Abstract
Introduction
This study addresses the alarming resurgence of measles in the Mbandaka urban health zone, where annual outbreaks persist despite systematic vaccination efforts targeting children aged 6 to 59 months. With a reported measles morbidity rate of 0.6%, the region is lagging behind the global objective of measles elimination by 2030.
Purpose
The purpose of this study is to identify and analyse the key determinants responsible for the repeated measles epidemics in Mbandaka, with a view to enhancing the effectiveness of prevention strategies.
Methods
A quantitative, prospective, cross-sectional, and analytical approach was used. Data were gathered through household surveys in the urban-rural health zone of Mbandaka, with a focus on public health variables influencing measles vaccination coverage and infection rates.
Results
Several socio-demographic and cultural variables were significantly associated with measles incidence and vaccination status. Age emerged as a key determinant: adults aged 30–39 showed a strong positive association with vaccination uptake (β = 0.34, p < 0.001), whereas those over 39 years had a lower likelihood (β = -0.11, p = 0.034). Male respondents (β = 0.09, p = 0.003) and those with primary (β = 0.21, p < 0.001) or university education (β = 0.14, p = 0.005) were more likely to have vaccinated children. Conversely, divorced or widowed individuals were less likely to ensure vaccination (β = -0.26, p < 0.001). Religious affiliation also played a critical role: Kimbanguists (β = 0.27, p < 0.001) and Muslims (β = 0.17, p = 0.014) showed higher vaccination rates, while Pygmies were less likely to vaccinate (β = -0.33, p < 0.001). Ownership of a vaccination card (β = 0.14, p < 0.001) and residence in specific health zones (β = 0.49, p < 0.001) positively influenced coverage. Vaccine abandonment was mainly due to distance to health facilities (β = 0.17, p = 0.022) and forgetfulness (β = 0.11, p = 0.003).
Conclusion
Measles remains a major public health issue in Mbandaka. Addressing education gaps, improving healthcare access, targeting high-risk religious and ethnic groups, and strengthening vaccination outreach could significantly reduce epidemic recurrence in the region.
References
Demewoz, A., Wubie, M., Mengie, M. G., Kassegn, E. M., Jara, D., Aschale, A., & Endalew, B. (2023). Second dose measles vaccination utilization and associated factors in Jabitehnan District, Northwest Ethiopia. Dose-Response, 21(1), 15593258231164042. https://doi.org/10.1177/15593258231164042
Driwale, A. (2005). Dirty data: Disease surveillance in Arua District, Uganda. Health Policy and Development, 3(1), 54–67. https://doi.org/10.5281/hsd.v3i1.1055
Eshetu, D., Tosisa, W., Regassa, B. T., Gadissa, B. H., & Andargachew, M. (2024). Epidemiology of measles outbreaks, incidence and associated risk factors in Ethiopia from 2000 to 2023: A systematic review and meta-analysis. BMC Infectious Diseases, 24, 914. https://doi.org/10.1186/s12879-024-09828-6
Ilyas, M., Afzal, S., Ahmad, J., Alghamdi, S., & Khurram, M. (2020). The resurgence of measles infection and its associated complications in early childhood at a tertiary care hospital in Peshawar, Pakistan. Polish Journal of Microbiology, 69(2), 1–8. https://doi.org/10.33073/pjm-2020-020
Likulu, E. (2020). Déterminants de la faible adhésion des femmes enceintes au dépistage volontaire du VIH à Mbandaka [Undergraduate thesis, ISTM-Kinshasa].
Lomanga, L. J., Yambayamba, M., Mambu Nyangi, T., Mondo Belinda Ayumuna, T., & Bosomba, P. (2024). Facteurs associés à la survenue de la rougeole chez les enfants de moins de 5 ans dans la Zone de Santé Rurale de Lingomo, Division Provinciale de la Santé Tshuapa, République Démocratique du Congo, 2019–2022. Journal of Interventional Epidemiology and Public Health, 7(4), 8. https://doi.org/10.11604/JIEPH.supp.2024.7.4.1693
Luang, J. (2020). La rougeole dans le monde en l’an 2000. Médecine tropicale et démographie, 41, 1–3.
Makarenko, C., San Pedro, A., Paiva, N. S., Santos, J. P. C. D., Medronho, R. A., & Gibson, G. (2022). Measles resurgence in Brazil: Analysis of the 2019 epidemic in the state of São Paulo. Revista de Saúde Pública, 56, 50. https://doi.org/10.11606/s1518-8787.2022056003805
Mekonnen, Z. A., Gelaye, K. A., Were, M. C., & Tilahun, B. (2020). Timely completion of vaccination and its determinants among children in northwest Ethiopia: A multilevel analysis. BMC Public Health, 20, 908. https://doi.org/10.1186/s12889-020-08935-8
MSF. (2023). Épidémies de rougeole en RDC. Médecins Sans Frontières. https://www.msf.org/fr/rdcongo/epid%C3%A9mies-de-rougeole-en-rdc-une-lutte-sans-fin
Noori, N., Skrip, L. A., Oron, A. P., McCarthy, K. A., Proctor, J. L., Chabot-Couture, G., Althouse, B. M., Phelan, K. P. Q., & Trehan, I. (2022). Potential impacts of mass nutritional supplementation on measles dynamics: A simulation study. American Journal of Tropical Medicine and Hygiene, 107(4), 863–872. https://doi.org/10.4269/ajtmh.21-1083
OMS. (2015). Épidémie de rougeole en République Démocratique du Congo: L’OMS et l’UNICEF préoccupés par l’extension de l’épidémie dans l’ancienne province du Katanga. https://www.afro.who.int/fr/news/epidemie-de-rougeole-en-republique-democratique-du-congo-loms-et-lunicef-preoccupes-par
OMS. (2019). La surveillance intégrée de la maladie et la riposte dans la région africaine: Guide technique (2e éd.). https://www.afro.who.int/sites/default/files/2017-06/IDSR-Technical%20-Guidelines-2010_French%20_final.pdf
OMS. (2024). Rougeole. https://www.who.int/fr/news-room/fact-sheets/detail/measles

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.