Cross-sectional Survey on Parental Perception and Attitude on Measles Vaccine: Low Hospital Measles Case Presentation in Rural Area in Enugu, Nigeria

Abstract

Introduction: The incidence of measles has spiked in recent times despite the efforts to its eradication using a highly effective measles vaccine. Vaccine coverage and underreporting of cases are the major challenges to this effort. Aim: This study was designed to assess the parental knowledge of measles, attitude to measles vaccine and practice of case notification in a rural area in Enugu Nigeria. Materials and Methods: A descriptive cross-sectional study was carried out during a house to house campaign on measles in Ogwuagor (a rural area in Enugu, with frequent cases of measles like symptoms) between June to November 2019. A pre-tested self/interviewer’s administered questionnaire was used to assess the knowledge of measles while Parental Attitude on Childhood Vaccine (PACV) questions were adopted and used to assess the attitude of parents to the measles vaccine. The participants were parents of at least one child of above 12 months of age. The findings and scores were analysed using IBM SPSS Statistic software for windows (SPSS statistical software V.21 (IBM Corp. 2019). The age of the respondents was grouped, and the simple mean obtained. The associations of variables; number of children, level of education and last antenatal care with respect to knowledge and attitude were analysed using Chi-square and p<0.05 was regarded as statistically significant. Results: Out of 652 households in the area, 213 were assessed. One hundred and ninety three (90.6%) expressed knowledge above average about measles and measles vaccine. The score was higher among mothers who had at least three children in their household (p=0.518), tertiary education (p=0.706) and their last antenatal care in a hospital (p=0.774). Majority of the participants had good knowledge about symptoms, transmission and prevention of measles. Only about half, 114 (53.5%) knew the complication of measles. All the respondents had a positive attitude to the measles vaccine. Forty seven (22.1%) of the respondents delayed having their child get a measles shot while 31 (14.6) had concern on the efficacy of the vaccine. Forty-eight 22.5% were concerned about the side-effects of the measles vaccine. The delays having their child get a measles shot, concern on the efficacy of the vaccine, and concern about the side-effects of the measles vaccine observed were significant (p=0.0001, 0.0001, 0.0001, respectively) among parents of more than two children. Conclusion: There was adequate knowledge on measles symptoms, transmission and prevention but poor knowledge of the complication. Their attitudes on the measles vaccine were generally good however, the expression of delays having their child get a measles shot, concern on the efficacy of the vaccine, and concern about the side-effects of the measles vaccine were significant among parents of more than two children. Also, few measles cases were treated in hospital. There is a need to educate parents on the complication of measles and the importance of early hospital presentation of suspected cases for confirmation and prompt management. This will help to prevent complications and community transmission.