National EPI coverage survey report in Ethiopia, 2006

Background: Routine EPI reports have shown an upward trend in immunization coverage in recent years in Ethiopia; however; regional disparities exist. Objective: To determine regional coverage of child and TT immunization and assess reasons for not utilizing immunization services. Methods: The revised 2005 WHO-EPI regional coverage cluster survey method was used to determine the sample size for the study. Regional immunization status of 12-23 months of children and mothers with 0-11 months of infants forchild immunization and TT immunization respectively were taken as the unit of analysis. A sample of 6;903 children between 12-23 months and 6;952 mothers with infants between 0-11 months from 468 clusters in 11 regions of the country were surveyed in June 2006. Results: The weighted national immunization coverage assessed by card plus history for children aged 12-23 months vaccinated before the age of one year was BCG 83.4; DPT1 84.3; DPT3 66.0; measles 54.3; and fully immunized children 49.9. The weighted national TT2+ coverage and rate of Protection at Birth (PAB) assessed by card plus history was 75.6and 63.0respectively. Conclusion: The survey showed a 10 percentage point of increment in DPT3 coverage compared to 2001 survey coverage. However; progress was not uniform in all regions of the country. Despite the improve-ment in the access to immunization in the country; DPT3 coverage was less than 30and dropout rate remained very high in three emerging regions. Effective behavioral change communication (BCC) strategies need to be designed and implemented to tackle high dropout rate in the program. Besides; health workers training program on interpersonal communication and Reaching Every District (RED) approach should be fully implemented to increase and sustain high level of immunization coverage in Ethiopia

Effect of Ivermectin (Mectizan) on Intestinal Nematodes

Ancillary to a community based mass treatment campaign of onchocerciasis with ivermectin; assessment of the drug's effect on various intestinal nematodes was made in Bebeka; Southwest Ethiopia between 23 April and 23 July; 1990. A total of 231 people were invited for the study and all consented. From each; stool specimen was collected before treatment; two weeks and three months after administration of ivermectin at a dose of 150 mcg/kg body weight. Various intestinal parasites were observed in many of the samples; ranging from single parasite up to five mixed infections per slide. Efficacy of ivermectin against Strongyloides stercoralis was 100 percent throughout the observation period. Eggs of Ascaris lumbricoides were found in 74.5 percent of the stool samples collected before treatment and this was reduced to 3.5 percent and 48.9 percent in the post-treatment samples of 15 days and three months; respectively. Similar observation was made for the other geohelminths at a lower cure rate. This finding shows that apart from its primary purpose in the control of onchocerciasis; ivermectin has the added benefit of eliminating ascaris and stronglyloides infection in areas where such parasites are co-endemic. Furthermore; its significant effect on the intensity of the other enteric nematodes will have a great impact on reducing transmission. The public health significance of population based mass chemotherapy with ivermectin is discussed