Impact of Measles Immunization in Children Less Than Five Years of Age

IMPACT OF MEASLES IMMUNIZATION IN CHILDREN LESS THAN
FIVE YEARS OF AGE ‘A CASE STUDY OF SAFANA LOCAL
GOVERNMENT AREA’
BY
FATIMA ABDULHADI
18/HPKK/0
A RESEARCH PROJECT SUBMITTED TO THE DEPARTMENT OF
ENVIRONMENTAL HEALTH SCIENCES, COLLEGE OF HEALTH
TECHNOLOGY KANKIA IRO, KATSINA STATE
IN PARTIAL FULFILLMENT OF THE REQUIREMENT FOR THE
AWARD OF NATIONAL DIPLOMA IN HEALTH EDUCATION AND
PROMOTION
BY
WEST AFRICAN HEALTH EXAMINATION BOARD (WAHEB)

NOVEMBER, 2020
DECLARATION
I declared that this project has been written as my personal effort and the
research work has not been submitted anywhere, all information, literature
sources are acknowledged by references.
____________________ _______ ____________________

Fatima Abdulhadi Date
(18/HPKK/0)
ii
APPROVAL PAGE
The research title “Impact of Measles Immunization in Safana Local
Government Area” meets the regulations for the ward of Diploma in Health
Education and Promotion approved for contribution to the knowledge and
humanity.
_____________________________________
Mal. NuraSurajo Kankia Sign & Date
Project Supervisor
_____________________________________
Mal.Sanusi Umar Radda Sign & Date
Head of Department (HOD)
_____________________________________
External Supervisor Sign & Date
iii
DEDICATION
The research is dedicated to my parents and my friends for their support,
advice and encouragement in writing this project may Allah help us through
here and hereafter with Jannatul Firdausi. Amen
iv
ACKNOWLEDGEMENT
All praise be to Allah (SWT) the lord of the world, the beneficent the
merciful, peace and blessing upon his prophet Muhammad (SAW) and his
guidance to the rest of the world.
I would like to appreciate the guidance and direction of my project
supervisor Malam NuraSurajo Kankia, who sacrifices his time both during
and after the lecture in reviewing and correcting the write-up the final draft
was made through his patience and made through his patience and guidance.
My special gratitude goes to the members of staff in environmental health
department and the school at large.
I will also like to show my concern to my dear Alhaji Ahmad (Teeman,
Dady) and my sisters and Brothers Khadija, Aisha, Hauwa’u, Zainab,
Haruna, Hafiz, Kabir, Lawal, Sakina Abdulhadi and also will like to show
my appreciation to my biological daughtersRukayya and Sa’adiya.
I will not leave this opportunity to go freely without fulfilling all my thanks
to my lovely parents for the special good care love, understanding, education
and other needs including funds support and adopting any stress just because
of me. I have nothing in form of money of power to pay them beside saying
JakallahuBikhairanas well as praying for them. The guidance, repentance,
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forgiveness and blessing of Allah be upon them and may the Aljannatul
Firdausi be their final abode.
I will forget to show my appreciation, gratitude and thanks to Kankia Iro
School of Health and Technology, its students and all the staff of Kankia Iro
School of Health and Technology for their support and encouragement.
I will forget to show my appreciation, gratitude and thanksto Malam
MannirLawal (Mock), Malam Abdulhadi, HOD Sanusi Umar Radda, Former
HOD Environmental Health Malam TanimuShehu (TU), Malam Sani Aliyu
Runka (Student Affairs) with our noble and able Malam AbubakarSurajo
(Dodo), Malam ZakariYa’u, Malam Aminu Ali, with his colleagues and
lastly to all academic and non-academic staff of the school for giving me
advice and adopting my mistakes.
I will also like to express my gratitude to my friends for ever and
everSalimaTukur (Salmus), Sakina BBK BawaleBala, AsiyaLawal,
Halimatu Sani, Aisha Inuwa, UmmyKharouphy, Maryam Lawal, Bilkisu
Musa (Billy) and Fatima Abdullahi Umar (Namesake).
I will also like to express my sincere gratitude to people that supports me
during my school education. I will never ever forget you in my life
AbdullahiAhmad Galadima Ammar Ibrahim.
vi
TABLE OF CONTENTS
Cover Page i
Declaration ii
Approval Page iii
Dedication iv
Acknowledgement v
Table of Contents vii
Abstract ix
CHAPTER ONE
1.1 General Introduction 1
1.2 Objectives of the Study 4
1.3 Historical Background of the Study Area 4
1.4 Scope and Limitation of the Study 6
1.5 Statement of the Problem 7
1.6Significance of the Study 9
1.7 Research Questions 9
1.8 Research Hypothesis 10
1.9 Operational Definition of Terms 11
CHAPTER TWO: LITERATUREREVIEW
2.1 Literature Review 12
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CHAPTER THREE
3.1 Research Design 24
3.2 Sample and Sampling Techniques 24
3.3 Instrument for Data Collection 24
3.4 Validity and Reliability of the Instrument 25
3.5 Administration of the Instrument 25
3.6 Techniques for Data Analysis 26
CHAPTER FOUR
4.1 Data Analysis and Data Presentation 27
4.2 Test of Hypothesis and Analysis of Result 44
CHAPTER FIVE
5.1 Recommendations 51
5.2Summary and Conclusion 54
5.3 List of Abbreviation 56
5.4 Bibliography 57
5.5 Appendix 58
5.6 Questionnaire 71
viii
ABSTRACT
The research was undertaken to ineptly analyze the impact of measles

immunization in children under five years of age in Safana Local
Government Area of Katsina State. The objectives of the study was to
determine the age limit for measles infection in children, to ascertain the
preventability of measles infection among children of Safana Local
Government Area and to assess the level of communicability of the disease
in Safana Local Government Area and to explore the complication,
prevention and control of measles. A large amount of literature was sought
and reviewed in order to develop insight into the problem of measles; the
research design employed was survey utilizing a structured questionnaire of
20 items in order to gather data to answer the research questions and test
hypotheses. Result of the study was discussed, analyzed, interpreted using
contingency tables, frequencies and percentages. The researchers in the
area of study and pave a lighted way to the mangers and planners of health
care both at the local government and state level.
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CHAPTER ONE
1.0 Introduction
1.1 Background of the Study
The word measles come from 16th century severe problems most especially
among children under the age of 5 years mostly in developing countries
which Nigeria is included measles can also be defined as a rubella disease
caused by virus specifically a paramyo virus of the germs called mobillirus
laid by Romsey Alison (1994). Measles is spread through respiration contact
with fluid from an infected persons nose and mouth either directly or through
aerosol transmitted or is highly contagious 95% of people are without sharing
a house with an Infected person will catch it .The incubation period usually
last for 10-14 days during which the symptoms sustained. Infected person can
remain contagious from the appearance of the first symptoms until 3 to 5 days
before rashes appears. Perry R. et-al (2004) state that clinical signification of
measles go as far back to at least 600 BC, however, then first scientific
description from small pox is attributed entitled book of small pox and
measles in (Arabic KitabFialsadariWa'alhasbah) in the past 150 years measles
has attributed death rate of about 200 million people worldwide estimates for
the annual mortality from measles very widely the David murphy (1998)
stated from ion 1954 the virus causing the diseases was isolated from an 11
1
years old boy form United State of America (USA) David Edmonton adopted
and propagated on click embryo tissue culture which lead to date 21 strain of
the measles virus been identified (diagnosis and treatment) measles virus
being leading to the availability of vaccine to prevent diseases from 1963. The
(WHO) which provide the public of the public of the fund for measles
campaign has reiterated that the plan to rid being threatened by such practice
and in fact might not be possible to attain on a visit to Nigeria. measles is a
significance Infectious disease whose rate of complication is very high
according to (WHO) 1990 vaccine fears could lead to unnecessary death
(WHO)and the united nation international children emergency fund
(UNICEF)in a Joint press release on disease control reported that global
immunization has cut measles from 871,000 in 1991 to one estimated 454,000
in 2004. The above achievement through major National Immunization
activities and better access of routine immunization the disease itself has
infected certain number of children with various complications. In under
developed nation with high rate of malnutrition and poor health care facility
rate 10% are common unlike in developing countries where the facility rate is
lower approximately on death per thousand. In patient the fatality rate 30%
measles is estimated to kill 674,000 children in developing countries annually
according to the UNICEF 1990.In Nigeria, government has just completed
2
Africa largest ever measles campaign in the effort to reduce measles death
and morbidity. UNICEF supported the week putting on the ground a budget
reaching it million. World health organization (WHO) and the red cross as
well as other members of measles international partnership also supported the
exercise showing a close statistic data from the federal ministry of health rate
of measles affecting the aged of five years were being reduce and recorded
due to level of Ignorance socio-cultural factors of families. (FMOH) federal
ministry of health public health department epidemiology division Abuja.
Release (2008) that statistical orientation of measles morbidity and mortality
that stand of the following
Year Mortality Morbidity

