Total population 20,675,000. Live births (LB) 349,715. Children <1 year 346,253. Children <5 years 1,778,050. Children <15 years 5,210,100

Transcription

1 Sri Lanka 4 Immunization system highlights There is a comprehensive multi-year plan (cmyp) for immunization system strengthening covering -6. A national policy on immunization has been developed. A standing National Technical Advisory Group on Immunization (NTAGI) exists in the form of an advisory committee on communicable disease. A national system to monitor Adverse Events Following Immunization (AEFI) exists. A national policy for health care waste management including waste from immunization activities exists. Sri Lanka achieved maternal neonatal tetanus (MNT) elimination status in 9. All 6 districts have updated micro-plans that include activities to raise immunization coverage. All 6 districts had >9% DTP-Hib-HepB3 coverage and >9% MCV coverage. An EPI coverage assessment survey was conducted in 4 in Killinochchi and Mullativu Districts. No stock-out of Vaccine was reported at the national and district level. Plan to introduce IPV in July 5. Table : Basic information 4 Total population,675, Live births (LB) 349,75 Children < year 346,53 Children <5 years,778,5 Children <5 years 5,, Pregnant women 349,75 Women of child bearing age (5-49 years) Neonatal mortality rate Infant mortality rate Under-five mortality rate Maternal mortality ratio Vaccine BCG DTP-Hib- HepB OPV JE MMR DTP DT Td TT Vitamin A Typhoid Age of administration At birth months, 4 months, 6 months 5,9,8 6.8 (per, LB) 9. (per, LB).4 (per, LB) 37.7 (per, LB) SEAR annual EPI reporting form, 4 and WHO, World Health Statistics 4 Table : Immunization schedule, 4 months, 4 months, 6 months, 8 months, 5 years 9 months year, 3 years 8 months 5 years years Pregnant women ( doses in st pregnancy and dose in subsequent 3 pregnancies) 6 to 59 months High risk group Division/Province/State/Region 9 District 6 Medical officer of health (MOH) areas 337 Population density (per sq. km) 34 Population living in urban areas 8% Population using improved drinking-water sources 94% Population using improved sanitation 9% Total expenditure on health as % of GDP 3.3% Births attended by skilled health personnel % Neonates protected at birth against NT 95% Census & Statistics Department, and Family Health Bureau/MOH. EPI history The law relating to the compulsory vaccination (against smallpox) is referred in the vaccination ordinance of 886. EPI was launched in 978. Inactivated JE vaccine was introduced in 988 and live JE vaccine was introduced nationwide in. Rubella introduced in 6. Vitamin A supplementation added in. MR and Td introduced in. Hepatitis B introduced in 3. Hib Pentavalent (DTP-Hib-HepB) introduced in 8. MMR introduced in. Source: WHO/UNICEF joint reporting form (JRF) 4 Source: cmyp 7- and -6 Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. World Health Organization SEARO/FHR/IVD July 5 Immunization and Vaccine Development South-East Asia Region

2 E P I FAC T S H E E T BCG DTP3 OPV3 MCV Diphtheria Cases Source: WHO/UNICEF coverage estimates. Figure 3: DTP-Hib-HepB3 coverage, 4 Figure 4: TT+ coverage and NT, % - 79% 8% - 89% TT+ Coverage Country official estimates, WHO vaccine-preventable diseases: monitoring system 4 & JRF 4. > 9% Source: SEAR annual EPI reporting form, 4 (administrative data) Table 3: OPV supplementary immunization activities (SIA), 7-4 Activity Target population (<5 years) DTP3 Coverage WHO/UNICEF coverage estimates 3. WHO vaccine-preventable diseases: monitoring system 4 & JRF 4. NT <7% Pertussis Cases Date of st round Date of nd round st round coverage (%) nd round coverage (%) 7,838,465 9-Jun-97 -Nov ,856,85 9-Sep-98 4-Oct ,3,556 -Sep- 6-Oct- 634,9 8-Oct- -Dec- S 54,8 -Sep- -Oct S 7,559 8-Sep- 6-Oct S 536,69 -Sep-3 9-Oct Source: NCCPE reports and WHO/UNICEF JRF World Health Organization SEARO/FHR/IVD July 5 Figure : DTP3 coverage, diphtheria and pertussis, 98-4 Figure : National immunization coverage, 98-4

3 Table 4: AFP surveillance performance indicators, 5-4 The last laboratory confirmed polio case due wild polio virus (WPV) was reported in November 3. Indicator AFP Wild poliovirus confirmed Compatible AFP rate Non-polio AFP rate Adequate stool specimen collection percentage 78% 78% 87% 8% 77% 8% 86% 8% 8% 75% Total stool samples collected % NPEV isolation % Timeliness of primary result reported Number of discarded AFP per, children under 5 years of age. Percent with specimens, 4 hours apart and within 4 days of paralysis onset. 3 5 to 7 result reported within 8 days and 8 onwards result reported within 4 days of sample received at laboratory. Figure 5: Non-polio AFP rate by district, 4 Figure 6: Adequate stool specimen collection percentage by district, 4 <. > No non-polio AFP case < 6% 6% 79% > 8% No AFP Source: Weekly Acute Flaccid Paralysis (AFP) data Source: Weekly Acute Flaccid Paralysis (AFP) data Table 5: Reported of vaccine preventable diseases, 5-4 Polio Diphtheria Pertussis Neonatal Tetanus (% of all Tetanus) Measles Rubella Mumps Japanese Encephalitis Congenital Rubella Syndrome ND ND 6 (5%) ND , (3%) (9%) , , ,7 4, , Source: WHO/UNICEF JRF ND=No data

