Coverage and Timing of Children's Vaccination: An Evaluation of the Expanded Programme on Immunisation in The Gambia.


Scott, S; Odutola, A; Mackenzie, G; Fulford, T; Afolabi, MO; Jallow, YL; Jasseh, M; Jeffries, D; Dondeh, BL; Howie, SR; D'Alessandro, U; (2014) Coverage and Timing of Children's Vaccination: An Evaluation of the Expanded Programme on Immunisation in The Gambia. PLoS One, 9 (9). e107280. ISSN 1932-6203 DOI: https://doi.org/10.1371/journal.pone.0107280

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Abstract

OBJECTIVE To evaluate the coverage and timeliness of the Expanded Programme on Immunisation (EPI) in The Gambia. METHODS Vaccination data were obtained between January 2005 and December 2012 from the Farafenni Health and Demographic Surveillance System (FHDSS), the Basse Health and Demographic Surveillance System (BHDSS), the Kiang West Demographic surveillance system (KWDSS), a cluster survey in the more urban Western Health Region (WR) and a cross sectional study in four clinics in the semi-urban Greater Banjul area of WR. Kaplan-Meier survival function was used to estimate the proportion vaccinated by age and to assess timeliness to vaccination. FINDINGS BCG vaccine uptake was over 95% in all regions. Coverage of DPT1 ranged from 93.2% in BHDSS to 99.8% in the WR. Coverage decreased with increasing number of DPT doses; DPT3 coverage ranged from 81.7% in BHDSS to 99.0% in WR. Measles vaccination coverage ranged from 83.3% in BHDSS to 97.0% in WR. DPT4 booster coverage was low and ranged from 43.9% in the WR to 82.8% in KWDSS. Across all regions, delaying on previous vaccinations increased the likelihood of being delayed for the subsequent vaccination. CONCLUSIONS The Gambia health system achieves high vaccine coverage in the first year of life. However, there continues to be a delay to vaccination which may impact on the introduction of new vaccines. Examples of effectively functioning EPI programmes such as The Gambia one may well be important models for other low income countries struggling to achieve high routine vaccination coverage.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Infectious and Tropical Diseases > Dept of Disease Control
Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) > Dept of Nutrition and Public Health Interventions Research (2003-2012)
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Research Centre: Centre for Maternal, Reproductive and Child Health (MARCH)
PubMed ID: 25232830
Web of Science ID: 342921200023
URI: http://researchonline.lshtm.ac.uk/id/eprint/2003658

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