DETERMINANTS OF MEASLES RESURGENCE IN SOUTHEAST ASIAN COUNTRIES :A SCOPING REVIEW

Measles remains a significant public health concern in Southeast Asia, with a resurgence of cases in recent years despite the availability of an effective vaccine. This scoping review aimed to identify immunization factors contributing to the increase in measles cases in the region between 2020 and 2025.A systematic literature search was conducted in Scopus, PubMed, and Garuda databases, yielding 27 eligible articles for review. Inclusion criteria focused on studies conducted in the Southeast Asia region, articles published between 2020-2025, full text, with discussions covering five main variables: Immunization Status, Knowledge, vaccine management, vaccine effectiveness, and public perception of immunization. All selected data were extracted and analyzed descriptively. The Findings consistently showed that children who were not immunized or had an incomplete immunization history had a 29.96 times greater risk of measles compared to those who were fully immunization. Low parental knowledge about vaccination, suboptimal vaccine management in cold chain, distribution, and storage, declining vaccine efficacy over time, and negative perceptions towards immunization due to cultural and religious beliefs also contribute to the increase in measles cases. Serological studies indicated that even with high two-dose measles vaccination coverage, optimal herd immunity may not be achieved, suggesting the need for considering a third dose. Improving public education, vaccine management systems, public trust in immunization and involving community leaders, are crucial for effective measles control. A multidimensional approach focusing not only on increasing vaccination coverage but also addressing these factors is necessary to reduce measles incidence and prevent future outbreaks in Southeast Asia.