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Measles in Selangor: A Comparative Analysis Between Adults and Children Using the E-Measles Registry, 2015-2024
N S Ismail1,2, M Mariam1, K Faridah2
1Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Selangor, Malaysia.
The Medical Journal of Malaysia
|January 30, 2026
Summary
Measles predominantly affects children in Selangor, Malaysia, despite a gradual increase in adult cases. Enhanced vaccination efforts and monitoring of age-specific trends are crucial for measles control and elimination.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- Measles remains a public health concern in Malaysia, with increasing reported cases despite high vaccination coverage.
- A potential shift in measles age-distribution, observed in highly vaccinated populations, necessitates understanding adult vs. child epidemiology.
- This study addresses the critical need for targeted interventions by comparing measles in adults and children in Selangor.
Purpose of the Study:
- To describe measles incidence in adults and children in Selangor.
- To compare sociodemographic, clinical, vaccine, and exposure-related differences between adult and child measles cases.
- To inform public health strategies for measles control and elimination.
Main Methods:
- A comparative cross-sectional study utilizing secondary data from the Selangor e-Measles Registry (2015-2024).
- Cases classified as adults (≥18 years) and children (<18 years); annual incidence calculated.
- Descriptive statistics and comparative tests (chi-square, Fisher's exact, Mann-Whitney U) used for analysis.
Main Results:
- 3954 confirmed measles cases: 13.7% adults, 86.3% children.
- Incidence consistently higher in children (RR 14.43-87.65).
- Adult cases showed a gradual increase, peaking in 2023 (16.4%); significant differences noted in nationality, ethnicity, symptoms, hospitalization, complications, and vaccination status (p<0.05).
Conclusions:
- Measles predominantly affects children in Selangor, but adult cases are rising.
- Strengthening the National Immunisation Programme (NIP) and Supplementary Immunisation Activities (SIAs) for young children is vital.
- Close monitoring of adult and older child cases is needed to detect epidemiological shifts; enhanced provider training and public education are recommended.
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