2006 2031 102100
2007 1143 73735
2008 1804 104069
2009 3742 217151
2010 1269 110242
2011 2294 169001
2012 1277 83343
2013 2925 1411738
2014 1294 82227
2015 3241 111108
After several rashes erupt usually on the face and upper neck, over about 3
3
days the rashes spread eventually reaching the hand and feet. The rashes last
for 5 to 6 days and then fade. On average, the rash occurs 14 days after
exposure to the virus within a range of 7 to 18 days. Most measles related
deaths are caused by complication associated with the disease. Serious
complication are more common in children under the aged of 5 or adults over
the aged of 30 the most serious complication include blindness encephalitis
(an infection that caused brain swelling) severe and related dehydration such
as pneumonia. Severe measles is more likely among the poorly nourished
young children especially those with insufficient vitamin A or whose immune
system has been weakened by HIV/AIDS or other diseases. Measles is still
common in many developing countries particularly in part of Africa and Asia.
The overwhelming majority (more than 95% of measles deaths occur in
countries with low per capital incomes and weak health infrastructure.
Measles outbreak can be particularly deadly in countries experiencing or
recovering from a national disaster or conflict damage to health infrastructure
and overcrowding in residential comes greatly increase the risk of infection.
Measles is a highly contagious serious disease caused by a virus before the
introduction of measles vaccine in 1963 and widespread vaccination major
epidemic occurred approximately every 2 to 3 years and measles caused an
estimated 2 to 6 million death every year, approximately 11000 people died
4
from measles in 2017 mostly children under the aged of 5 years. Despite the
availability of safe and effective vaccine measles is caused by a virus in the
paramyxovirus family and it is normally passed through direct contact the
respiratory tract then spread throughout the body. Measles is a human disease
and is not known to occur in animals. During 2000 to 2017, measles
vaccination prevented an estimated 21.1 million death. Global measles deaths
have decrease by 80% from an estimated 54,500 in 2000 to 110,000 in 2017.
Sign and Symptoms
The first sign of measles is usually a high fever which begins about 10 to 12
days after exposure to the virus and last it to 7 days. A runny nose, a cough,
red watery eye and small white spots inside the cheeks can develop in the
initial stage.
1.2 Historical Background of the Area of the Study
Safana Local Government area was created in 1889 by the former Head of
state and commander in chief of armed forces of the Federal Republic of
Nigeria General Ibrahim Badamasi Babangida (IBB) sequel to the Dasuki
report on Local Government. Safana is a Local Government Area in Katsina
State Nigeria. It is headquarters are in the town of Safana in the east of the
area at 120 24I30N 7024I25IE the western boarder of the area is shared with
5
Zamfara State and has two distinct Head Zamfara Katsina and Gatarin
Katsina. It has an area of 282km2 and a population of 183,779 at the 2006
census. Also Safana local Government is one of the serving 34 local
governments in the state. And has its administration seat located in Safana
town. The local government area fall under central senatorial district of
Katsina State consisting of 10 wards and ten councilors who represent the
wards. The incumbent executive chairman is the head of the council and is
responsible for the delegation of authority and representing the communities
under its jurisdiction in the state level.
LOCATION: Safana Local Government is situated in southern part of
Katsina State, it is bounded by Dutsin-ma Local Government, Kurfi Local
Government and Dan-musa Local Government, in the west it is west it is
bounded by Zamfara state where by in the north it is bounded by Batsari
Local Government.
EDUCATION: In term of education, Safana Local Government has both
primary and post primary schools there are (51) fifty one primary school and
(9) nine post primary schools, they are;
1. Government Pilot Secondary School (GPSS)

2. Community Day School Safana (CDSS)
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3. Government Day Secondary School Zakka
4. Government Day Secondary School Baure
5. Government Day Secondary School Babban-Duhu
6. Government Day Junior Secondary School Marina
7. Government Day Secondary School Tsaskiya
8. Government Day Junior Secondary School Gora
9. Government Day Secondary School Runka
HEALTH: Safana Local Government has reached a development stage in
terms of health care (PHC) department has forty one (41) dispensaries with
nine (9) PHC one (1) comprehensive and the primary health care (PHC)
department consist of six (6) units as listed below;
1. Disease control unit
2. Monitoring and evaluation unit
3. Essential drugs unit
4. Health education unit
5. Maternity and child health (MCH) unit
6. National program on immunization (NPI) unit
TRIBE: Tribe inhabitants of the Safana Local Government Area are
predominantly Muslims of Hausa and Fulani tribe. The two (2) main native
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languages spoken are Hausa and Fulfulde, although other languages like
English are spoken by the people who come to Safana town for Governmental
duties or business.
POPULATION: Safana Local Government has a total population of 183,207
as according to the national population census figures in the 2006.
EDUCATION: Safana Local Government in terms of education has three (3)
nursery schools and four (4) primary schools and two (2) secondary schools
both public and private and many Islamic schools in the town.
HEALTH SERVICES CONDITION: In its effort to dearly or totally
eradicate the spreads of killer diseases in the area, Safana local Government
has recorded ninety percent (90%) immunization exercise and immediate
control of gastroenteritis in the area. The local Government has one
comprehensive hospital at Safana clinic at Runka, Gora, Tsaskiya,
Kunamawa, Illela, Mai-kada and lots of others for preventive and curative
health services.
ADMINISTRATION: The local government has a chairman and vice
chairman and ten (10)councilors all elected. It has also a district head
(yariman Katsina hakimin Safana).
WEATHER: This varies according to the season generally it is cool in the

