Assessment of neonatal tetanus elimination in an African setting by lot quality assurance cluster sampling (LQA-CS).
Neonatal tetanus (NT) elimination, < 1 case per 1,000 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 30,000 US dollars excluding costs of consultants. NT incidence was below the elimination threshold (< 1/1,000 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.
Cotter
B
B
European Programme, for Intervention Epidemiology Training (EPIET), Istituto Superiore di Sanita, 299 Viale Regina Elena, 00161, Rome, Italy.
Bremer
V
V
Stroh
G
G
Msambichaka
K
K
Mabuzane
E
E
Munyoro
M
M
Shirehwa
F
F
Biellik
R
R
Birmingham
M
M
D000328:Adult; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D011785:Quality Assurance, Health Care; D013742:Tetanus / Q000517:prevention & control*; D013745:Tetanus Toxoid / Q000276:immunology*; D014611:Vaccination; D015030:Zimbabwe
D013745:Tetanus Toxoid