Evaluation of the EPI survey methodology for estimating relative risk

Precision in estimation of relative risks using a standardized sampling method proposed by the WHO Global Programme on AIDS was evaluated using a Monte Carlo model simulating actual populations; the proposed survey design represents a modification of the methodology used by the WHO Expanded Programme on Immunization (EPI) to estimate immunization coverage among children. This study suggests that in actual populations the proposed survey strategy is a reasonable alternative to the use of simple random sampling (SRS) at the second stage of cluster sampling. Although varying such population characteristics as the seroprevalence rate, nonresponse rate, and rate of misclassification of exposure failed to demonstrate a clear advantage of one method over the other, the added cost and difficulty of implementing SRS under field conditions warrant further consideration of the EPI-like methodology for use in estimating relative risks.