8
morning, hot in the afternoon and cool in the evening. Harmattan season is on
November to February, the month of April to may signal the arrival rainy
season which last to September. The major crops or types of cultivated are
beans, groundnuts Guinea corn etc.
COMMUNITY DEVELOPMENT: The people of Safana local government
area are generally hardworking community, they always rely on self-effort,
and they organized themselves in to community development without seeking
assistance from government or non-governmental organization to improve
living standards of their people. The people of Safana local government area
are peace loving as well as low abiding and knowing the value of health
,hence turn out in mass during the monthly environmental sanitation as
decreed by the federal government of Nigeria. Because, they agreed that
prevention is better and cheaper than euro as it requires minimum fund efforts
in contrast to when the disease has established itself fully.
AGRICULTURAL DEVELOPMENT: Safana local government is one of
the foods producing area is rich with partial land capable of producing both
cash and food crops in large quantity for the improvement of the standard of
living of the producers and their neighboring community. Notable among
these crops are maize, millet, groundnut, beans, cassava potatoes etc.
9
Animal rearing is another agricultural activity that the local government is
noted for. Adequate posture and drinking water couple with the nonexistence
of dangerous insect as tsetse fly males the area favorable for rearing animals.
COMMERCE AND INDUSTRIES: The people of Safana local government
has the attraction of natural forest reserve which accommodates a large
number of Fulani from different places of the state and even our neighboring
Niger republic called DAJIN RUGU and one natural spring water coming
under the big stone at Himi Northern part of Runka village.
1.3 Statement of the Problem
In the human endeavor, health is very important especially when considering
the life of continuity. Measles is an acute and highly contagious rare
respiration infection that caused by called morbilli capable of producing
epidemic. Measles is very common disease in the tropic. Hearing
complication and disability with death rate but predominantly disease men
with death rate at that research work is meant to find out the extent of this
infection in Safana local government area of Katsina state to produce or
eradicate possible occurrence of transmitting the disease, measles is spread by
direct contact with nasal secretion of infected person less frequently by
airborne transmission disease. Epidemiology; what? Who is at risk and why
10
(transmission) when? First sign of measles is usually a high fever which
begins about 10 to 12 days after exposure to the virus and lasts 4 to 7 days. A
runny nose, cough, red and watery eyes, small white spots inside the cheek
can develop in the initial stage.
1.4 Objective of the Study
1. To educate and highlight parent on the possible ways of contacting the
diseases.
2. To identify and exist the best measure to the taken in order to minimize the
rate of the infection among children of less than five years measles.
3. To stress the importance of health education to parent as to eradicate
culture practice taboos related to measles.
4. To assist the morbidity and mortality rate among children under five years.
5. To ascertain with the knowledge the community on the how treatment is
given to children.
1.5 Limitations
The study relates to Safana local government area to word due to time factors
for the study and financial problems that will enable for collecting data
research various words.

