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.
European Programme, for Intervention Epidemiology Training (EPIET), Istituto Superiore di Sanita, 299 Viale Regina Elena, 00161, Rome, Italy.
B
B
Cotter
V
V
Bremer
G
G
Stroh
K
K
Msambichaka
E
E
Mabuzane
M
M
Munyoro
F
F
Shirehwa
R
R
Biellik
M
M
Birmingham
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