EPI Fact ShEEt 74 948 Population density (per sq. km) 135 Population living in urban areas 48%...

World Health Organization• SEARO/FGL/IVD • 31 August 2016World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development

South-East Asia Region

Immunization andVaccine Development


Thailand 2016

Immunization system highlights

� There is a comprehensive multi-year plan (cMYP) for immunization covering 2013–2016.

� A standing national technical advisory group on immunization (NTAGI) fully functional.

� 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.

� A national policy on seasonal influenza vaccination exists.

� 100% of all vaccine costs as well as routine immunization costs financed by the government.

� All 928 districts have updated micro-plans that include activities to raise immunization coverage.

� Rotavirus vaccine provided to 2 and 4 months children through a pilot project in Sukhothai Province.

� HPV vaccine provided to girl students of grade 5 and 6 through a pilot project in Pranakhonsri Ayuthaya Province.

� JE live attenuated vaccine started in 2013 in 8 provinces then expanded to cover 29 provinces in 2014 and will be expanded the whole country in 2016.

Source: WHO/UNICEF joint reporting form (JRF) 2015

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 1: Basic information1 2015Division/Province/State/Region 77

District 928

Sub-district 7 427

Village 74 948

Population density (per sq. km) 135

Population living in urban areas 48%

Population using improved drinking-water sources

96%

Population using improved sanitation 93%

Total expenditure on health as % of GDP 4.5%

Births attended by skilled health personnel 100%

Neonates protected at birth against NT 91%

Total population 65 729 098

Live births (LB) 675 530

Children <1 year 650 332

Children <5 years 3 676 952


Pregnant women 675 530

Women of child bearing age (15–49 years)

17 284 706

Neonatal mortality rate2 3.5 (per 1 000 LB)

Infant mortality rate2 6.3 (per 1 000 LB)

Under-five mortality rate2 8.1 (per 1 000 LB)

Maternal mortality ratio2 23.3 (per 100 000 LB)

1 SEAR annual EPI reporting form (AERF) 2015 and WHO, World Health Statistics 2015 2 Bureau of policy and strategy, MOPH

Vaccine Age of administration

BCG At birth

HepB At birth, 1 month (new-born from HepB carrier mother)

DTP-HepB 2 months, 4 months, 6 months

OPV 2 months, 4 months, 6 months, 1.5 years, 4 years

MMR 9 Months, 2.5 years

DTP 1.5 years, 4 years

Td School children in grade VI (12 years) and pregnant women at 1st contact, +1 month, +6 months (depending on vaccination history)

JE_Inactd 1 years (2 doses 4 weeks apart), 2.5 years

JE_LiveAtd 1 years, 2.5 years (sub-national)

EPI history � EPI launched in 1977. � 1977 - BCG for newborns, DTP for infants at 2

and 4 months. � 1982 - OPV introduction, DTP 3rd dose for

infants at 6 months. � 1984 - MCV for 9–12 months infants. � 1986 - Rubella vaccine for 6th grade girls. � 1991 - DTP 4th dose for infants 1.5–2 years. � 1992 - HepB vaccine scaled up nation-wide. � 1993 - Rubella vaccine for 1st grade students. � 1996 - MCV for 1st grade students. � 1997 - MCV and rubella vaccine were

substituted by MMR for students. � 2000 - JE_Inactd vaccine introduced

countrywide. � 2000 - DTP 5th dose introduced for children

aged 4 years. � 2004 - Influenza vaccine introduced for HCWs. � 2008 - Influenza vaccine introduced for high

risk adults. � 2008 - DTP-HepB vaccine introduced. � 2010 - MCV vaccine substituted with MMR for

9–12 months infants. � IPV introduced in 2015. � Type 2 component of OPV withdrawn on 29

April 2016 by switching from tOPV to bOPV.

Table 2: Immunization schedule, 2015

Source: cMYP 2013–2016 and EPI/MOPH


E P I F a c t S h E E t

Figure 12: Confirmed (Lab and Epi linked) measles outbreak associated cases, by age, 2010–2015

Figure 10: Immunity against measles: Immunity profile by age in 2015*

Figure 13: Unimmunized confirmed (Lab and Epi linked)measles outbreak associated cases, by age, 2010–2015

Figure 14: Network of laboratories


*Modeled using MSP tool ver 2 based on coverage data up to 2015.

