Prevalence of Drop out and associated factors in Measles immunization among children in Kanyakumari District, Tamilnadu, India.

Download Article

DOI: 10.21522/TIJPH.2013.04.02.Art059

Authors : Alber M Mathiarasu, Pethuru Devadason, Usha Devi Karunakaran


Introduction: Measles is the main cause of childhood morbidity and mortality and highly prevalent worldwide. Over the last 15 years there has been a general decline in all the reported Vaccine Preventable Diseases in India but the decline in measles incidence is far below the expected level. WHO targets measles next to polio for eradication.

Objectives: 1) To determine the immunization coverage in measles in Kanyakumari district and 2) To identify the factors associated with Drop outs.

Methodology: This is a community based cross sectional study conducted in whole Kanyakumari district in Tamilnadu, India from June 2012 to May 2013 with 210 children in the age group between 12 and 23 completed months selected by 30 x 7 cluster sampling method. Structured pre tested Questionnaire was used to collect data. 

Results:  Mean age of the children was 18.1 ± 3.1 (SD) months. Out of 210 children, 171 children (81.4%) were immunized for measles vaccination. 64.9% vaccinated in Government facility and  35.1% of children in private setup. Forgetfulness due to longer timegap between OPV/DPT 3rd Dose and Measles vaccine was the most common factor for drop out constituting 25.6%.  Area of Residence, Marital Status of the parents, Total Income, Distance and the Availability of Immunisation card are the significantly associated with Dropouts. 

Conclusion: The prevalence of dropout is 18.6%. Forgetfulness, Area of residence, Marital status and Income of parents, Distance, Availability of immunization card were the significant factors associated with Drop outs.


[1.] Abhishek Kumar, S.K. Mohanty. (2009). Understanding the Factors Associated with slow Progress in Childhood Immunisation in India. Paper Submitted in XXVI IUSSP International Population Conference in Marrakech, Morocco. 2009.

[2.] Akhalesh Kumar Shakya, Vibha Shukla, Harjeet Singh Maan, Tapan N Dhole. (2012). Identification of different lineages of measles virus strains circulating in Uttar Pradesh, No rth India. Virology Journal, 9:237  DOI:10.1186/1743-422X-9-237.

[3.] Bhagyalaxmi A, Kedia G, Rawal VS. (2007). Study of incidence of measles and vaccination coverage in Ahmedabad urban slums. Indian J Public Health 2007;51(1):52-53.

[4.] DLHS 2007-08. District Level household and Facility Survey 2007-08. Fact Sheets India. Ministry of Health and Damily Welfare, Nirman Bhavan, New Delhi 110011.

[5.] Freeman PA, Thomason JA, Bukenya GB, (1992). Factors affecting the use of immunization among urban settlement dwellers in Papua New Guinea. PNG Med J. 1992 Sep; 35(3) : 179-85.

[6.] Gregory A. Poland, Robert M Jacobson. (2012). The Re-Emergence of Measles in Developed Countries: Time to Develop the Next-Generation Measles Vaccines? Vaccine Jan 5, 2012; 30(2): 103–104.

[7.] Hussen Mohammed, Alemayehu Atomsa. (2013). Assessment of Child Immunization Coverage and Associated Factors in Oromia Regional State, Eastern Ethiopia. Science, Technology and Arts Research Journal .Jan-Mar 2013,2(1): 36-41.

[8.] Kishore J. (2011). Reproductive and Child Health Program –II. In: J. Kishore (Editor), National Health Programs of India, 9th Edition. Century Publishers, New Delhi, 2011: 155-160.

[9.] National Rural health Mission 2014. Disease Alerts /Outbreaks Reported and Responded to by the States / UTs through IDSP 22nd week 2014. Ministry of Health and Family Welfare, Nirman Bhavan, New Delhi -110011. Available at: Accessed on 02 June 2014.

[10.] Niyi Awofeso, Anu Rammohan, Kazi Iqbal. (2013). Age-appropriate vaccination against measles and DPT-3 in India – closing the gaps. BMC Public Health, 13:358  DOI:10.1186/1471-2458-13-358.

[11.] Owino LO, Irimu G, Olenja J, Meme JS. (2009). Factors influencing immunization coverage in Mathare Valley, Nairobi, East Afr Med J. 2009 Jul; 86(7) 322-9.

[12.] Pushpa Narayan. (2011). TN moms to get cash for vaccines. The Times of India (Chennai Edition), Aug 1, 2011. Availabel at Accessed on 20 Feb 2014.

[13.] Rajesh Vaidhya. (2009). Measles. In: RajVir Bhalwar, Chief Editor, Text Book of Public Health and Community Medicine, First Edition, New Delhi, AFMC, 2009: 1089-92.

[14.] Rup Kumar Phukan, Manash Pratim Barman, Jagadish Mahanta. (2009). Factors Associated with Immunization coverage of children in Assam, India : Over the first year of life. Journal of Tropical Pediatrics. Volume, 55, Issue 4 : Pp. 249 – 252.

[15.] Singh P, Yadav R.J. (2000). Immunization status of children of India. Indian Pediatrics; 37: 1194–1199.

[16.] Surender N Gupta, Naveen Gupta. (2009). Two highly immunized hilly areas versus double measles outbreak investigations in district Kangra, Himachal Pradesh, India, in 2006. Public Health Research; 1(1): 14-20.

[17.] UNICEF - Coverage Evaluation Survey 2009: National Fact Sheet. Ministry of Health and Family Welfare, Nirman Bhavan, New Delhi – 110011.

[18.] VK Desai, SJ Kapadia, Pradeep Kumar, Siddharth Nirupam. (2003). Study of Measles Incidence and Vaccination Coverage in Slums of Surat City. Indian Journal of Community Medicine Vol. XXVIII, No.1, Jan.-Mar., 2003. 10-14.

[19.] World Health Organization. (2014). Fact Sheet – Measles, Fact sheet N°286, Updated February 2014. Available at: /factsheets/fs286/en/ accessed on 23 March 2015.