EPIDEMIOLOGY AND CLINICAL CHARACTERISTICS OF MUMPS
AMONG CHILDREN AND ADOLESCENTS: A CROSS-SECTIONAL STUDY
IN CISOKA PUSKESMAS.
INDONESIA
Muhammad Ikmal Syafii1.
David Christian2.
Indri3.
Trisna Amerdista3 Faculty of Medicine.
Muhammadiyah University of Jakarta.
Jakarta.
Indonesia Faculty of Medicine.
Tarumanagara University.
Jakarta.
Indonesia Faculty of Medicine.
Syarif Hidayatullah Jakarta Islamic State University.
Banten.
Indonesia Corresponding Email: ikmallsyafii@gmail.
ABSTRACT
Background: Mumps remains a vaccine-preventable illness with periodic outbreaks in areas with low immunization coverage.
Rural settings often show higher susceptibility due to limited healthcare access.
Aims: To determine the prevalence and clinical characteristics of mumps among children and adolescents at Cisoka Puskesmas.
Indonesia.
Methods: A cross-sectional study was conducted on all pediatric patients clinically diagnosed with mumps from January to March 2025 based on WHO criteria.
Demographic data.
MR vaccination status, clinical features, and household exposures were obtained through interviews and clinical Descriptive analysis was performed using SPSS 26.
Result: Seventy-six mumps cases were identified, yielding a prevalence of The highest age-specific prevalence occurred in children aged 6Ae11 years .
45%).
Unilateral parotitis accounted for 71.
1% of cases.
Common symptoms included fever .
1%), chewing pain .
8%), and painful swallowing .
3%).
Only 59.
2% had received MR vaccination, and 65.
lived in close contact with at least one active smoker.
Conclusion: Mumps continues to circulate among the pediatric population in rural Tangerang, driven by inadequate MR vaccination coverage and modifiable household-level exposures such as close contact with smokers.
Strengthening immunization uptake and reducing preventable exposures are critical to mitigate future outbreaks.
Keywords Mumps.
Epidemiolog Clinical Characterist Children.
Adolescents.
Rural Health International Journal of Nursing and Midwifery Science (IJNMS).
Volume 9.
Issue 3.
December 2025
INTRODUCTION
Mumps is a vaccine-preventable viral illness that primarily affects children and adolescents.
It is caused by a respiratory droplets and typically presents with parotid gland swelling, fever, and constitutional symptoms (Rausch-Phung et , 2.
Although often self-limiting, mumps may lead to complications such as orchitis, oophoritis, meningitis, and hearing loss, particularly among unvaccinated or older pediatric patients (Bhanu et al.
, 2025.
Rausch-Phung et al.
, 2.
According to the World Health Organization (WHO), mumps should be suspected in individuals presenting with acute unilateral or bilateral parotid swelling lasting at least two days without an apparent alternative cause (CDC.
WHO, 2.
Before widespread vaccination, mumps posed a major global health burden, with annual incidence rates ranging from 40 to 726 cases per 100,000 population (Su et , 2.
The introduction of mumpscontaining vaccines significantly reduced disease incidence and complications Despite this progress, outbreaks have resurfaced in recent years, including among vaccinated individuals, especially in high-exposure settings such as schools and communal environments (Lam et al.
, 2020.
Perez Duque et al.
, 2021.
Shah et al.
, 2.
Indonesia has adopted the national measlesAerubella (MR) vaccination program as part of its strategy to eliminate measles and control rubella and mumps (Chacko et , 2.
However, recent surveillance data indicate a resurgence of suspected mumps As of November 13, 2024, the Ministry of Health recorded 6,593 suspected cases, with a substantial increase during November (Menur, 2.
Contributing factors include suboptimal uptake of the complete two-dose regimen, unequal vaccine access, and persistent logistical barriers in rural regions (Albers et al.
, 2022.
Lam et al.
, 2.
From a nursing perspective, this study draws on community health nursing principles and PenderAos Health Promotion Model, emphasizing how parental beliefs, environmental exposures, and preventive behaviors shape mumps susceptibility in pediatric populations (Khoshnood et al.
This framework supports a community-oriented interpretation of the Despite increasing reports of mumps resurgence describing age-specific prevalence and clinical presentations in rural Indonesian primary care settings remain limited.
