Impact of Expanded Programme on Immunization (EPI) on Rates and Trends in Admission of Neonatal Tetanus and Measles

Abstract

Summary: Impact of the Expanded Programme on Immunization (EPI) on neonatal tetanus (NNT) and measles, two of the target diseases in the programme, was studied retrnspectively, using the rates of and trends in admissions of these diseases. Trends in admission were determined, using the technique of analysis of time-series, four-point and eight-point moving averages for NNT and measles, respectively. During the five-year period covered by the study, more cases of NNT were admitted than measles (P < 0.01); similarly, mortality from NNT was higher (P < 0.001) than that from measles. There was a positive impact of EPI on the rates of admission of both diseases, as evident from the decrease in the rates, as well as by the decreasing trends in the admissions. The decreasing trend for measles started in 1984, about one year before the launching of the EPI in Port Harcourt, but this became more marked about two years after the launching. Regarding NNT, a sustained decreasing trend started about a year after the launching, having been preceded by a period of an increasing trend that appeared to be due to the generally low immunization coverage rates of between nine and 23 percent for measles, DPT and tetanus toxoid among the target population, comprising children from birth to one year and pregnant women.