Coverage and Timing of Children's Vaccination: An Evaluation of the Expanded Programme on Immunisation in The Gambia

• Published in: PloS one Vol. 9; no. 9; p. e107280
• Main Authors: Scott, Susana, Odutola, Aderonke, Mackenzie, Grant, Fulford, Tony, Afolabi, Muhammed O., Jallow, Yamundow Lowe, Jasseh, Momodou, Jeffries, David, Dondeh, Bai Lamin, Howie, Stephen R. C., D'Alessandro, Umberto
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 18.09.2014; Public Library of Science (PLoS)
• Subjects: Age; Age Distribution; Analysis; Bacillus Calmette-Guerin vaccine; BCG; BCG Vaccine - administration & dosage; BCG Vaccine - therapeutic use; Biology and Life Sciences; Child, Preschool; Children; Children & youth; Childrens health; Councils; Cross-Sectional Studies; Demographics; Diphtheria-Tetanus-Pertussis Vaccine - administration & dosage; Diphtheria-Tetanus-Pertussis Vaccine - therapeutic use; Disease; Drug dosages; Epidemiology; Female; Gambia; Haemophilus influenzae; Health surveillance; Hepatitis; Humans; Immunization; Immunization Schedule; Infant; Low income areas; Male; Mass Vaccination - statistics & numerical data; Measles; Measles Vaccine - administration & dosage; Measles Vaccine - therapeutic use; Medical research; Medication Adherence; Medicine and Health Sciences; Mortality; National Health Programs - statistics & numerical data; Pneumonia; Public health; Studies; Surveillance; Surveys; Survival analysis; Tetanus; Vaccination; Vaccines; Viruses; Whooping cough; Gambia; United Kingdom > UK
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0107280

To evaluate the coverage and timeliness of the Expanded Programme on Immunisation (EPI) in The Gambia. Vaccination data were obtained between January 2005 and December 2012 from the Farafenni Health and Demographic Surveillance System (FHDSS), the Basse Health and Demographic Surveillance System (BHDSS), the Kiang West Demographic surveillance system (KWDSS), a cluster survey in the more urban Western Health Region (WR) and a cross sectional study in four clinics in the semi-urban Greater Banjul area of WR. Kaplan-Meier survival function was used to estimate the proportion vaccinated by age and to assess timeliness to vaccination. BCG vaccine uptake was over 95% in all regions. Coverage of DPT1 ranged from 93.2% in BHDSS to 99.8% in the WR. Coverage decreased with increasing number of DPT doses; DPT3 coverage ranged from 81.7% in BHDSS to 99.0% in WR. Measles vaccination coverage ranged from 83.3% in BHDSS to 97.0% in WR. DPT4 booster coverage was low and ranged from 43.9% in the WR to 82.8% in KWDSS. Across all regions, delaying on previous vaccinations increased the likelihood of being delayed for the subsequent vaccination. The Gambia health system achieves high vaccine coverage in the first year of life. However, there continues to be a delay to vaccination which may impact on the introduction of new vaccines. Examples of effectively functioning EPI programmes such as The Gambia one may well be important models for other low income countries struggling to achieve high routine vaccination coverage.