EPI history EPI launched in 980 HepB vaccine introduced in 003 AD syringes introduced in 003 HepB birth dose introduced in 004 DTP-HepB vaccine introduced in 006 MCV introduced in 008 DTP-Hib-HepB vaccine introduced in 0 IPV vaccine introduced in 05 topv to bopv switched on 8 April 06 Source: cmyp 06-00 and EPI/MOPH 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. Table : Basic information 07 Total population 5,030,070 Live births 34,774 Children < year 339,367 Children <5 years,696,094 Children <5 years 5,97,740 Pregnant women 34,30 WCBA (5-49 years) 6,574,80 Neonatal mortality rate Infant mortality rate Under-five mortality rate Maternal mortality ratio 0.7 (per,000 LB) 5. (per,000 LB) 0.0 (per,000 LB) 8 (per 00,000 LB) Division/Province/State/Region District 0 Population density (per sq. km) 6 Population living in urban areas 6% Population using improved 00% drinking-water sources Population using improved 8% sanitation Total expenditure on health as % of GDP Births attended by skilled health 00% personnel Neonates protected at birth 97% against NT SEAR annual EPI reporting form, 07 WHO, Global Health Observatory (GHO) data http://apps.who.int/ gho/data accessed on 3 May 08 - Table : Immunization schedule, 07 Vaccine BCG HepB DTP-Hib-HepB OPV IPV Measles Td Vitamin A Table 3: Immunization system highlights cmyp for immunization 06-00 NTAGI Spending on vaccines financed by the government Spending on routine immunization programme financed by the government Updated micro-plans that include activities to improve immunization coverage National policy for health care waste management including waste from immunization activities National system to monitor AEFI Most recent EPI CES >80% coverage for DTP-Hib- HepB3 fully functional no data 45% 0 districts (00%) in place in place National Immunization Coverage Survey 0 districts (00%) >90% coverage for MCV 0 districts (00%) >0% drop-out rate for DTP-Hib- HepB to DTP-Hib-HepB3 Source: WHO/UNICEF JRF 07 Age of administration Birth Birth 6 weeks, 0 weeks and 4 weeks 6 weeks, 0 weeks and 4 weeks 4 weeks 9 months and 5 months 3 months and 4 months of pregnancy 6-59 months Source: WHO/UNICEF JRF, 07 none Figure : National immunization coverage, 980 07 980 985 990 995 000 005 00 05 06 07 BCG 50 5 99 8 78 94 98 97 97 98 DTP3 50 55 98 64 56 79 93 96 96 97 OPV3 50 65 99 88 93 97 99 99 99 99 MCV 9 38 98 67 78 96 99 98 99 99 Source: WHO and UNICEF estimates of national immunization coverage, July 08 World Health Organization SEARO/FGL/IVD 3 July 08
Figure : DTP3 coverage, diphtheria and pertussis cases, 980-07 Figure 3: TT+ coverage and NT cases, 980-07 WHO and UNICEF estimates of national immunization coverage, July 08 WHO vaccine-preventable diseases: monitoring system 08 Country official estimates, 980-07 WHO vaccine-preventable diseases: monitoring system 08 DTP-Hib-HepB3 coverage by province Figure 4: 06 Figure 5: 07 form, 06 (administrative form, 07 (administrative <70% 70% - 79% 80% - 89% >90% Table 4: Reported cases of vaccine preventable diseases, 0-07 Year Polio Diphtheria Pertussis NT (% of all tetanus) Measles Rubella Mumps JE CRS 0 0 0 8 0 0 0 0 03 0 0 0 0 0 0 0 0 0 04 0 0 0 0 3 0 0 0 0 05 0 0 0 0 0 0 0 0 0 06 0 0 0 0 3* 0 0 0 0 07 0 0 0 0 0 0 0 0 0 Source: WHO/UNICEF JRF (multiple years) *Import and/or import related
Table 5: AFP surveillance performance indicators, 0-07 The last laboratory confirmed polio case due to WPV was reported in 996. Indicator 0 03 04 05 06 07 AFP cases 5 6 5 99 05 04 Wild poliovirus confirmed cases 0 0 0 0 0 0 Compatible cases 0 0 0 0 0 0 Non-polio AFP rate.8.0.00.7.83.76 Adequate stool specimen collection percentage 00% 00% 00% 00% 98% 97% Total stool samples collected 69 6 84 56 94 0 % NPEV isolation 9 5 4 4 % Timeliness of primary result reported 3 94 9 99 95 93 95 Number of discarded AFP cases per 00,000 children under 5 years of age. Percent with specimens, 4 hours apart and within 4 days of paralysis onset. 3 Result reported within 4 days of sample received at laboratory. Non-polio AFP rate by province Adequate stool specimen collection % by province Figure 6: 06 Figure 8: 06 Figure 7: 07 Figure 9: 07 < -.99 > No non-polio AFP case <60% 60% - 79% >80% No AFP case Table 6: OPV and JE SIAs Year Antigen Geographic coverage Target age Target population Coverage (%) Round Round Round Round 000 OPV NID <5 years,47,99 99.6 99.7 00 OPV NID <5 years,0,380 98.8 99.5 00 OPV NID <5 years,098,940 99.7 99.8 009 JE SNID to 3 months and 4 to 5 years Source: WHO/UNICEF JRF (multiple years),500,000 99.5
