Abstract
BackgroundFollowing an outbreak of yellow fever in northern Uganda in December 2010, Ministry of Health conducted a massive emergency vaccination campaign in January 2011. The reported vaccination coverage in Pader District was 75.9%. Administrative coverage though timely, is affected by incorrect population estimates and over or under reporting of vaccination doses administered. This paper presents the validated yellow fever vaccination coverage following massive emergency immunization campaigns in Pader district.MethodsA cross sectional cluster survey was carried out in May 2011 among communities in Pader district and 680 respondents were indentified using the modified World Health Organization (WHO) 40 × 17 cluster survey sampling methodology. Respondents were aged nine months and above. Interviewer administered questionnaires were used to collect data on demographic characteristics, vaccination status and reasons for none vaccination. Vaccination status was assessed using self reports and vaccination card evidence. Our main outcomes were measures of yellow fever vaccination coverage in each age-specific stratum, overall, and disaggregated by age and sex, adjusting for the clustered design and the size of the population in each stratum.ResultsOf the 680 survey respondents, 654 (96.1%, 95% CI 94.9 – 97.8) reported being vaccinated during the last campaign but only 353 (51.6%, 95% CI 47.2 – 56.1) had valid yellow fever vaccination cards. Of the 280 children below 5 years, 269 (96.1%, 95% CI 93.7 – 98.7) were vaccinated and nearly all males 299 (96.9%, 95% CI 94.3 – 99.5) were vaccinated. The main reasons for none vaccination were; having travelled out of Pader district during the campaign period (40.0%), lack of transport to immunization posts (28.0%) and, sickness at the time of vaccination (16.0%).ConclusionsOur results show that actual yellow fever vaccination coverage was high and satisfactory in Pader district since it was above the desired minimum threshold coverage of 80% according to World Health Organization. Massive emergency vaccination done following an outbreak of Yellow fever achieved high population coverage in Pader district. Active surveillance is necessary for early detection of yellow fever cases.
Highlights
Following an outbreak of yellow fever in northern Uganda in December 2010, Ministry of Health conducted a massive emergency vaccination campaign in January 2011
Pader district is found in northern Uganda and this region borders South Sudan which is prone to sporadic yellow fever outbreaks [17]
Study design We estimated the yellow fever vaccination coverage through a cluster survey based on the methodology recommended by World Health Organization for determining vaccination coverages of routine Expanded Program for Immunization (EPI) vaccines [21]
Summary
Following an outbreak of yellow fever in northern Uganda in December 2010, Ministry of Health conducted a massive emergency vaccination campaign in January 2011. This paper presents the validated yellow fever vaccination coverage following massive emergency immunization campaigns in Pader district. Yellow fever is an acute vaccine preventable viral haemorrhagic disease found mainly in tropical regions of Africa and America. The number of yellow fever cases has increased over the past two decades due to declining population immunity to infection, deforestation, urbanization, population movements and climate change This disease has no cure and treatment is symptomatic, aiming at reducing symptoms for the comfort of the patient and mass vaccination is the most important preventive measure [5]. Despite mass vaccination campaigns to prevent and control these outbreaks, the risk of major yellow fever epidemics, especially in densely populated, poor urban settings, both in Africa and South America, has greatly increased [8]. Yellow fever is considered an emerging, or reemerging disease of considerable importance
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