Impact of Measles Vaccination Coverage on Disease Severity Among Children Under Five Years of Age in Diyala Province, Iraq

Background: Measles is one of the acute and very contagious diseases for children, but it can be successfully controlled by vaccination.Objectives: To evaluate the impact of measles vaccination coverage on the severity of measles among children aged less than five years in Diyala Province, Iraq, during the year 2024 outbreak.Materials and Methods: A cross-sectional study was conducted from January to March 2024 at the Al-Batool Teaching Hospital, Baquba, Diyala, Iraq. Ninety-two children admitted with symptoms of measles underwent detailed clinical and serological examinations. We used descriptive, bivariate, and multiple logistic regression analyses to analyze the data. We set the statistical significance at a P-value of less than 0.05.Results: The total number of cases were 92 children with a mean age of 26 ± 2.46 months, and 44.6% were below 1 year old. Most of the children were unvaccinated (84.8%), severely infected (80.4%), and complicated with pneumonia (70.7%), with positive IgM antibodies for measles (83.7%). Multiple logistic regression analysis showed that children below one year of age [Odds Ratio (OR) = 7.909, 95% CI: 1.610 to 38.860, P-value = 0.011], unvaccinated (OR = 6.300, 95% CI: 1.489 to 26.657, P-value = 0.012), and those with low-educated mothers (OR = 4.013, 95% CI: 1.982 to 16.389, P-value = 0.035) were significantly associated with severe illness. Conclusion: During the year 2024 measles outbreak in Iraq, the severity of the illness was exacerbated among unvaccinated children aged below one year and those with low-educated mothers.