4 Figure 7: MCV & MCV coverage and, 98-4 Figure 8: MCV coverage by district, Measles Cases MCV Coverage MCV coverage WHO/UNICEF coverage estimates. WHO vaccine-preventable diseases: monitoring system 4 & JRF 4. <7% 7% - 79% 8% - 89% > 9% Source: SEAR annual EPI reporting form, 4 (administrative data) Table 6: MCV supplementary immunization activities Table 7: Districts with more than 95% MCV coverage Vaccine, geographic coverage, target group Target Coverage Achieved Number of districts % M, nationwide catch-up, years to 5 years MR, nationwide catch-up, 6 years to years M, nationwide, 6 months to months,987,847 95%,89,36 7% 76,587 96% Source: WHO/UNICEF JRFs 4 6 Source: WHO/UNICEF JRF (multiple years) Figure 9: Sporadic and outbreak associated * by month and MR SIA coverage, M SIA (96%) Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan-3 Feb-3 Mar-3 Apr-3 May-3 Jun-3 Jul-3 Aug-3 Sep-3 Oct-3 Nov-3 Dec-3 Jan-4 Feb-4 Mar-4 Apr-4 May-4 Jun-4 Jul-4 Aug-4 Sep-4 Oct-4 Nov-4 Dec-4 Sporadic Outbreak associated *Includes laboratory confirmed and epidemiologically linked Source: SEAR Monthly VPD reports Immunization and Vaccine Development South-East Asia Region

5 Figure : Immunity against : Immunity profile by age in 5* Percent of population % 9% 8% 7% 6% 5% 4% 3% % % % Age (in years) Protected by maternal antibodies Protected by routine vaccination with nd dose Immune due to past infection *Based on coverage and SIA data up to 4 Source: Modeled using MSP tool ver Protected by routine vaccination with st dose Protected by SIAs Susceptible Figure : Immunity against : Immunity profile by age in 6* Percent of population % 8% 6% 4% % % Age (in years) Protected by maternal antibodies Protected by routine vaccination with st dose Protected by routine vaccination with nd dose Protected by SIAs Immune due to past infection Susceptible * Assuming the schedule and coverage of st and nd dose of Measles containing vaccine is unchanged in 5 and there are no changes on the schedules of the routine vaccination. Source: Modeled using MSP tool ver Figure : Confirmed (Lab and Epi linked) outbreak associated, by age, -4 Figure 3: Unimmunized confirmed (Lab and Epi linked) outbreak associated, by age, n= n= n= n= n= n= n= n= n=763 n= (%) (%) (%) (84%) (%) 3 4 < year -4 years 5-9 years -4 years 5+ years < year -4 years 5-9 years -4 years 5+ years Source: SEAR annual EPI reporting form (multiple years) Source: SEAR annual EPI reporting form (multiple years) Table 8: Suspected sporadic and Outbreak associated and rubella, -4 Routine/sporadic Outbreak associated suspected case death labconfirmed labconfirmed rubella suspected outbreak Outbreak Investigated case death outbreak* confirmed case* confirmed rubella outbreak* confirmed rubella * ,58, ,7,56 Source: Monthly VPD Reporting to WHO/SEARO * Laboratory confirmed & epidemiologically- linked

6 EPI FACT SHEET Table 9: Quality of field and laboratory surveillance for and rubella, -4 Case classification (number) Indicators Suspected Measles Lab-confirmed Measles Epi-Linked Clinically-confirmed Rubella Lab-confirmed Epi-Linked Discarded non- non-rubella Annual incidence of confirmed Measles per million total population Annual incidence of confirmed Rubella per million total population Proportion of all suspected and rubella that have had an adequate investigation initiated within 48 hours of notification Discarded non- non-rubella incidence per, total population Proportion of subnational administrative units reporting at least two discarded non- non-rubella per, total population Proportion of sub-national surveillance units reporting to the national level on time Target - - 8% 8% 8% ,8, % 4 3,7, % Source: SEAR Annual EPI Reporting Form, 4 ND=No data Table : Performance of Laboratory Surveillance, -4 % Serum specimen collected from suspected Total Serum Specimen received in Laboratory % serum specimens tested Specimen Positive for Measles IgM Specimen Positive for Rubella IgM % Results within 4 of receipt % Outbreak tested for viral detection Genotypes detected No. % No. % Measles Rubella ND ND B 3 8 3, 7., ND ND ND 4 69,5 98.7, ND B3 ND Source: SEAR Annual EPI Reporting Form, 4 ND=No data Figure 4: Network of laboratories, 4 Medical Research Institute, Colombo - National polio laboratory - National and rubella laboratory - National Japanese encephalitis laboratory - Rotavirus laboratory Lady Ridgeway Hospital, Colombo - Invasive bacterial disease laboratory For contact or feedback: Expanded Program on Immunization Ministry of Health, Colombo, Sri Lanka Tel: ; Fax: paba@health.gov.lk, ana_amarasinghe@yahoo.co.uk Immunization and Vaccine Development (IVD) WHO-SEARO, IP Estate, MG Marg, New Delhi, India Tel: , Fax: SEAREpidata@who.int, World Health Organization SEARO/FHR/IVD July 5 Immunization and Vaccine Development South-East Asia Region