Factors Associated with Measles Occurrence among Children Aged 6 Months to 10 Years in Ludimbi Health Zone, Lukula, Democratic Republic of the Congo, 2016–2022: A Case-Control Study.

Abstract

Introduction: Measles remains a major cause of childhood morbidity and mortality in Africa. In the DRC, recurrent outbreaks reflect insufficient and uneven vaccine coverage, especially in rural areas. This study aimed to identify factors associated with measles resurgence among children aged 6 months to 10 years in Ludimbi Lukula Health Zone from 2016 to 2022.

Methods: A case-control study was conducted with 300 measles cases and 600 controls. Data were collected via KoboCollect from parents. Variables included vaccination status, nutritional condition, medical history, living conditions, and education level. Chi-square tests and logistic regression were used for analysis.

Results: Cases were concentrated in the Bemane (23.7%) and Luanga (19.7%) areas. Acute malnutrition was more prevalent among children with measles (54.3%) compared to those without (49.0%), with increased severity in boys and infants under one year old . Children from poor households were particularly vulnerable (35.0%). More than 90% of mothers were aware of measles, primarily through health workers, and considered vaccination the main form of prevention. Several factors were identified: health area, education, occupation, financial resources, age, and vaccination status, with the risk being four times higher among unvaccinated children.

Conclusion: Measles occurrence was associated with nutritional, socioeconomic, vaccination, and health-system-related factors. Integrated public health actions are needed to strengthen vaccine coverage, improve nutritional care, and include vulnerable populations in prevention strategies.