Immunization Coverage Surveys and Linked Biomarker Serosurveys in Three Regions in Ethiopia

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2016 Mar 3

PMID 26934372

Citations 19

Authors

Mark A Travassos

Berhane Beyene

Zenaw Adam

James D Campbell

Nigisti Mulholland

Seydou S Diarra

Tassew Kassa

Lisa Oot

Jenny Sequeira

Mardi Reymann

William C Blackwelder

Yukun Wu

Inna Ruslanova

Jaya Goswami

Samba O Sow

Marcela F Pasetti

Robert Steinglass

Amha Kebede

Myron M Levine

Affiliations

Soon will be listed here.

Abstract

Objective: Demographic and health surveys, immunization coverage surveys and administrative data often divergently estimate vaccination coverage, which hinders pinpointing districts where immunization services require strengthening. We assayed vaccination coverage in three regions in Ethiopia by coverage surveys and linked serosurveys.

Methods: Households with children aged 12-23 (N = 300) or 6-8 months (N = 100) in each of three districts (woredas) were randomly selected for immunization coverage surveys (inspection of vaccination cards and immunization clinic records and maternal recall) and linked serosurveys. IgG-ELISA serologic biomarkers included tetanus antitoxin ≥ 0.15 IU/ml in toddlers (receipt of tetanus toxoid) and Haemophilus influenzae type b (Hib) anti-capsular titers ≥ 1.0 mcg/ml in infants (timely receipt of Hib vaccine).

Findings: Coverage surveys enrolled 1,181 children across three woredas; 1,023 (87%) also enrolled in linked serosurveys. Administrative data over-estimated coverage compared to surveys, while maternal recall was unreliable. Serologic biomarkers documented a hierarchy among the districts. Biomarker measurement in infants provided insight on timeliness of vaccination not deducible from toddler results.

Conclusion: Neither administrative projections, vaccination card or EPI register inspections, nor parental recall, substitute for objective serological biomarker measurement. Including infants in serosurveys informs on vaccination timeliness.

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