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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)...
Abstract

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.

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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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