This information hampers targeted prevention efforts, particularly in underserved areas where vaccination gaps and household-level exposures may differ from urban Puskesmas Cisoka Tangerang serves a large pediatric and healthcare infrastructure, making it a relevant site to characterize local patterns of mumps infection.
This study provides new evidence by documenting detailed mumps clinical patterns and age-specific prevalence in a rural primary care facility, which has not been previously reported in Banten Province.
This cross-sectional study aims to determine the prevalence of mumps and describe its clinical manifestations among Puskesmas Cisoka.
By identifying key demographic and clinical characteristics, the findings are expected to support more targeted public health interventions and strengthen outbreak preparedness in similar rural communities.
METHOD
This cross-sectional study employed total sampling of all pediatric patients presenting to the Cisoka Puskesmas pediatric clinic between January and March The final sample of 76 cases represented all clinically diagnosed mumps cases during the study period.
Data were collected prospectively through structured International Journal of Nursing and Midwifery Science (IJNMS).
Volume 9.
Issue 3.
December 2025 assessments performed outpatient visits.
Inclusion criteria were: .
age 0Ae18 years, .
clinical diagnosis of mumps with parotid gland swelling with or without constitutional symptoms, and .
symptom onset within seven days.
Exclusion criteria were: .
incomplete clinical records, .
known immunodeficiency, and .
mumps vaccination within the preceding four weeks.
Mumps was defined according to WHO criteria as acute onset of unilateral or bilateral parotid swelling without another apparent cause.
Quality control procedures included calibration of the digital axillary thermometer prior to data collection, standardized training of interviewers to ensure consistent history-taking, and crosschecking of clinical findings by two clinicians to enhance interrater reliability.
Body temperature was measured using a calibrated digital axillary thermometer, with fever defined as Ou37.
5AC.
Clinical symptoms, including headache, myalgia, fatigue, pain while swallowing, and pain while chewing, were recorded as presence or absence based on structured caregiver interviews or adolescent self-report.
Exposure variables followed operational definitions: household smoker referred to Ou1 person smoking inside the home daily.
contact referred to sharing the same living space for >4 hours per day.
Data were entered into standardized case report forms and analyzed using SPSS 0 (IBM.
USA).
Analyses were primarily descriptive.
This study utilized available electronic medical records with prior permission from Cisoka Rural Health Center and was conducted in accordance with ethical research standards under ethical B/400.
7/V/PKMCSK/2025.
2Ae5 years .
4%) and 12Ae17 years .
7%).
Females made up 56.
6% of cases.
More than half reported household exposure to a confirmed case .
3%), and 65.
8% lived with at least one active smoker.
vaccination coverage among cases was Table 1.
Demographic Characteristics.
Exposure History, and Vaccination Status of Mumps Cases Categories Percentage Age Group Total .
2-5 years 6-11 years 12-17 years Male Female Home School Yes Yes Gender Close Contact House Smokers MR Vaccinated Fever was the most frequent symptom .
1%), followed by chewing pain .
8%) and swallowing pain .
3%).
Headache .
7%), myalgia .
2%), and fatigue .
2%) occurred less frequently.
Parotid swelling was unilateral in most patients .
1%), while 28.
9% had bilateral A prior history of mumps was reported by 10.
5% of participants.
RESULTS
A total of 76 pediatric patients diagnosed with mumps were included.
Children aged 6Ae11 years comprised the largest proportion .
9%), followed by ages International Journal of Nursing and Midwifery Science (IJNMS).
Volume 9.
Issue 3.
December 2025 Table 2.
Clinical Features and Parotitis Distribution Among Mumps Patients Clinical Features Symptoms Total .
Percentage Fever Headache Myalgia Fatigue Swallowing Pain Pain Chewing Left Right Bilateral Yes Parotitis Laterality History of Mumps Age-specific prevalence analysis showed the highest prevalence among children aged 6Ae11 years .
45%), followed by adolescents aged 12Ae17 years .
and children aged 2Ae5 years .
36%).
The overall prevalence of mumps among the pediatric population at risk was 4.
38% .
CI: 3.
35%).
Table 3.
Age-Specific Prevalence of Mumps Cases in the Pediatric Population of Cisoka Puskesmas.
