Title : Measles outbreak linked to vaccine hesitancy among children and adults in Kasumbalesa, Chililabombwe district, Zambia (December 2024-February 2025)
Abstract:
Introduction
Measles, caused by measles virus which belongs to the paramyxoviridae family, remains a global public health problem, particularly in sub-Saharan Africa. Zambia continues to experience sporadic measles outbreaks, especially among anti-vaccination groups and in high-density areas. We investigated the demographic and clinical characteristics of cases; assessed knowledge and practices; and assessed vaccination status.
Methods
We conducted a case series study design and collected data from ten affected individuals using a structured questionnaire on Kobo Collect tool. A measles case was defined as any resident of kasumbalesa town in Chililabombwe district presenting with a fever and generalized rash, along with one or more of the following: cough, coryza or conjunctivitis from December 2024 to February 2025. We obtained both verbal and written consent from participants and received permission from provincial and district health offices to conduct the investigation. Data were analyzed using R software to generate proportions and frequencies of the cases.
Results
Ten active cases were investigated (four males, six females). Ages ranged from 3 months to 24 years, with a median age of 6 years and an interquartile range (IQR) of 3 to13 years. All ten cases belonged to the same family, which was part of a Christian denomination called Zion, known to rely solely on prayers rather than conventional medicine for treating illness. Seven cases (70%) had reported travel to the DRC before symptom onset. Nine (90%) had not received any measles vaccine, while one case (10%) was not yet eligible for the first dose. Both adults (100%) interviewed on knowledge and practice lacked knowledge about the under-five vaccination schedule, signs and symptoms of measles, and preventive measures to protect family members from contracting measles.
Conclusion
Findings suggest that religious beliefs may influence vaccine hesitancy, leading to measles outbreaks in certain communities. The high proportion of unvaccinated individuals and travel-related exposure highlight potential gaps in immunization coverage. Strengthening routine measles vaccination efforts and increasing targeted community education, particularly in high-risk religious groups, may help prevent future outbreaks.