11
1.6 Scope of the Study
The research work is intended to lower the problem of measles infected in
relation to children between 5 to 9 years in Safana area in the first place the
research supposed to cover a large are beyond Safana local government area,
but due to financial constraints which affect transportation from one place to
another in order to acquire all necessary data needed for successful
implementation of the project, therefore the research has been limited to
Safana local government area which serve as a case of study.
1.7 Signification of the Study
The main important of this research work is to serve as identifier of problems.
Therefore, this piece of the research work after successful compiling it will
help government, NGOs, research work for further reference. And also much
effort is placed by government and non-governmental organization and health
workers are preventing the problem but not much rescue was observed. That
the application of the study finding will assist in allowing the care provision.
1.8 Research Question
1. Does measles has any aged limit in children?
2. Does measles has possible prevention measure of controlling the
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infection?
3. Can measles be a communicable or non-communicable disease?
4. Does measles disease caused by virus?
5. Does measles has any complication in children and adult?
1.9 Research Hypothesis
1. Yes measles has any aged in children.
2. Yes that measles has possible prevention measure of controlling the
infection.
3. That is say measles be communicable disease.
4. Yes measles disease is caused by virus.
5. Yes measles has complication in children and adults.
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1.10 Definition of Terms
1. Broncho pneumonia: This is the type of part mining that involves the
avail concentrated around the branch.
2. Coryza: Acute infection of the upper respiratory characterized by propose
discharge from nasal measles, sneezing, watering of the eyes.
3. Cough: Voluntary or reflex expulsive of air from the lungs.
4. Fever: Is the elevation of body temperature above the normal range.
5. Incubation period: It is the period between the day of infection and
appearance of the symptoms.
6. Infection: Invasion of disease causing organism in to the body where they
multiply and causes the disease.
7. Koplick: Small white spot which sometimes appear on the mucus
membrane before the general rashes appear.
8. Susceptible: This is the capability of individual being easily affected by
the diseases (infection).
9. Morbidity: Is a state of being with diseases.
10.Mortality: Is a state of being liable with diseases.
14
11.Infection: Is a successful invasion establishment of growth and
multiplication of an infectious agent in the tissue of the host.
12.Exo-erythrocytic: This refers to the development change of the parasite in
the parenchymatous cell of liver before the infectious of the erythrocytes.
13.Erythrocytic: Is the invasion and occurrence of development changes of
the parasite in the red blood cell (erythrocyte).
14.Schizogony: Is the sexual cycle of the parasite in human host.
15.Sporogony: These are infective forms of the parasites that are found in the
salivary gland of the measles virus.
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CHAPTER TWO
LITERATURE REVIEW
National Program on Immunization (NPI) in basic guide for routing
immunization service provides (2018) define measles as being caused by the
virus and they are highly infected i.e. very easily spreads. The disease is so
infections and fatal that consideration of such situation recognized by the
National Program on Immunization (NPI) target disease.
It is constantly present in some population and often occurs in epidemic
proportion in condition of overcrowding and poverty where large numbers of
non-immunized people are in close contact this stage is set for measles
epidemic.
The cause of measles is mean a pathophysiology by happening ranging from
pathophysiological organization being caused by virus, a measles of the
mobilli virus by the germs parasmyxo virus family leading to serve
complication particularly in children aged less than 5 years and adults aged
over 20 years.
Conceptual Definition of Measles
Margret D. (1979) defined measles as an acute virus contagious disease with
16
incubation period of 10 to 14 days. Measles is a highly contagious and acute
infectious disease caused by virus of genus mobilli virus family paramyxi
viridian, measles is a serious disease that caused fever and other complication.
measles is also called rubella, highly contagious but rare respiratory infection
cause by virus, causing total body skin rashes, United State of America
(USA) 1963 defined measles as highly contagious viral disease that can kill
more children through an uncommon disease in the United State of America
(USA) by the year 1963 a total of 242,000 children worldwide suffered from
the disease produce fever with temperature of 100 f (38.30c) generalized
rashes that cover three days caught, runny nose and red eyes or conjunctivitis.
The complication of measles infection results in death from inflammation of
the brain. Difference between measles and rubella it shall be noted in defining
and understanding. Rubella is the scientific name used for German measles a
different virus illness which is dangerous that can caused miscarriage and
total death.
Terms used to describe Measles
Other terms or names include hard measles red measles, seven days measles,
nine days measles and morbilli. Historically measles was known and
described as early as the 7th century. However the United State of America
(USA) stated that it was not until than the research first to prevent measles.
17
Before the vaccine was made available almost every child becomes infected
with the virus because it was not so easy for routing vaccination. There were
approximately 3-4 million cases of measles and 500 deaths due to measles
each year. There were initially two types of vaccine developed against
measles, one was developed from a virus that had been kill and a live measles
vaccine that was weak and cold no longer cause the disease, unfortunately all
the vaccine where not effective in preventing from getting the disease and
they were used to identified discontinue in 1967. A live virus vaccine modify
a number of times was identified in preventing the disease hence a live
attenuated vaccine was arrived at to prevent measles everywhere in the world.
Pathophysiology of Measles Virus
measles virus is among the genus mobilli virus, the virus live in the mucous
membrane, the other nose and throat of a child or adult is contagious from
four days before the rashes appear, when someone with measles cough,
sneezes or talk the infected droplet may also be a surface where they remain
active and contagious for several hour in infected child and contact the virus
by putting his fingers in his mouth or nose after touching the infected surface
one the virus get inside the body, it will typically grow in the cell that time
infected will separate through the body including the respiratory system and
the skin. When the virus gain entrance via inhalation it will settle down the
18
epithelial line of respiratory tract then set inflammation process which is
limited to the respiratory tract cause febrile condition sneezing, rashes,
redness of the eyes. Conjunctivitis then the virus spread to lymphocytes to
destroy immune system of that individual then it will follow the route to the
blood stream leading to viremia resulting to high body temperature, diarrhea,
vomiting and koplicks spot; if there is a good treatment and the nutritional
diet.
Clinical Features
National Program on Immunization (NPI) (2006) classified measles signs and
symptoms from incubation period of seven days to ten days having signs and
symptoms with high fever, runny nose cough red and watery eyes and so sots
inside cheek (koplicks spot) after several days slight raised rashes
development spreading from trace and upper neck to the body then to the
hand and teeth over a period of about 5 days it last for 5 to 6 days and fades.
Another author Parker, A. Staggs and Dayen W. et-at (2018) classify measles
as in various stages ranging from cathodal paroxysmal and stage of
desquamation, an implication of a (2018) of measles outbreak in India for
sustained elimination of mashes.in the United State of America (USA) report
of measles go as far back to at least 600 before Christ (BC) however the
19
scientific description of the disease and its distinction from small pore is
attributed to the person physician Ibn Razi (Rhazes) 860 – 932 who published
a book entitled the book of small pox and measles in Arabic in roughly the
last 150years. Measles has been estimated to have killed about 200 million
people worldwide.in 1954 the virus causing the disease was isolated from 11
years old boys from United States David Edmonton adopted and propagated a
chick embryo tissue culture.
License vaccine to prevent the disease became available in 1963.worldwide
health organization and the united nation international children emergency
fund (UNICEF 2016). Announced African region with the highest death from
measles.
World Health Organization (WHO) and (UNICEF) are trying to halt measles
death in Africa in comparison with the 200 toll by the end of 2006 through the
enforcing routine, measles immunization for at least 90 of under-five. The
two agencies is also aim to give all children aged between nine month and 14
years a second chance of vaccination.
An increase in number of state in Nigeria has been committed to make sure
children are immunized against measles. World Health Organization (WHO)
said (1999) Kano, Kaduna, Kebbi and Jigawa which are among the west hit
20
state, conducted special campaigns in February 2005 to protect child against
measles said by world health organization spokeswomen curcuma while
immunization have been carried out in the last an a regional basic Nigerian
government plan execute its first nationwide measles in December 2010
Table of Disease and Mentality Produced by Epidemiological Unit
Federal Ministry of Health [FMOH]
Year Morbidity Mortality
2006 102166 2031
2007 73735 1142
2008 164069 1804
2009 21715 3742
2010 110242 1269
2011 169001 2294
2012 83343 1277
2013 141738 2925
2014 82227 1294
2015 111108 3241
21
Diagnosis
The clinical diagnosis of measles requires of history of fever of at least three
days together with one good observation of koplick spot is also diagnosis pf
measles. Alternatively laboratory diagnosis of measles can be done with
confirmation of positive measles or isolation of measles virus from
respiratory specimen.
Positive contact with other patient known to have measles adds strong
epidemiology evidence to the diagnosis. There is no specific treatment or
antiviral therapy. For uncomplicated measles will recover with rest and
supportive treatments. Some patient will develop pneumonia as a sequel to
the measles. Historically a unique cell can be found in the para cortical region
of higher plastic hymphnode affected with the condition
Treatment
NPI basic guide on routine immunization in (2006) specified treatment for
measles. if measles is suspected a health care provider should be contacted.
The health care provider can confirm the diagnosis and provide home care
instrument to relieve the dis comfort of the symptoms.
Treatment of uncomplicated measles is symptomatic and supportive with anti-
pyretic fluid, calamine lotion and vitamin A administration which helps to the
22
complication of eye damage and blindness with measles should receive
vitamin A supplement as soon as they are seen at a healthy facility and second
dose should be given the next day.
1. Antibiotic for secondary bacterial infection
2. General nutritional support and the treatment of hydration with Oral
Rehydration Solution (ORS) may be necessary.
3. Encouraging children with measles to eat drink good nutritional status.
Age Immediately Diagnosis Next Day
Infant less than 6 month 50,000
Infant 6 – 11 months 100,00010 100,00010
Children 12 months plus 200,00010 200,00010
Complications
Complications with measles are relatively common ranging from relatively
mild and less serious hydration from diarrhea which may be a problem
especially in infants.
 Inflammation of the middle ear
 Pneumonia which is the most common cause of death associated with
23
measles
 Severe diarrhea
The complications are usually more severe amongst adult who catch the virus.
The fatality rate from measles for otherwise in healthy people in developed
countries is low; approximately 1 death per thousand cases in under
