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Assessment of neonatal tetanus elimination in an African setting by lot quality assurance cluster sampling (LQA–CS)

Published online by Cambridge University Press:  29 April 2003

B. COTTER ,
V. BREMER ,
G. STROH ,
K. MSAMBICHAKA ,
E. MABUZANE ,
M. MUNYORO ,
F. SHIREHWA ,
R. BIELLIK  and
M. BIRMINGHAM
B. COTTER
Affiliation:
European Programme for Intervention Epidemiology Training (EPIET), Istituto Superiore di Sanita, 299 Viale Regina Elena, 00161, Rome, Italy
V. BREMER
Affiliation:
Robert Koch-Institute, Seestrasse 10, 13353 Berlin, Germany
G. STROH
Affiliation:
Department of Vaccines and Biologicals, Vaccine Assessment and Monitoring Team, World Health Organisation, Geneva, Switzerland
K. MSAMBICHAKA
Affiliation:
World Health Organisation, Intercountry Zimbabwe, PO Box 5160, Harare, Zimbabwe
E. MABUZANE
Affiliation:
Ministry of Health, PO Box CY 1122 Causeway, Harare, Zimbabwe
M. MUNYORO
Affiliation:
Ministry of Health, PO Box CY 1122 Causeway, Harare, Zimbabwe
F. SHIREHWA
Affiliation:
Ministry of Health, PO Box CY 1122 Causeway, Harare, Zimbabwe
R. BIELLIK
Affiliation:
World Health Organisation, Intercountry Zimbabwe, PO Box 5160, Harare, Zimbabwe
M. BIRMINGHAM
Affiliation:
World Health Organization, Department of Vaccines and Biologicals, Vaccine Assessment and Monitoring Team, Geneva, Switzerland
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Abstract

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Neonatal tetanus (NT) elimination, <1 case per 1000 live births (LB), was assessed at district level in Zimbabwe using a combined lot quality assurance–cluster sampling survey (LQA–CS). Three of the highest risk districts were selected. NT was considered eliminated if fewer than a specified number of NT deaths (proxy for NT cases) were found in the sample determined using operating characteristic curves and tables. TT2+ vaccine coverage was measured in mothers who gave birth 1–13 months before the survey and women aged 15–49 years. NT was considered as eliminated, TT2+ coverage was 78% (95% CI 71–82%) in women aged 15–49 and 83% (95% CI 76–89%) in mothers. The survey cost US$ 30000 excluding costs of consultants. NT incidence was below the elimination threshold (<1/1000 LB) in the surveyed districts and probably in all districts. LQA–CS is a practical, relatively cost effective field method which can be applied in an African setting to assess NT elimination status.

Type
Research Article
Information
Epidemiology & Infection , Volume 130 , Issue 2 , April 2003 , pp. 221 - 226
Copyright
© 2003 Cambridge University Press