Short term evaluation of a rural immunization program in Nigeria.
BACKGROUND
Immunization remains the primary strategy in both the control and prevention of common childhood diseases, particularly in the developing world. Immunization and preprimary health care services were commenced in a rural community in Nigeria in 1998, when vaccine coverage for all Expanded Program on Immunization (EPI) diseases (tuberculosis, polio, diphtheria, pertussis, tetanus, measles, and hepatitis B) was considerably low with only 43% of children fully immunized.


METHODS
Children aged 0-2 years and living in a rural community were recruited into the study. Data on vaccination history was collected by both vaccination card and maternal history. Three hundred and twenty-seven children were recruited into the study. Study participants were vaccinated for EPI diseases. Hepatitis-B vaccine was administered at birth, and a combined diphtheria and tetanus toxoids, and pertussis whole cell vaccine (DTP) plus hepatitis-B vaccine was administered in a single injection after six weeks.


CONCLUSIONS
Two years after the program was started, immunization coverage rates were 94% for BCG, 88% for DTP (third dose), and 82% for measles. All antigens showed significant improvements from baseline values (p < 0.0001). Eighty four percent of children were fully immunized against all six diseases, compared with 43% at the commencement (p < 0.0001). Hepatitis-B coverage (three doses) was 58%. The vaccination program has significantly improved vaccination coverage and could be a model for under served, non-industrialized communities.
Odusanya
O O
OO
Department of Community Health & Primary Care, Lagos State University College of Medicine, Ikeja, Nigeria.
Alufohai
J E
JE
Meurice
F P
FP
Clemens
R
R
Ahonkhai
V I
VI
D001500:BCG Vaccine / Q000008:administration & dosage; D002675:Child, Preschool; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007115:Immunization Schedule; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008458:Measles Vaccine / Q000008:administration & dosage; D009549:Nigeria / Q000453:epidemiology; D023321:Poliovirus Vaccines / Q000008:administration & dosage; D015397:Program Evaluation; D019035:Rural Health Services / Q000706:statistics & numerical data*; D017678:Sex Distribution
D001500:BCG Vaccine; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D008458:Measles Vaccine; D023321:Poliovirus Vaccines