developed nations with high rate of malnutrition and poor health care taking
rate of low percent are common. In immune- comprised patients, the fatality
rate is approximately 80 percent.
Pneumonia occurs in up to 6 percent of reported measles cases and accounts
for 60 percent of death from measles. Encephalitis inflammation of the brain
can also occur. Other complication include convulsion (seizures).
The risk of complication varies with age infant under the age of 2 years and
adult over the age of 20 have a 20% to 30 % chance of complication often
requiring hospitalization school age children have a 3%, 5% chance of serious
complication.
Prevention
Measles can be prevented by immunization, about 95% of vaccinated person
are being protected with low dose and practically everyone is protected with
24
low dose.
All children should be vaccinated to protect themselves and other from
measles. the measles vaccine is part of the measles mumps rubella (MMR)
vaccine series given to children beginning of 12 months of age.
Measles vaccine made before 1929 may not have been as effective as vaccine
made today because of this, Doctors often recommend that person vaccinated
before 1980 receive another measles vaccination if there is measles outbreak
in the area especially if they are in school and have not received measles
vaccine for any reason. Children who were vaccinated with inactivated
vaccine.
Most children recover, eventually high mortality rate will be observed among
children who are malnourished or virus disinfect particularly in developing
countries. Vaccination remains the best protection against the measles. It can
be prevented also through public health education campaign.
25
CH APTER THREE
RESEARCH METHODOLOGY
Research Design
The study is design is used in order to answer the questions that will satisfy
the curiosity. It also solves the problem and establishes a course affective
relationship between the variables under study, i.e. effect of measles in
children between the age of 9months.
Area of Study
The area of study is Safana Local Government Area of Katsina State, it is
located in the northern part of Safana Local Government Area, thedistrict is
along the main road that leads to Safana. It has 10 political wards.
People in Safana district are mainly Hausa and Fulani by tribe and practice
Islam as their religion, other tribes across Niger Republic Area are also living
in the area.
26
They practice different types of occupation to sustain their life. Among the
noble ones are cash crops farming, producing species, tomatoes, onion,
cotton, carrot, groundnuts, millets, maize, guinea corn etc. and they also
engage in business as another source of income in terms of education, the
people of Safana district area are mostly illiterate. They have 51 both primary
and secondary schools.
Health and other social amenities of Safana District is lucky to have a health
inconformity with Primary Health Care (PHC) Department has 41
dispensaries with 9 PHC, 1 comprehensive and 1 cold chain office or store as
the headquarter, Safana Primary Health Care (PHC) department consist of
seven units. There is electricity and water supply in the district with other
wells and boreholes, the population of Safana Local Government Area as for
projection of 2006 census is 185,207.
Target Population and Universe of the Study
For actual and reliable information one hundred (100) respondents comprising
of Health Personnel of different cadre with various working experience where
considered for the study. They were selected within the area of study.
Sampling Techniques
27
The sampling technique is randomized or the selection is first serve criteria
adopted in the issuance of the instrument until the required number is
obtained.
Instrument for Data Collection
Closed structured questionnaire was used for data collection because of its
uniformity (appendix). The questionnaire was divided into two sections A and
B. Section A consists of personal data of the respondent while Section B
consists of the questions regarding the effects of measles infection, its causes
and how toprevent its future occurrence.
Validity and Reliability of Instrument
Instrument was designed to ensure validity of the study, object research
questions and information of patients records were considered in its design.
It was later taken to project supervisor for necessary corrections and
suggestions. The instrument was tested with a small sample of the target
population to ensure the reliability and validity for the research purpose.
Administration of Instrument
28
Administration the manner through which the instrument administered to
appropriate respondents was through direct hand to hand message, so as to
ensure that the average was accurately collected as a result, 100
questionnaires were printed and distributed all the 100 questionnaires were
filled correctly and returned.
Techniques for Data Analysis
The techniques applied for the data is statistical analysis, so as to prove the
hypothesis or basic assumption using chi-square (X2)
x 2=¿
KLMN
The formula was derived from 2 x 2 contingency tableasshown below:
Gender Responses Total
Yes No
Male A B K
Female C D L
Total M N M
29
CHAPTER FOUR
DATA PRESENTATION AND ANALYSIS
4.0 INTRODUCTION
This chapter deals with the presentation and interpretation of data. The data
was presented showing the frequency of response and percentage it presented.
Data finding anddiscussion of results below is the result of data collected
from one hundred (100) printed questionnaires that were distributed to the
respondents.
Table 4.1: Age Distribution
Age Noof Responses Percentage (%)
21 – 25 36 36%
26 – 30 20 20%
31 – 35 24 24%
36 and above 20 20%
30
Total 100 100%
The table above discussed the age distribution of the respondents, 36
respondents representing 36% of the total respondents are those at age 21 – 25
years and those at the age of 26 – 30 years are 20 respondents representing
20% of the total respondents, 24 respondents representing 24% of the total
respondents are those at the age of 31 – 35 years of age, while 20 respondents
representing 20% of the total respondents are between the age 36 and above,
therefore, the majority of the respondents are with the age of 21 – 25 years.
Table 4.2: Sex Distribution
Sex Noof Responses Percentage (%)
Male 30 30%
Female 70 70%
Total 100 100%
The table above discussed the sex distribution of the respondents, 30
respondentsrepresenting 30% of the total respondents are male, while 70
respondents representing 70% of the total respondents are females, and
therefore the majority of the respondents are female.
Table 4.3: Marital Status
31
Marital Status Noof Responses Percentage (%)
Married 60 60%
Single 40 40%
Total 100 100%
The table above discussed the marital status of the respondents, 60
respondents representing 60% of the total respondents are married, while 40
respondents representing 40% of the total respondents are single. Therefore,
the majority of the respondents are married.
Table 4.4: Educational Background
Educational Background Noof Responses Percentage (%)
Formal 90 90%
Informal 10 10%
Total 100 100%
The table above discussed the educational background of the respondents, 90
respondents representing 90% of the total respondents indicates that they have
formal education, 10 respondents representing 10% of the total respondents
32
have informal education;the majority of the respondents have formal
education.
Table 4.5: Occupation of the Respondents
Age Noof Responses Percentage (%)
Civil Servant 10 10%
Student 50 50%
Business 20 20%
Self-employed 20 20%
Total 100 100%
The table above discussed the occupation of the respondents, 10 respondents
representing 10% of the total respondents are civil servants, 50 respondents
representing 50% of the total respondents are students, 20 respondents
representing 20% of the total respondents are business, while 20 respondents
representing 20% of the total respondents are self-employed, therefore, the
majority of the respondents are students.
Table 4.6: Religion of the Respondents
Religion Noof Responses Percentage (%)
33
Islam 95 95%
Christianity 5 5%
Total 100 100%
The table above discussed the religion of the respondents, 95 respondents
representing 95% of the total respondents are Muslims and5 respondents
representing 5% of the total respondents are Christians’ majority of the
respondents are Muslims.
Table 4.7: Are you aware of a disease called measles?
Answer Noof Responses Percentage (%)
Yes 80 80%
No 20 20%
Total 100 100%
The table above discussed the views of the respondents if they are aware of a
disease called measles, 80 respondents representing 80% of the total
respondents are aware about measles disease,while 20 respondents
34
representing 20% of the total respondents are not aware about measlesdisease.
The majority of the respondents are knowledgeable about measles infection.
Table 4.8: What are the common signs and symptoms of measles?
Diarrhea 10 10%
Vomiting 10 10%
Cough and rashes 70 70%
Earache 10 10%
Total 100 100%
The table above clearly discussed the views of the respondents on the
common signs and symptoms of measles, 10 respondents representing 10% of
the total respondents indicated diarrhea, 10 respondents representing 10% of
the total respondents made mention of vomiting, 70 respondents representing
70% of the total respondents identified cough and rashes as the common signs
and symptoms of measles, while 10 respondents representing 10% of the total
respondents viewed earache as the common sign and symptom of
measles.The majority of the respondents indicated that cough with rashes as
the common signs and symptoms of measles.
35
Table 4.9: At what period/month do you receive cases of measles?
January – March 20 20%
April – June 10 10%
July – September 50 50%
October – December 10 10%
Total 100 100%
The table above clearly discussed the views of the respondents on whatperiod
or month do they receive cases of measles, 20 respondents representing 20%
of the total respondents indicated that January – March is the period they
receive cases of measles, 10 respondents representing 10% of the total
respondents made mention of April - June, 50 respondents representing 50%
of the total respondents responded that they receive cases of measles on July –
September, while 10 respondents representing 10% of the total respondents
are viewed that October – December as the month/period they receive case of
measles. The majority of the respondents indicated that July – September.
Table 4.10: How many cases did you treat per day?
36
1 – 10 60 60%
11 – 20 20 20%
21 – 30 10 10%
31 and above 10 10%
Total 100 100%
The table above clearly discussed the views of the respondents on the cases
treated per day, 60 respondents representing 60% of the total respondents are
of the view of 1 – 10cases, 20 respondents representing 20% of the total
respondents are of the view of 11 – 20cases, 10 respondents representing 10%
of the total respondents are of the view that 21 – 30cases treated per day,
while 10 respondents representing 10% of the total respondents are of the
viewof 30 and above cases treated per day.
Table 4.11: What age group is affected most?
0 – 11months 5 5%
1 – 2years 30 30%
37
3 – 4years 60 60%
5 and above 5 5%
Total 100 100%
The table above clearly discussed the views of the respondents on the age
group affected most, 5 respondents representing 5% of the total respondents
indicated that 0 – 11months are the age group mostly affected, 30 respondents
representing 30% of the total respondents indicated 1 – 2years, 60
respondents representing 60% of the total respondents are of the view that 3 –
4years group of age are affected most, while 5 respondents representing 5%
of the total respondents are of the view of 5 and above years.
Table 4.12: What common complication do you observe most if any?
Pneumonia 15 15%
Otitis media 15 15%
Malnutrition 20 20%
Death 50 50%
Total 100 100%
38
The table above clearly discussed the views of the respondents on a common
complication of measles, 15 respondents representing 15% of the total
respondents indicated pneumonia, 15 respondents representing 15% of the
total respondents made mention of otitis media is the common complication,
20 respondents representing 20% of the total respondents identified
malnutrition as the common complication of measles, 50 respondents
representing 50% of the total respondents indicated thatdeathis the common
complication of measles. The majority of the respondents indicated that death
is the common complication of measles.
Table 4.13: Expectantly what causes death in measles infected patients?
Not receiving treatment in time 40 40%
Use of traditional medicine 35 35%
Measles associated with 15 15%