Figure 0: MCV coverage and measles cases, 980-07 WHO and UNICEF estimates of national immunization coverage, July 08 WHO vaccine-preventable diseases: monitoring system 08 MCV coverage by province MCV coverage by province Figure : 06 Figure 3 : 06 form, 06 (administrative form, 06 (administrative Figure : 07 Figure 4 : 07 form, 07 (administrative form, 07 (administrative <80% 80% - 89% 90% - 94% >95% Table 7: MCV SIAs Figure 5: Sub-national risk assessment - measles and rubella Year Antigen Geographic Coverage Target group 007 M nationwide 6 months to 45 years Target Coverage 6,3,376 99.9 Source: WHO/UNICEF JRF Very High Risk High Risk Medium Low Not Available World Health Organization SEARO/FGL/IVD 3 July 08
Figure 6: Immunity against measles - immunity profile by age in 07* *Modeled using MSP tool ver Figure 7: Sporadic and outbreak associated measles cases* by month 0-07 *Includes laboratory confirmed and epidemiologically linked cases and all cases are imported Source: SEAR Monthly VPD reports Figure 8: Immunization status of confirmed (laboratory and Epi linked) measles outbreak associated cases, by age, 0-07 form (multiple years) *imported cases
Table 8: Surveillance performance indicator for measles and rubella, 0-07 Case classification (number) Indicators Year No. of Suspected Measles Lab-confirmed Measles Epi-Linked Clinically-confirmed Lab-confirmed Rubella Epi-Linked Discarded non-measles non-rubella cases Annual incidence of confirmed Measles cases per million total population Annual incidence of confirmed Rubella cases per million total population Proportion of all suspected measles and rubella cases that have had an adequate investigation initiated within 48 hours of notification Discarded non-measles non-rubella incidence per 00,000 total population Proportion of provinces reporting at least two discarded non-measles non-rubella cases per 00,000 total population Proportion of sub-national surveillance units reporting to the national level on time Target 80% 80% 80% 0 66 0 0 0 0 65 0 0 00 0.7 0 00 03 63 0 0 0 0 0 63 0 0 00 0.6 0 00 04 35 3 0 0 0 0 3 0. 0 00 0.53 0 00 05 3 0 0 0 0 0 3 0 0 00 0.54 0 00 06 73 0 0 0 0 0 73 0 0 00 0.3 0 96 07 505 0 0 0 0 0 505 0 0 00.0 0 97 Source: : SEAR Annual EPI Reporting Form (multiple years) Table 9: Performance of laboratory surveillance, 0-07 Year Serum specimen collected from suspected measles cases Serum specimen received in laboratory within 5 days of collection Specimen positive for measles IgM Specimen positive for rubella IgM % Results within 4 days of receipt Genotypes detected No (%) No (%) No. % No. % Measles Rubella 0 66 (00%) 66 (00%) 0 0 00 ND ND 03 63 (00%) 63 (00%) 0 0 0 0 00 ND ND 04 35 (00%) 35 (00%) 3 0 0 00 ND ND 05 3 (00%) 3 (00%) 0 0 0 0 00 - - 06 73 (00%) 73 (00%) 0 0 0 0 00 - - 07 06 (%) 06 (00%) 0 0 0 0 00 - - Source: SEAR Annual EPI Reporting Form (multiple years) ND=No data Figure 9: Laboratory network Central Hygiene Anti Epidemic Institution - National polio laboratory - National measles & rubella laboratory For contact or feedback: Expanded Program on Immunization Ministry of Public Health, Pyongyang, DPR Korea Phone: +850--384077, Fax: +850--440446 Email: bogon.moph@star-co.net.kp Immunization and Vaccine Development (IVD) WHO-SEARO, IP Estate, MG Marg, New Delhi 000, India Tel: +9 3370804, Fax: +9 33705 Email: SearEpidata@who.int, www.searo.who.int/entity/immunization