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Short term evaluation of a rural immunization program in Nigeria
O O Odusanya1, J E Alufohai, F P Meurice
1Department of Community Health & Primary Care, Lagos State University College of Medicine, Ikeja, Nigeria.
Insights
Childhood immunization coverage in rural Nigeria significantly increased from 43% to 84% within two years. This successful vaccination program highlights a potential model for improving child health in underserved communities globally.
Area of Science:
- Public Health
- Pediatrics
- Epidemiology
Background:
- Immunization is crucial for controlling childhood diseases, especially in developing nations.
- A rural Nigerian community initiated an immunization program in 1998 with low initial vaccine coverage (43%).
Purpose of the Study:
- To assess the impact of a community-based immunization program on vaccine coverage in rural Nigeria.
Main Methods:
- A cohort of 327 children aged 0-2 years in a rural Nigerian community were studied.
- Vaccination history was collected via vaccination cards and maternal recall.
- Children received vaccines according to the Expanded Program on Immunization (EPI) schedule, including Hepatitis B and DTP.
Main Results:
- Immunization coverage significantly improved: BCG (94%), DTP third dose (88%), measles (82%).
- Full immunization rates rose from 43% to 84% (p < 0.0001).
- Hepatitis B vaccine coverage reached 58% after three doses.
Conclusions:
- The vaccination program demonstrated a significant improvement in childhood immunization coverage.
- The program's success suggests it can serve as a model for similar underserved, non-industrialized regions.
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.
Results And 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.
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