malnutrition
When large number of children 10 10%

are affected without previous
immunization
Total 100 100%
39
The table above clearly discussed the views of the respondents on the causes
of death in measles infected patients, 40 respondents representing 40% of the
total respondents indicated that not receiving treatment in time, 35
respondents representing 35% of the total respondents indicate use of
traditional medicine cause the complication of death, 15 respondents
representing 15% of the total respondents stated thatmeasles associated with
malnutrition, while 10 respondents representing 10% of the total respondents
are with the viewthat when large number of children are affected without
previous immunization. Therefore, majority of the respondents are of the
view of not receiving treatment in time.
Table 4.14: Does the communities believe that measles can be prevented
and treated?
Yes 90 90%
No 10 10%
Total 100 100%
The table above discussed the views of the respondents on the prevention of
measles, 90 respondents representing 90% of the total respondents believed
40
that measlescan be prevented, while 10 respondents representing 10% of the
total respondents do not believethat measles can be prevented. Therefore,
majority of the respondents believed with the statement.
Table 4.15: What possible measure can be used to reduce or control the
disease?
Health education 20 20%
Immunization 70 70%
Proper treatment 6 6%
Isolation 4 4%
Total 100 100%
The table above clearly discussed the views of the respondents on the possible
measures that can be used to reduce or control the disease, 20 respondents
representing 20% of the total respondents believed health education is the
possible measure to reduce or control the disease, 70 respondents representing
70% of the total respondents are of the view that immunization is the possible
measure used to reduce or control the disease, 6 respondents representing 6%
of the total respondents identified that proper treatment is the measure use to
41
control the disease, while 4 respondents representing 4% of the total
respondents indicated that isolation is the possible measure to reduce or
control the disease. Therefore, majority of the respondents have the view that
immunization is the possible measure to reduce or control the disease.
Table 4.16: How is measles spread?
By direct contact 25 25%
By droplet from nose 60 60%
By eating with infected 10 10%

person
Poor sanitation 5 5%
Total 100 100%
The table above clearly discussed the views of the respondents on how
measles spread, 25 respondents representing 25% of the total respondents are
of the view that measles can be spread through direct contact, 60 respondents
representing 60% of the total respondents are of the view that measles can be
spread through droplet from nose, 10 respondents representing 10% of the
total respondents are of the view that measles is spread by eating with
42
infected person, while 5 respondents representing 5% of the total respondents
indicated that through poor sanitation. Therefore, majority of the respondents
have the view that measles disease is spread through droplet from nose.
Table 4.17: Does the government assist your communities toward
prevention of measles?
Yes 95 95%
No 5 5%
Total 100 100%
The table above discussed the views of the respondents on whether
government assists them towardthe prevention of measles, 95 respondents
representing 95% of the total respondents agreed that government assist their
communities toward prevention of measles, while 5 respondents representing
5% of the total respondents do not agreed that government assist them in
prevention of measles infection.
Table 4.18: If yes, which among the following ways?
43
Provision of vaccines 30 30%
Public enlightenment 20 20%
Health personnel 40 40%
All of the above 10 10%
Total 100 100%
The table above clearly discussed the views of the respondents on which way
does the government assists them in prevention and control ofmeasles
infection, 30 respondents representing 30% of the total respondents indicates
government assist them through provision of vaccines, 20 respondents
representing 20% of the total respondents indicates that government
assistthem through public enlightenment, 40 respondents representing 40% of
the total respondents indicates that government assists them through health
personnel, while 10 respondents representing 10% of the total respondents
indicated that government assists them through all of the mentioned ways.
Therefore, majority of the respondents have the view that government
assiststhem through health personnel.
Table 4.19: Which method do you think is appropriate for treatment of
measlesin your community?
44
Medical services 96 96%
Traditional services 4 4%
Total 100 100%
The table above clearly discussed the views of the respondents on the best
method that is appropriate for treatment of measles, 96 respondents
representing 96% of the total respondents are of the view that medical
services is the most appropriate treatment,4 respondents representing 4% of
the total respondentsare of the view that traditional medicines is the most
appropriate treatment of measles, majority of the respondents are of the view
that medical services are the appropriatetreatment of measles.
Table 4.1:In your own words what do you think will be best method in
preventing measles infection in children of 0 – 59months?
Immunization 97 97%
Traditional herbalist 3 3%
45
Total 100 100%
The table above clearly discussed the views of the respondents on what they
think is the best method of prevention of measles, 97 respondents
representing 97% of the total respondents indicates that immunization is the
best method of the prevention of measles, 3 respondents representing 3% of
the total respondents indicates that traditional herbalist is the best method of
the prevention of measles, majority of the respondents are of the view that
medical services are the appropriate treatment of measles infection among
children of 0 – 59months.
4.2 TEST OF HYPOTHESIS AND ANALYSIS OF RESULT
Nwanna (1990) defined analysis of data as those techniques whereby a

researcher extract information that was not apparently there before and which
will enable a summary description of the subject under discussion.
In the following analysis the test statistic used is chi-square method (x 2)
dichotomous in nature of inferential statistic, we reject null hypothesis (Ho)
and assumed the null hypothesis (Ho) is not reliable with regard to this
research caution need to be taken when drawing conclusion on the test of
hypothesis because the pairs of value are greater or less.
46
4.2.1 TEST OF HYPOTHESIS I
Ho: Measles has any age limit in children.
Ha: The above statement is not true
i.e. Ho: P # 0 Vs Ha: P – 0
Table 4.2.1: Does measles has any age limit in children?
Yes No
Male 70 1 71
Female 27 2 29
Total 97 3 100
(P<0.05)
From the appendix BI, since x2 calculated 0.04 < x2 tab 0.05 at 1df = 3.841,
we therefore concluded and accepted null hypothesis (Ho) the result (P <
0.05) it clearly shows that out of one hundred (100) respondents representing
both sexes, 97 respondents representing both sexes agreed with the hypothesis
(Ho) as such they are majority, while 3 respondents representing both sexes
also disagreed with the hypothesis (Ho) as such they are minority, we
therefore, concluded and accept null hypothesis (Ho) that measles has age
limit in children.
47
4.2.2 TEST OF HYPOTHESIS II
Ho: Measles has possible preventivemeasures of controlling infection

measures of controlling infection.
i.e. Ho: P # 0 Vs Ha: P – 0
Table 4.2.2: Does measles has possible preventive measures of controlling

the infection?
Yes No
Male 43 2 45
Female 53 2 55
Total 96 4 100
(P<0.05)
From the appendix BII, since x2 calculated 0.04< x2 tab 0.05 at 1df = 3.841,
48
therefore, concluded and accept null hypothesis (Ho) that measles has
possible measures of controlling the infection.
4.2.3 TEST OF HYPOTHESISIII
Ho: Measles can be communicable disease.
i.e. Ho: P # 0 Vs Ha: P – 0
Table 4.2.3: Can measles be communicable disease?
Yes No
Male 58 2 60
Female 39 1 40
Total 97 3 100
(P<0.05)
From the appendix BII, since x2 calculated 0.05< x2 tab 0.05 at 1df = 3.841,
49
therefore, concluded and accept null hypothesis (Ho) that measles is a
communicable disease.
4.2.4 TEST OF HYPOTHESIS IV
Ho: Measles has possible preventive measures of controlling infection

