Risk factors for measles outbreak in Al-Dali Governorate, Yemen

Background: In addition to the recent civil war in Yemen, the COVID-19 pandemic resulted in a collapse of the health system, a decline in vaccination coverage, and the spread of numerous outbreaks. In 2022, a measles outbreak impacted Al Dali governorate. This study aimed to describe the demographics of measles patients, measles risk factors, and disease outcomes in Al Dali Governorate, Yemen. Methods: All measles-infected children who sought medical attention at Al Tadhamon Hospital in Al Dali, Yemen, between February and December 2022 were included in this prospective and observational study. Results: During the study period, 154 parents gave their consent to enroll their children in this study; 88 (57.1%) were males, and 66 (42.9%) were females. The mean age of the children was 3.56±2.90 (0.3–12 years). More than half of the mothers (n=88, [57.1%]) were illiterate or had a basic educational level, while most of the fathers (n=126, [81.8%]) were well-educated. Nutritional status was normal in most children (n=146, [94.8%]), and all children were unvaccinated. Most children (n=152, [98.7]) came from areas having measles and most of them (n=130, [84.4]) were in contact with measles cases. Health facilities were close (<3 km) to many children (n=151 [98.1]), and house ventilation was good in 66.2% (n=102) of cases while crowdedness was found in 135 (87.7) cases. Family members were 7 or more in 90 (58.4) cases. Two children under the age of 5 years died because of the disease. Conclusion: Our study showed that the main risk factor for the recent measles outbreak in Al Dali governorate was lack of vaccination, as all involved children were unvaccinated. Routine immunization needs to be reinforced through health centers in different districts and community education about the dangers of the disease and the benefits of the vaccines should be enhanced to prevent outbreaks from recurring.