Spatial analysis of measles cases and vaccination coverage in the Somali region, eastern Ethiopia

Abdilahi Ibrahim Muse ^1,2* Mahdi Yonis Kayat ¹ Mohamed Harir Aden ¹ Jemal Beksisa Shuramu ³ Shikur mohammed ³ Musse Ahmed Ibrahim ⁴ Binyam Mohammedbirhan Berhe ⁴ Ahmed Abdi Kalinle ⁵ Sahardiid Abdilahi ²

• ¹ Regional Data Management Center for Health, Somali region Health Bureau, Jigjiga, Ethiopia
• ² Public health department, institute of health science, Jigjiga University, Jigjiga, Ethiopia
• ³ Ethiopian Public Health Institute, addis ababa, Ethiopia
• ⁴ Medicine department, institute of health science, Jigjiga University, jigjiga, Ethiopia
• ⁵ Public health emergency directorate, Somali region health bureau, Jigjiga, Ethiopia

Background: Measles is a major public health concern that causes morbidity and mortality among children. In 2019, measles incidence reached its highest level in 23 years, with low measles containing vaccine dose one coverage playing a vital role. It can be prevented by two doses of the measles vaccine, either alone or in combination with measles-rubella (MR), which is a low-cost strategy for lowering morbidity and mortality among children. Objectives: To conduct spatial analysis of measles cases and vaccination coverage in the Somali region, Eastern Ethiopia.Methods: This retrospective study was done by using public health emergency directorate measles data from 2022-2023 and four years (July 2019-July 2023) of vaccination data from district health information system version 2.36. After the data completeness and consistency were ensured, it was cleaned and recoded. STATA version 17 and QGIS version 3.38 software were used for the data analysis.Results: From 2022 to 2023, the disease affected more than 5930 people. The majority of the participants, 5260 (88.7%), were under the age of 59 months, with 3184 (53.7%) being male. Furthermore, the majority of residents were from Nogob 2238 (37.7%), Erer 1027 (17.3%), and Jarar 954 (16.1%). According to clinical symptoms, 5950 (100%) of the cases had fever, cough, and rash, and more than two-thirds, 4901 (82.6%), had complications. A measles vaccination coverage of 59.4% and a measles incidence of 0.087 per 100 people were found in the region.Conclusions: This study found a very low measles vaccination coverage. Furthermore, Nogob, Erer, and Jarar zones showed the highest measles incidence rate, respectively. It is recommended to strengthen routine immunization services according to the national vaccination agenda, categorize, and reach unvaccinated children through catch-up vaccination campaigns. A concerted effort should be made to improve MCV2 coverage in hard-to-reach areas of the region. Special focus should be given to vaccine cold chain management in the zone and its districts with high vaccination coverage but also a high measles incidence rate. An investigation should be done into the associated factors of the higher incidence despite its vaccination coverage.Keywords: Spatial analysis, measles, vaccination coverage, Somali region, Ethiopia