not being fully vaccinated against measles.

Recommendation
There is a need to strengthen the defaulter tracing system to follow up the children who default after receiving MCV 1, focusing interventions on the identified factors.