Bella Ainur Rokhma, Qiara Hasna Azzahro, Lucia Yovita Hendrati

FACTORS AFFECTING SUSPECTED MEASLES IN TODDLERS IN KEDUNGWARU DISTRICT, TULUNGAGUNG REGENCY IN 2023

Introduction

Factors affecting suspected measles in toddlers in kedungwaru district, tulungagung regency in 2023. Discover factors influencing suspected measles in Kedungwaru toddlers (2023). Timely immunization, maternal knowledge & attitudes are significant. Room density & ventilation show no impact.

Abstract

Background: Measles cases worldwide are still a serious concern, especially the increasing mortality rate. In 2021, 128,000 people lost their lives due to measles, and the number increased to 136,000 in 2023, with the highest death rate in toddlers. Purpose: To determine the relationship between the timeliness of measles immunization, maternal knowledge, and maternal attitudes towards suspected measles in toddlers in Kedungwaru District, Tulungagung Regency. Methods: A case-control study design was used, with a sample of 42 toddlers: 12 in the case group (measles suspects) and 30 in the control group (not measles suspects). Data were analyzed using bivariate binary logistic regression to examine the relationship between each independent variable and the dependent variable, and multivariate analysis to identify the variables most strongly associated with the incidence of measles suspects. Results: There is a significant effect between the timeliness of measles immunization, maternal knowledge, and maternal attitudes towards the incidence of measles suspects (p-value=0.02; OR=6.00 for timeliness of immunization; p-value=0.03; OR=5.18 for maternal knowledge; p-value=0.02; OR=5.50 for maternal attitudes). However, the children's room density variable (p = 0.31) and ​​the ventilation area in children's rooms (p=0.50) do not show a significant effect. Conclusion: The timeliness of measles immunization, maternal knowledge, and maternal attitude have a significant effect on suspected measles in toddlers, with the timeliness of immunization as the most dominant factor, while child's room density and the width of the room's ventilation do not have a significant effect.

Review

This study addresses a critically important public health issue: factors contributing to suspected measles among toddlers, particularly given the recent global increase in measles mortality. The researchers employed a case-control design to investigate the relationships between immunization timeliness, maternal knowledge, maternal attitudes, and suspected measles in Kedungwaru District. The findings highlight significant associations, indicating that timely measles immunization, adequate maternal knowledge, and positive maternal attitudes are protective factors against suspected measles. The use of bivariate and multivariate binary logistic regression to analyze the data is appropriate for this type of epidemiological investigation, and the identification of immunization timeliness as the most dominant factor provides a clear actionable insight. While the study tackles a relevant problem and identifies important associations, several methodological limitations warrant consideration. The most notable concern is the small sample size, consisting of only 42 toddlers (12 cases and 30 controls). This limited sample size significantly constrains the statistical power, potentially leading to unstable odds ratio estimates and limiting the generalizability of the findings, especially for multivariate analysis. Furthermore, the abstract refers to "suspected measles" without detailing the diagnostic criteria, which could introduce variability or misclassification bias if a standardized case definition was not rigorously applied. The lack of significant effect for children's room density and ventilation area, while reported, might also be influenced by the insufficient sample size rather than a true absence of association. Despite these limitations, the study offers valuable insights into key modifiable factors influencing suspected measles incidence in the study area. The confirmation of immunization timeliness, maternal knowledge, and attitude as significant determinants underscores the need for targeted public health interventions focusing on improving vaccination uptake and enhancing parental awareness and positive health behaviors. Future research would benefit immensely from a larger-scale study with a more robust sample size to confirm these findings and improve generalizability. Additionally, future studies could explore the specific barriers to timely immunization and effective strategies for improving maternal knowledge and attitudes, thereby contributing to more effective measles control and prevention efforts in similar settings.

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