Epidemiology of measles infection in rural Uttar Pradesh, India

Abstract

Introduction: Measles infection continues to be a significant public health problem among children, with a high attack and incidence rate in India. The objective of this study was to estimate the measles attack rate among children in rural disadvantaged communities in India, and identify factors associated with measles infections. Methodology: Using a convenient sample of 2,615 children aged 5 years and under residing in four villages in Kanpur district in Uttar Pradesh, we conducted a cross-sectional study with valid and reliable questionnaire to determine the measles attack rates. Sociodemographic and economic characteristics including age, gender, health care access, measles prevention, vaccination, and vitamin A supplementation were included in the study. Descriptive statistics were reported using frequencies and proportions. A multivariable logistic regression model was conducted to delineate the factors associated with measles infections in these children. Results: Overall 12% of children reported measles attacks during the past 12 months, and 23% reported taking vitamin A supplementation. Grade 2 and 3 malnutrition was significantly associated with increased measles infections, while vaccination coverage and compliance with Universal Immunization Program was associated with decreased measles attacks. Conclusion: Malnutrition was identified as a major factor for measles infections in these children. Study findings necessitate the need for appropriate policy measures and health education initiatives about the importance of adequate nutrition in children. In addition, study results contribute to ongoing efforts in measles vaccination coverage and high compliance for Universal Immunization Program among children in India.