PriMera Scientific Medicine and Public Health (ISSN: 2833-5627)

Case Report

Volume 6 Issue 6

Factors Associated with Measles During Epidemics in There Tshopo, Democratic Republic of Congo, From 2013 to 2023

Franck d’Assise Mebwa Mohala*, Alliance Tagoto, Emmanuel Tebandite, Michel Saliki, Theophile Yanyongo, Samuel Bosongo and Joris Losimba Likwela

June 04, 2025

Abstract

Introduction: The objective of this study is to analyze the sociodemographic, environmental, health and political factors linked to measles during epidemics in the Tshopo province from 2013 to 2023.

Methods: A cross-sectional observational study based on retrospective data collection was conducted on confirmed measles cases between 2013 and 2023. A comprehensive sample of 3,739 confirmed measles cases from the literature review was used. Data were entered into an Excel sheet and analyzed using STATA®13 software.

Results: Individuals living in rural areas had a 3.07 times higher risk (p < 0.0001) of developing measles and were 28.1% less likely to be diagnosed than those in urban areas. Children under 5 years of age were 32.95 times more likely (p < 0.0001) to contract the disease. Males had a 1.14 times higher risk (p = 0.0001) than females. Vaccination status (Hazard Ratios: 0.7973) and good nutritional status (Hazard Ratios: 0.69) were associated with a significantly decreased risk of measles. The presence of complications was associated with a significantly increased risk of measles (2.6).

Conclusion: This study confirms the elevated risk in young children and highlights complex associations with vaccination status, nutritional status, complications, and residential environment. Survival analyses highlight the protective effect of vaccination against the development of complications and the negative impact of poor nutritional status.

Keywords: measles; associated factors; epidemic; Tshopo

References

  1. Misin A., et al. “Measles: An Overview of a Re-Emerging Disease in Children and Immunocompromised Patients”. Microorganisms 8.2 (2020): 276.
  2. Perry RT., et al. “Progress toward regional measles elimination--worldwide, 2000-2013”. MMWR Morb Mortal Wkly Rep 63.45 (2014): 1034‑8.
  3. Khan J, Shil A and Prakash R. “Exploring the spatial heterogeneity in different doses of vaccination coverage in India”. PloS One 13.11 (2018): e0207209.
  4. http://www.euro.who.int/en/media-centre/sections/press-releases/2019/over-100-000-people-sick-with-measles-in-14-months-with-measles-cases-at-an-alarming-level-in-the-european-region,-who-scales-up-response
  5. https://www.who.int/news-room/fact-sheets/detail/measles
  6. Benn CS and Aaby P. “Measles vaccination and reduced child mortality: Prevention of immune amnesia or beneficial non-specific effects of measles vaccine?”. J Infect 87.4 (2023): 295-304.
  7. “A Retrospective Investigation of a Measles Outbreak in a District in North-western Nigeria”. World Journal of Public Health.
  8. Noori N., et al. “Potential Impacts of Mass Nutritional Supplementation on Measles Dynamics: A Simulation Study”. Am J Trop Med Hyg 107.4 (2022): 863‑72.
  9. Aurangzeb B., et al. “Clinical Outcome in Children Hospitalized with Complicated Measles”. J Coll Physicians Surg Pak 15.9 (2005): 547-51.
  10. Hj L., et al. “Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: a systematic review of published literature, 2007-2012”. Vaccine 32.19 (2014).
  11. Leong WY. “Measles cases hit record high in Europe in 2018”. J Travel Med 25.1 (2018): tay080.
  12. One size does not fit all: local determinants of measles vaccination in four districts of Pakistan. BMC International Health and Human Rights.
  13. Márcia de Cantuária Tauil, Ana Paula Sayuri Sato and Eliseu Alves Waldman. “Factors associated with incomplete or delayed vaccination across countries: A systematic review”. Vaccine 34.24 (2016): 2635-43.
  14. World Health Organization Regional Committee for Africa Progress towards measles elimination in the African region by 2020: information document (2017).
  15. Vaccination coverage survey among children aged 6-23 months in the Democratic Republic of Congo. Study report from the Kinshasa School of Public Health (2022).
  16. Matondo FS., et al. “Determinants of measles outbreak in the city of Kinshasa, Democratic Republic of the Congo in 2022: A case-control study”. J Interv Epidemiol Public Health (2024).
  17. Strategic Measles Outbreak Response Plan: 2021-2023: Measles Outbreaks: Prevention, Preparedness, Response, and Recovery.
  18. Vincent Dossou Sodjinou., et al. “Epidemiological characteristics of a protracted and widespread outbreak in the Democratic Republic of Congo, 2018 – 2020”. Pan African Medical Journal (2022).
  19. Cristina Makarenko., et al. “Measles resurgence in Brazil: analysis of the 2019 epidemic in the state of São Paulo”. Rev Saude Publica (2022).
  20. Mogensen SW., et al. “Introduction of standard measles vaccination in an urban African community in 1979 and overall child survival: a reanalysis of data from a cohort study”. BMJ Open 6.12 (2016): e011317.
  21. Aaby P., et al. “Reduced childhood mortality after standard measles vaccination at 4-8 months compared with 9-11 months of age”. BMJ 307.6915 (1993): 1308‑11.
  22. Schneider EB. “The effect of nutritional status on historical infectious disease morbidity: evidence from the London Foundling Hospital, 1892-1919”. Hist Fam 28.2 (2023): 198‑228.
  23. Noori N., et al. “Potential Impacts of Mass Nutritional Supplementation on Measles Dynamics: A Simulation Study”. Am J Trop Med Hyg 107.4 (2022): 863‑72.