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  • Cited by 3
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    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Hedt-Gauthier, Bethany L Mitsunaga, Tisha Hund, Lauren Olives, Casey and Pagano, Marcello 2013. The effect of clustering on lot quality assurance sampling: a probabilistic model to calculate sample sizes for quality assessments. Emerging Themes in Epidemiology, Vol. 10, Issue. 1, p. 11.

    Palmer, Stephen R. and Evans, Meirion R. 2010. Topley & Wilson's Microbiology and Microbial Infections.

    Pezzoli, Lorenzo Andrews, Nick and Ronveaux, Olivier 2010. Clustered lot quality assurance sampling to assess immunisation coverage: increasing rapidity and maintaining precision. Tropical Medicine & International Health,


Assessment of neonatal tetanus elimination in an African setting by lot quality assurance cluster sampling (LQA–CS)

  • B. COTTER (a1), V. BREMER (a2), G. STROH (a3), K. MSAMBICHAKA (a4), E. MABUZANE (a5), M. MUNYORO (a5), F. SHIREHWA (a5), R. BIELLIK (a4) and M. BIRMINGHAM (a6)
  • DOI:
  • Published online: 01 April 2003

Neonatal tetanus (NT) elimination, <1 case per 1000 live births (LB), was assessed at district level in Zimbabwe using a combined lot quality assurance–cluster sampling survey (LQA–CS). Three of the highest risk districts were selected. NT was considered eliminated if fewer than a specified number of NT deaths (proxy for NT cases) were found in the sample determined using operating characteristic curves and tables. TT2+ vaccine coverage was measured in mothers who gave birth 1–13 months before the survey and women aged 15–49 years. NT was considered as eliminated, TT2+ coverage was 78% (95% CI 71–82%) in women aged 15–49 and 83% (95% CI 76–89%) in mothers. The survey cost US$ 30000 excluding costs of consultants. NT incidence was below the elimination threshold (<1/1000 LB) in the surveyed districts and probably in all districts. LQA–CS is a practical, relatively cost effective field method which can be applied in an African setting to assess NT elimination status.

Corresponding author
Author for correspondence: Public Health Surveillance Scientist, Department of Public Health, Southern Health Board, Sarsfield House, Wilton, Cork, Ireland.
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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
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