measures of controlling infection.
i.e. Ho: P # 0 Vs Ha: P – 0
Table 4.2.4: Does measles has any complication in children and adult?
Yes No
Male 57 3 60
Female 39 1 40
Total 96 4 100
(P<0.05)
From the appendix BIV, since x2 calculated 0.39< x2 tab 0.05 at 1df = 3.841,
50
therefore, concluded and accept null hypothesis (Ho) that measles has
complication in children and adult.
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATION
5.1 Summary
51
The entire research project was aimed at in depth analysis on the impact of
measles immunization in children aged less than 5 years in Safana Local
Government Area of Katsina State.
Chapter one discussed the basic concept of the background of study,
statement of the problem, objectives of the study, scope and limitation of the
study, significance of the study, research questions and research hypotheses.
Chapter two is on the review of related literatures on the study, the reviews
were presented on those aspects that are related to the study. This includes
conceptual definition of measles virus and clinical features, treatment,
complications and preventions.
Chapter three describes relevant procedures upon which the data were
collected which include: research design, target population and universe of
the study, sampling techniques, instrument for data collection, validity and
reliability of the instrument and technique for data analysis.
Chapter four is the analysis and interpretation of the data obtained, the
summary of the major findings were enumerated and discussion on the
findings were also made.
52
Chapter five summarizes the research, conclusion and recommendations were
drawn based on the findings of the research.
5.2 Conclusion
The impact of measles immunization among children under 5 years of age
cannot be over emphasized as such the government, public and individuals all
have roles to play in ensuring compliance in vaccination, methods of
prevention and treatment of the infection.
5.3Recommendation
In order to effectively control and prevent measles in children age less than 5
years in Safana Local Government Area. The following recommendations
were made to government and public at large within the area of study.
Government:
1. Government should carry out an intensive campaign with aim to prevent
and control measles.
2. Government should draw new health policy with a view of improving
health care delivery system on transmission of diseases in the
community.
53
3. Government should identify campaign on immunization especially on
health education team provided in the community.
4. Health educators should put more effort in the general public on
immunization.
Public:
1. The public by their research report should be enlightened on the
importance of active participation in controlling and prevention of
measles in the community.
2. Children should get two doses of MMR vaccine, starting with the first
dose at 12 – 15 month of age and second doses at 4 through year of age.
3. CDS recommended that people get MMR vaccine to be protected against
measles.
4. Teens and adults should also be up to date on their MMR vaccination.
Individuals:
1. Individual should consult the doctors about which vaccine their children
should have and when. Vaccination not only protects children from
developing serious diseases but also protect the community in reducing
the spread of infectious diseases.
54
2. Individual should help keep their children safe and protected from
measles and vaccines preventable diseases. It is important you and your
children who are able to get vaccinated are fully immunized.
3. Children get many immunizations in childhood, a community awareness
campaign called every child by two ages’ parent to make sure their
children are protected against the measles and other diseases of childhood
before the child reaches 2 years of age.
4. Each and every parent should take more responsibilities of accessing
health services on children immunization against measles and other child
killer diseases.
5.4 List of Abbreviation
55
LGA Local Government Area
WHO World Health Organization
UNICEF United Nation International Children Emergency Fund
ET-AL And Others
EHT Environmental Health Technician
e.g. Example
Tab Tabulated
FMOH Federal Ministry of Health
NPI National Program on Immunization
EPI Expanded Program on Immunization
B.C Before Christ
ORS Oral Rehydration Solution
MMR Measles Mumps Rubella
NGOs Non-Governmental Organizations
i.e. That is
5.4 BIBLIOGRAPHY
56
1. Ambuna, E. Osekwe(1960 – 96) Comprehensive Certificate Biology for
Secondary School P. 6.
2. Case Based Data Available At WHO – HQ for your Of Onset 2011.
3. David Murphy (1998), The Virus The Disease Was Isolated From An 11
Years Old Boy From United States of America (USA) 1954.
4. Ferry R.T. HelsayN.D (2004), The Clinical Significant Of Measles Go As
Far Back To Eat Least 60 BC.
5. MebrienJ. And Murphy Et-al Measles Outbreak Is Doubting Journal Pp
580.
6. Percentage of Cases 6 Months Calculated using Denominator Cases with
Known Age (Cases Missing Age are Excluded from Denominator).
7. Population: UNDP Estimate or Year 2015 (Revision 2013).
8. Parker A. Toggs W. Dayan G. et-al (2006) Implication of 2005 Measles
Outbreak in Indian for Sustained Elimination of Measles in the United
State 355 (5) 447 – 55.
9. Rutter M. (2005) Incidence of Autism Spectrum Disorder Change
Overtime and their Meaning. A Paediatric 94 Journal PP15.
10.Therry S.B (2014) Measles Virus Textbook the Paediatric Infection
Diseases 85 – 99.
11.Turkey E.F and Volken R.H (2005) Their Bugs are Worse than Their Bite
Washington Post April 3.PBal.
12.Vaccine Coverage: WUENIC 5 – Year Average (2007 – 2011).
13.Vaccination Introduction: WHO Spread Sheet.
14.Vaccination Schedule: As Reported In 2016 JRF Submission.
15.WHO: AlyaDabbagh, Minal Patel, Katrina Kiesinger Thomas Cherian.
APPENDIX BI
57
1st Step = Formulate hypothesis
Ho: Measles has any age limit in children
i.e. Ho: P # 0 Vs Ha: P – 0
2nd Step = Select the Level of Significance
i.e. alpha (ϖ) and degree of freedom (df), ϖ = 0.0513.841
df = (r – 1) (e – 1)
= (2 – 1) (2 – 1)
=1ϖ1
3rd Step = State Test Statistic

( ad−bc ) 2m
Let the test statistic be X2 =
Klmn
4th Step = State Decision Rule
i. Reject null hypothesis (Ho) if X2 calculated > X2 tab which is equal

to 0.05 ate degree of freedom (df) = 3.841
ii. Accept null hypothesis (Ha) if X2 calculated < X2 tab 0.05 at degree
of freedom (df) 1 = 3.841.
5th Step = Compute test statistic in table 4:2:1
[ ( ad−bc ) ] 2 m
X2 =
Klmn
[ (70 X 1 ) −(2 X 27)] 2 X 100

X2 =
70 X 30 X 97 X 3
[ (70 )−(54)] 2 X 100

X2 =
611100
256 X 100
X2 = 611100
58
25600
X2 = 611100 X2 = 0.04
6th Step = Apply Decision Rule
Since X2 calculated 0.53 <X2 tab 0.05 at df = 3.841, we therefore concluded

and accepted that null hypothesis (Ho) that measles has age limit in children.
7th Step = Draw a table critical value of chi-square distribution.
P < 0.05 X2 0.05 = 3.841
APPENDIX BII
Ho: That measles has possible preventive measures and

controlmeaslesinfection.
i.e. Ho: P # 0 Vs Ha: P – 0
59
df = (r – 1) (e – 1)
= (2 – 1) (2 – 1)
=1ϖ1 =1

( ad−bc ) 2m
Klmn

[ ( ad−bc ) ] 2 m
X2 =
Klmn
[ (70 X 1 ) −(2 X 27)] 2 X 100

X2 =
70 X 30 X 97 X 3
[ (70 )−(54)] 2 X 100

X2 =
611100
256 X 100
X2 = 611100
25600
X2 = 611100
X2 = 0.04
60
and accepted that null hypothesis (Ho) that there are possible preventive
measures of controlling measles infection.
P < 0.05 X2 0.05 = 3.841
APPENDIX BIII
Ho: That measles can be a communicable disease.
i.e. Ho: P # 0 Vs Ha: P – 0
df = (r – 1) (e – 1)
61
= (2 – 1) (2 – 1) =1ϖ1 =1

( ad−bc ) 2m
Klmn

[ ( ad−bc ) ] 2 m
X2 =
Klmn
[ (70 X 1 ) −(2 X 27)] 2 X 100 [ (70 )−(54)] 2 X 100

X2 = X2 =
70 X 30 X 97 X 3 611100
256 X 100 25600

X2 = 611100
X2 = 611100
X2 = 0.04

and accepted that null hypothesis (Ho) that measles is a communicable
diseases.
62
P < 0.05 X2 0.05 = 3.841
APPENDIX BIV
Ho: Measles is caused by virus.
i.e. Ho: P # 0 Vs Ha: P – 0
df = (r – 1) (e – 1)
= (2 – 1) (2 – 1)
=1ϖ1
=1
Let the test statistic be

