Epidemiological Investigation of Measles Outbreaks in Somalia: A Retrospective Study

Abstract

Background: Measles has been a significant and persistent public health challenge in Somalia, with frequent outbreaks reported across the country, which is grappling with a complex humanitarian crisis, decades of political instability, and recurrent natural disasters. This study aimed to assess the epidemiology of measles by examining the affected individuals' outcomes, laboratory results, and demographic characteristics. Methods: We conducted a retrospective study analyzing measles cases reported to the National Public Health Reference Laboratory across various states in Somalia, from January to June 2024. We then employed rigorous data analysis using SPSS version 26. Results: Of the 1266 suspected measles cases received at the laboratory, 58.4% were confirmed as measles positive. The highest attack rate was observed in children under 1 year old, with 133 cases per 100,000 individuals. Males accounted for 57.4% of the cases, with an attack rate of 155 cases per 100,000 individuals. Overall, 98.3% of the cases were unvaccinated individuals. The highest number of cases was reported in the states of Banadir, Hirshabelle, and Galmudug, accounting for 32.6%, 20.5%, and 19.6%, respectively. The sex of the children was statistically associated with measles (p-value = 0.026), while age was also statistically significant (p-value = 0.001). Conclusion and Recommendations: These findings indicate a significant measles outbreak, particularly among unvaccinated individuals, with children under 1 year old being the most vulnerable. Males showed a higher attack rate compared to females. To mitigate future outbreaks, health authorities should focus on intensifying vaccination campaigns in the most affected regions and age groups. Strengthening healthcare infrastructure and raising public awareness about the importance of vaccination are also essential to prevent future outbreaks and improve public health.