Skip Navigation


IJE Advance Access originally published online on April 9, 2007
International Journal of Epidemiology 2007 36(3):633-641; doi:10.1093/ije/dym025
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrowOA All Versions of this Article:
36/3/633    most recent
dym025v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Luman, E. T
Right arrow Articles by Cairns, L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Luman, E. T
Right arrow Articles by Cairns, L.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Published by Oxford University Press on behalf of the International Epidemiological Association 2007.
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org

Comparison of two survey methodologies to assess vaccination coverage

Elizabeth T Luman1,*, Alemayehu Worku2, Yemane Berhane2,4, Rebecca Martin1,3,5 and Lisa Cairns1

1 Global Immunization Division, National Immunization Program, US Centers for Disease Control and Prevention.
2 Department of Community Health, Faculty of Medicine, Addis Ababa University.
3 World Health Organization, Africa Region, EPI – East Africa.

* Corresponding author. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS E05, Atlanta, GA 30333. E-mail: ECL7{at}cdc.gov.


  Abstract

Background Measuring vaccination coverage permits evaluation and appropriate targeting of vaccination services. The cluster survey methodology developed by the World Health Organization, known as the ‘Expanded Program on Immunization (EPI) methodology’, has been used worldwide to assess vaccination coverage; however, the manner in which households are selected has been criticized by survey statisticians as lacking methodological rigor and introducing bias.

Methods Thirty clusters were selected from an urban (Ambo) and a rural (Yaya-Gulelena D/Libanos) district of Ethiopia; vaccination coverage surveys were conducted using both EPI sampling and systematic random sampling (SystRS) of households. Chi-square tests were used to compare results from the two methodologies; relative feasibility of the sampling methodologies was assessed.

Results Vaccination coverage from a recent measles campaign among children aged 6 months through 14 years was high: 95% in Ambo (both methodologies), 91 and 94% (SystRS and EPI sampling, respectively, P-value = 0.05) in Yaya-Gulelena D/Libanos. Coverage with routine vaccinations among children aged 12–23 months was <20% in both districts; in Ambo, EPI sampling produced consistently higher estimates of routine coverage than SystRS. Differences between the two methods were found in demographic characteristics and recent health histories. Average time required to complete a cluster was 16h for EPI sampling and 17 h for SystRS; total cost was equivalent. Interviewers reported slightly more difficulty conducting SystRS.

Conclusions Because of the methodological advantages and demonstrated feasibility, SystRS would be preferred to EPI sampling in most situations. Validating results in additional settings is recommended.

Keywords EPI cluster survey, systematic random sampling, sampling methodology, vaccination coverage survey, Ethiopia, measles, routine vaccinations

4 Present address. Addis Continental Institute of Public Health.

5 Present address. National Center for HIV/AIDS, Viral Hepatitis, STD, and TB prevention, US Centers for Disease Control and Prevention.

Accepted 2 February 2007


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.