EPI immunization coverage, timeliness and dropout rate among children in a West Cameroon health district: a cross sectional study

Abstract

Background: Monitoring of the expanded program on immunization's performance is not only limited to routine periodic reports but equally includes surveys. Based on unpublished national EPI surveillance data from the past 5 years in Cameroon, the Foumban health district has reported a high number of vaccine preventable disease suspected cases. Contradictory information on the immunization coverage in this district exists from both administrative data and published literature. As a result, the objective of this study was to estimate the immunization coverage and dropout rate in age group 12-23 months and timeliness in age group 0-59 months among children in Foumban Health District (Cameroon), in 2018. Method: This was a descriptive cross-sectional study targeting randomly selected children aged 0-59 months from Foumban health district. Data were collected by trained and supervised surveyors using a pretested questionnaire to describe the immunization coverage, timeliness and dropout rate in eighty clusters of about thirty buildings selected by stratified random sampling in July 2018. Results: In total, 80 clusters covering 2121 buildings were selected and all were reached (100%). A total of 1549 (81.2%) households accepted to participate in the survey and 1430 children aged 0-59 months including 294 (20.6%) aged 12-23 months were enrolled into the study. Of these 1430 children, 427 [29.9 (27.4-32.2)%] aged 0-59 months were vaccinated with evidence. In the age group 12-23 months, the immunization coverage with evidence of BCG, DPT-Hi + Hb 3 and measles/rubella were 28.6(23.4-33.9)%, 22.8 (18.1-27.6)% and 14.3 (10.3-18.1)% respectively. Within age group 0-59 months; the proportion of children who missed their vaccination appointments increased from 23.3 to 31.7% for the vaccine planned at birth (BCG) and last vaccine planned (Measles/Rubella) for the EPI program respectively. In age group 12-23 months; the specific (DPT-Hi + Hb1-3) and general (BCG-Measles/Rubella) dropout rates of vaccination with evidence were 14.1 and 50.0% respectively. Conclusion: Documented immunization coverage, dropout rate and timeliness in Foumban Health district are lower than that targeted by the Cameroon EPI. Competent health authorities have to take necessary actions to ensure the implementation of national guidelines with regards to children access to immunization. Also, studies have to be conducted to identify determinants of low immunization coverage and delays in immunization schedules as well as high dropout rates.

Analysis of Haemophilus species in patients with respiratory tract infections in Yaoundé, Cameroon

“…Vaccination against H. influenzae serotype b (Hib) was introduced in Cameroon in 2009 through the Expanded Program on Immunization and it is free of charge for children aged 0-11 months. Vaccine coverage varies from 22.8 to 93.3% according to location (Ateudjieu et al, 2020;Chiabi et al, 2017;Gervaix et al, 2012). Since the introduction of this vaccine in many countries, the burden of Haemophilus-related infections has been increasingly dominated by non-typeable H. influenzae (NTHi).…”

Tracking Demographic Movements and Immunization Status to Improve Children's Access to Immunization (TDM-IAI): Protocol for a Field-Based Randomized Controlled Trial

“…Main data collected included the immunization status and timing regarding BCG, polio zero, DPT-Hi+Hb1, DPT-Hi+Hb2, and DPT-Hi+Hb3 and sociodemographic characteristics. The sampling and implementation process of the surveys were similar but independent [ 1 ]. The surveys were conducted by independent survey teams different from the team in charge of implementation of the intervention under investigation.…”

“…Vaccines save lives cheaply, and many countries have adopted a number of antigens to be administered to children and pregnant women under the Expanded Programme on Immunization (EPI). The program has been successfully implemented in many contexts but in many others, vaccination performance in terms of coverage, completeness, and timeliness remains low and is associated with outbreaks of vaccine preventable diseases [1][2][3].…”

“…Community-based sessions are outreach activities organized by health facility staff in collaboration with community volunteers. Due to limited resources (human, financial, vaccine supply and cold chain, transportation, and power supply) on one hand and limited knowledge of caregivers and their demographic movements on the other, many children fail to receive their planned vaccine doses, be vaccinated on time, or complete their vaccination as required by the national EPI program [ 1 , 5 ].…”

Effect of Mobile Phone Text Message Reminders on the Completion and Timely Receipt of Routine Childhood Vaccinations: Superiority Randomized Controlled Trial in Northwest Ethiopia

“…Reports also show that globally, 5.9 million children were partially vaccinated in 2018 leaving many children susceptible to VPDs [ 18 ]. In low-income countries, failure to attend vaccination appointments is still a significant problem to health care providers, thereby contributing to delayed and missed vaccinations [ 12 , 19 , 20 ]. Studies in low-and-middle-income countries have also shown that despite relatively high vaccination coverage, there is a gap in the timeliness of childhood immunization [ 21 - 26 ].…”