( ad−bc ) 2m
X2 =
Klmn

63
[ ( ad−bc ) ] 2 m
X2 =
Klmn
[ ( 45 X 1 )−(5 X 49)] 2 X 100

X2 =
50 X 50 X 94 X 6
[ ( 45 )−(245) ] 2 X 100
X2 =
940000
−( 256 ) 2 X 100
X2 =
940000
40000
X2 = 940000
X2 = 0.04

and accepted that null hypothesis (Ho) that measles is caused by virus.
64
P < 0.05 X2 0.05 = 3.841
APPENDIX BV
Ho: Measles has complication in children and adult.
i.e. Ho: P # 0 Vs Ha: P – 0
i.e. alpha (ϖ) and degree of freedom (df)ϖ = 0.0513.841
df = (r – 1) (e – 1)
= (2 – 1) (2 – 1)
=1ϖ1
=1
Let the test statistic be

( ad−bc ) 2m
X2 =
Klmn

65
[ ( ad−bc ) ] 2 m
X2 =
Klmn
[ (57 X 1 ) −(3 X 39)] 2 X 100

X2 =
60 X 40 X 96 X 4
[ (57 )−(117)] 2 X 100

X2 =
9216000
3600 X 100
X2 = 9216000
360000
X2 = 9216000
X2 = 0.39

and accepted that null hypothesis (Ho) that measles has complication in
children.
66
P < 0.05 X2 0.05 = 3.841
SAMPLE QUESTIONNAIRE
Katsina State College of Health Science and Technology KankiyaIro School

of Health Technology Kankia Katsina State
Dear respondent;
I am a final year student of the above named college, pursuing National

Diploma in Health Education and Promotion, conducting a research project
on the effect of measles infection on children under 5 years of age. Any
information given in the regard will be treated confidential and restricted.
SECTION ‘A’ BIO DATA OF THE RESPONDENT
1. Age: 21-25years ( ) 26-30years ( ) 31-35years ( ) 36 and

above ( )
2. Sex: Male ( ) Female ( )
3. Marital Status: Single ( ) Married ( )
4. Educational Background: Formal ( ) Informal( )
5. Occupation: Civil Servant ( ) Student ( )Business( ) self-employed
( )
67
6. Religion: Islam ( ) Christianity( )
SECTION B
7. Are you aware of a disease called measles? Yes ( ) No ( )
8. What are the common sign and symptom of measles?
a. Diarrhea ( )
b. Vomiting( )
c. Cough with rashes ( )
d. Earache
9. At what period/month do you receive cases of measles?
a. January – march ( )
b. April - June ( )
c. July - September ( )
d. October - December ( )
10.How many cases did you treated per day?
a. 1 - 10 ( ) b. 11 – 20 ( ) c. 21 – 30 ( ) d. 30 and above ( )
11.What age group is affected most?
a. 0 – 11months ( ) b. 1 – 2years ( ) c. 3 – 4years ( )
12.What common complication do you observe most if any?
a. Pneumonia ( ) b. Otitis media ( )c. Malnutrition ( ) d. Death ( )
13.Expectantly what causes the complication and death?

68
a. Not receivingtreatment in time ( )
b. Used for traditional medicine ( )
c. When large number of children are affected without previous immunization ( )
d. Measles associated with malnutrition ( )
14.Does the community belief the measles can be prevented? Yes ( ) No
( )
15.What possible measure can be used to reduce control the disease?
a. health education ( ) b. Immunization ( ) c. Proper treatment ( )
d. Isolation ( )
16.How is measles spread?
a. By direct octant( )
b. By droplet from nose ( )
c. By eating with infected person ( )
d. Poor sanitation ( )
17.Does government assist in prevention and control of measles?
Yes ( ) No ( )
18.If yes,by which of the following ways?
a. Provision of vaccine ( )
b. Public enlightenment ( )
69
c. Health personnel ( )
d. All of the above ( )
19.Which method do you think is appropriate for treatment of measles in your
community?
a. Medical services ( ) b. Traditional services ( ) c. All of the above ( )
20.In your own words, what do you think will be best method in preventing
measles infection among children 0 – 59months?
a. Immunization ( ) b. Traditional herbalist ( ) c. All of the above ( )
70

Impact of Measles Immunization in Children Less Than Five Years of Age

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Impact of Measles Immunization in Children Less Than Five Years of Age

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IMPACT OF MEASLES IMMUNIZATION IN CHILDREN LESS THAN

FIVE YEARS OF AGE ‘A CASE STUDY OF SAFANA LOCAL

A RESEARCH PROJECT SUBMITTED TO THE DEPARTMENT OF

ENVIRONMENTAL HEALTH SCIENCES, COLLEGE OF HEALTH

TECHNOLOGY KANKIA IRO, KATSINA STATE

IN PARTIAL FULFILLMENT OF THE REQUIREMENT FOR THE

AWARD OF NATIONAL DIPLOMA IN HEALTH EDUCATION AND

WEST AFRICAN HEALTH EXAMINATION BOARD (WAHEB)

sources are acknowledged by references.

____________________ _______ ____________________

The research title “Impact of Measles Immunization in Safana Local

Education and Promotion approved for contribution to the knowledge and

The research is dedicated to my parents and my friends for their support,

here and hereafter with Jannatul Firdausi. Amen

guidance to the rest of the world.

I would like to appreciate the guidance and direction of my project

My special gratitude goes to the members of staff in environmental health

department and the school at large.

I will also like to show my concern to my dear Alhaji Ahmad (Teeman,

Dady) and my sisters and Brothers Khadija, Aisha, Hauwa’u, Zainab,

my appreciation to my biological daughtersRukayya and Sa’adiya.

JakallahuBikhairanas well as praying for them. The guidance, repentance,

Firdausi be their final abode.

I will forget to show my appreciation, gratitude and thanks to Kankia Iro

School of Health and Technology for their support and encouragement.

I will forget to show my appreciation, gratitude and thanksto Malam

MannirLawal (Mock), Malam Abdulhadi, HOD Sanusi Umar Radda, Former

HOD Environmental Health Malam TanimuShehu (TU), Malam Sani Aliyu

advice and adopting my mistakes.

I will also like to express my gratitude to my friends for ever and

everSalimaTukur (Salmus), Sakina BBK BawaleBala, AsiyaLawal,

Halimatu Sani, Aisha Inuwa, UmmyKharouphy, Maryam Lawal, Bilkisu

Musa (Billy) and Fatima Abdullahi Umar (Namesake).

I will also like to express my sincere gratitude to people that supports me

during my school education. I will never ever forget you in my life

AbdullahiAhmad Galadima Ammar Ibrahim.

Approval Page iii

Table of Contents vii

1.1 General Introduction 1

1.2 Objectives of the Study 4

1.3 Historical Background of the Study Area 4

1.4 Scope and Limitation of the Study 6

1.5 Statement of the Problem 7

1.6Significance of the Study 9

1.7 Research Questions 9

1.8 Research Hypothesis 10

1.9 Operational Definition of Terms 11

CHAPTER TWO: LITERATUREREVIEW

2.1 Literature Review 12

3.1 Research Design 24

3.2 Sample and Sampling Techniques 24

3.3 Instrument for Data Collection 24

3.4 Validity and Reliability of the Instrument 25

3.5 Administration of the Instrument 25

3.6 Techniques for Data Analysis 26

4.1 Data Analysis and Data Presentation 27

4.2 Test of Hypothesis and Analysis of Result 44

5.2Summary and Conclusion 54

5.3 List of Abbreviation 56

The research was undertaken to ineptly analyze the impact of measles

1.1 Background of the Study

among children under the age of 5 years mostly in developing countries

________________ _ __________________