Abstract
BackgroundIt was long speculated that there could be under-immunized pockets in the war affected Northern part of Sri Lanka relative to other areas. With the cessation of hostilities following the military suppression of the rebellion, opportunities have arisen to appraise the immunization status of children in areas of re-settlement in former war ravaged districts.MethodsWe conducted a cross-sectional study to describe the coverage and age appropriateness of infant vaccinations in a former conflict district during the phase of re-settlement. The target population comprised all children of re-settled families in the age group of 12 – 23 months in the district. We selected a study sample of 300 children from among the target population using the WHO’s 30 cluster EPI survey method. Trained surveyors collected data using a structured checklist. The infant vaccination status was ascertained by reviewing vaccination records in the Child Health Development Record or any other alternative documentary evidence.ResultsThe survey revealed that the proportion of fully vaccinated children in the district was 91%. For individual vaccines, it ranged from 92% (measles) to 100% (BCG, DPT/OPV1). However, the age appropriateness of vaccination was less than 50% for all antigens except for BCG (94%). The maximum number of days of delay of vaccinations ranged from 21 days for BCG to 253 days for measles. Age appropriate vaccination rates significantly differed for DPT/OPV1-3 and measles during the conflict and post-conflict stages while it did not for the BCG. Age appropriate vaccination rates were significantly higher for DPT/OPV1-3 during the conflict while for the measles it was higher in the post conflict stage.ConclusionsThough the vaccination coverage for infant vaccines in the war affected Kilinochchi district was similar to other districts in the country, it masked a disparity in terms of low age-appropriateness of infant immunizations given in field settings. This finding underscores the need for investigation of underlying reasons and introduction of remedial measures in the stage of restoring Primary Health Care services in the ex-conflict zone.
Highlights
It was long speculated that there could be under-immunized pockets in the war affected Northern part of Sri Lanka relative to other areas
We considered vaccinations as invalid when infant vaccinations were given before the scheduled age in the national immunization schedule or else they were given before an appropriate minimum interval of time in relation to DTP+ Hepatitis B+ Hib/OPV which are given in a series
In contrast to the BCG, we found that the age-appropriateness of DTP + hepatitis B + Hib, OPV vaccinations was significantly higher during the conflict
Summary
It was long speculated that there could be under-immunized pockets in the war affected Northern part of Sri Lanka relative to other areas. Similar to countries where similar, long standing conflict situations prevailed, it is reasonable to believe that the Internally Displaced Population (IDP) did not have adequate access to Primary Health Care (PHC) services due to hostilities between the government forces and rebels [1]. This situation may have affected the vaccination coverage for basic childhood vaccines (National Immunization Schedule at the time of the study is given in Table 1), placing IDPs at a disadvantaged position relative to the general Sri Lankan population which have had a very high vaccination coverage for a considerable period of time [2] [3]. The entire population of these districts was displaced as a result
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