JanuaryAeMarch 2025
Age
Group
Total
Total
Case
Populatio
n at Risk
Prevalenc
DISCUSSION
This epidemiological and clinical characteristics of pediatric mumps in the Cisoka Puskesmas region during early 2025.
The overall prevalence of 4.
38% is noteworthy, with the highest burden among children aged 6Ae11 years .
45%).
This age pattern likely reflects intense school-based exposure and insufficient herd immunity in partially vaccinated communities.
Most patients exhibited classic mumps features, including fever .
1%),
chewing pain .
8%), and swallowing pain .
3%), consistent with international clinical patterns (CDC, 2024.
Rausch-Phung et al.
, 2.
However, many did not develop systemic symptoms such as fatigue or myalgia, highlighting variability in presentation and the importance of diagnostic vigilance in primary care.
Unilateral parotitis was more frequent .
1%) than bilateral swelling .
9%).
This contrasts with earlier studies involvement, 73.
3% in Bhat et al.
in Bhanu et al.
(Bhanu et al.
, 2025.
Bhat et , 2.
Early presentation within three days of fever may explain this difference, as bilateral enlargement often emerges later in the disease course.
Only 10.
5% reported a history of prior mumps, suggesting most infections were primary, although the potential for recall bias remains.
No complications such as orchitis, meningitis, or hearing loss were documented, possibly reflecting younger age, prompt evaluation, and generally mild disease severity.
MR vaccination coverage was low, with only 59.
2% receiving at least one dose.
This figure remains well below the 95% herd immunity threshold recommended to prevent outbreaks (Ainurafiq et al.
, 2.
Suboptimal coverage likely sustained community transmission, consistent with findings from previous studies (Melgar et , 2.
Indonesian persistent inequalities in MR vaccine uptake.
Challenges include geographic disparities, urban-rural differences, limited access to health facilities, and fragile immunization infrastructure (Ainurafiq et al.
, 2.
Behavioral barriers also play a major role.
Parental hesitancy is reinforced by misinformation, low health literacy, and International Journal of Nursing and Midwifery Science (IJNMS).
Volume 9.
Issue 3.
December 2025 limited trust in health authorities (Hadi.
Pronyk et al.
, 2.
Cultural and religious perspectives affect acceptance, emphasizing the need for deeper community-level engagement (Pronyk et al.
Although large-scale initiatives like the 2017-2018 MR campaign demonstrated government commitment, their long-term effectiveness may be compromised if these structural and behavioral barriers remain Experience from Japan similarly shows that targeted vaccination programs can still fall short without strong communication strategies and logistical support (Sato et al.
, 2.
A substantial proportion of patients .
8%) lived with active smokers.
Passive smoke exposure may increase susceptibility to viral infections by irritating the respiratory tract and impairing mucosal immunity (Qiu et al.
, 2016.
Strzelak et al.
Past outbreak investigations also link smoking to higher mumps transmission risk.
Ladbury et al.
reported that smoking during a youth event tripled the risk of infection (RR 3.
95% CI: 1.
6Ae6.
(Ladbury et al.
Similar exposure dynamics may be occurring within households in this study.
From a nursing standpoint, these findings align with community health nursing principles, emphasizing early detection, household risk mitigation, and community-level prevention strategies.
The patterns observed also reflect key constructs from PenderAos Health Promotion Model, where parental beliefs, environmental exposures, and preventive behaviors, particularly vaccination, shape pediatric (Khoshnood et al.
, 2.
The studyAos cross-sectional design limits causal inference, and its single-center setting may restrict generalizability to broader rural populations.
Self-reported vaccination status is vulnerable to recall While clinical diagnosis is acceptable during outbreaks, the lack of laboratory confirmation (RT-PCR or IgM testin.
may affect diagnostic precision.
Overall, mumps continues to affect school-aged children in rural Indonesia.
Gaps in MR vaccination coverage and Strengthening immunization programs, promoting parental education, improving early clinical recognition, and addressing domestic risk factors, such as smoking, are essential for reducing disease burden and preventing future outbreaks.
CONCLUSIONS
This study shows that mumps remains present in Cisoka Puskesmas, with an overall prevalence of 4.
concentrated among school-aged children.
Suboptimal MR vaccination coverage and household exposures, particularly passive smoke, continue to support transmission.
Strengthening improving parental addressing modifiable home environments are key steps to reducing mumps burden in similar rural communities.
REFERENCES