Source: SEAR annual EPI reporting form ND= No data

*Modeled using MSP tool ver 2 assuming the schedule and measles containing vaccine (MCV) coverage remain unchanged

Source: SEAR annual EPI reporting form ND = No data

Routine/sporadic cases Outbreak associated cases

Year No. of suspected

case

No. of death

No. of lab-confirmed

measles cases


rubella cases

No. of suspected

outbreak

No. of Outbreak

Investigated

No. of case

No. of death

No. of measles

outbreak*

No. of confirmed

measles case*

No. of confirmed

rubella outbreak*

No. of confirmed

rubella cases*

2010 2 273 0 ND ND 0 0 0 0 ND ND ND

2011 3 056 0 67 13 12 11 269 0 9 22 0 1

2012 5 195 0 799 69 12 10 147 0 9 46 0 0

2013 2 633 0 271 42 8 8 59 0 7 39 0 0

2014 1 191 0 70 19 0 0 0 0 0 0 0 0

2015 588 0 57 36 7 23 60 0 9 9 2 35

Source: Monthly VPD Reporting to WHO/SEARO * Laboratory confirmed & epidemiologically- linked ND=No data

Table 8: Suspected sporadic and Outbreak associated measles and rubella cases, 2010–2015

Table 9: Quality of field and laboratory surveillance for measles and rubella, 2012–2015

Year

No. o

f Sus

pect

ed M

easl

es

Case classification (number) Indicators

Measles Rubella

Disc

arde

d no

n-m

easl

es n

on-

rube

lla c

ases

Annu

al in

cide

nce

of

confi

rmed

Mea

sles

cas

es p

er

mill

ion

tota

l pop

ulat

ion

Annu

al in

cide

nce

of

confi

rmed

Rub

ella

cas

es p

er

mill

ion

tota

l pop

ulat

ion

Prop

ortio

n of

all

susp

ecte

d m

easl

es a

nd ru

bella

cas

es

that

hav

e ha

d an

ade

quat

e in

vest

igat

ion

initi

ated

with

in

48 h

ours

of n

otifi

catio

n

Disc

arde

d no

n-m

easl

es

non-

rube

lla in

cide

nce

per

100

000

tota

l pop

ulat

ion

Prop

ortio

n of

sub

natio

nal

adm

inis

trativ

e un

its re

porti

ng

at le

ast t

wo

disc

arde

d no

n-m

easl

es n

on-r

ubel

la c

ases

pe

r 100

000

tota

l pop

ulat

ion

Prop

ortio

n of

sub

-nat

iona

l su

rvei

llanc

e un

its re

porti

ng

to th

e na

tiona

l lev

el o

n tim

e

Lab-

confi

rmed

Epi-L

inke

d

Clin

ical

ly-c

onfir

med

Lab-

confi

rmed

Epi-L

inke

d

Target – – 80% 2 80% 80%

2012 5 207 976 0 3 491 90 0 485 15.19 1.4 31.36 0.75 9.21 ND

2013 2 641 325 2 1 819 50 0 405 5.07 0.78 26.98 0.63 6.58 ND

2014 1 184 75 3 68 21 1 300 1.2 0.34 ND 0.46 3.95 ND

2015 1015 59 3 92 34 14 377 0.95 0.73 ND 0.58 9.21 ND

Source: SEAR Annual EPI Reporting Form ND=No data

Table 10: Performance of Laboratory Surveillance, 2012–2015

Year

% Serum specimen collected from

suspected measles cases

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

2012 ND ND ND ND ND ND ND ND ND ND ND


2014 37.5 416 100 75 18 21 5.1 92.1 100 B3 ND

2015 54.7 506 100 61 12.1 36 7.1 94.5 100 H1 2B


For contact or feedback: Chief, Vaccine Preventable Disease Section Ministry of Public Health, Nonthaburi, Thailand Tel: +66-2-5903199, Fax + 66-2-9659152 Email: [email protected], www.moph.go.th

Immunization and Vaccine Development (IVD)WHO-SEARO, IP Estate, MG Marg, New Delhi 110002, IndiaTel: +91 11 23370804, Fax: +91 11 23370251Email: [email protected], www.searo.who.int/entity/immunization

Susceptible Immune due to past infectionProtected by SIAs Protected by routine vaccination with 2nd doseProtected by routine vaccination with 1st dose Protected by maternal antibodies

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Perc

ent o

f pop

ulat

ion

Age (in years)


0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Perc

ent o

f pop

ulat

ion

Age (in years)

0

20

40

60

80

100

120

2010 2011 2012 2013 2014 2015

<1 year 1-4 years 5-9 years 10-14 years 15+ years

ND n=94 n=180 n=50 n=1 n=10

0

20

40

60

80

100

120

2010 2011 2012 2013 2014 2015


ND n=94 n=180 n=46 n=1 n=10 (100%) (100%) (92%) (100%) (100%)

National Institute of Health, Nonthaburi - Regional reference polio laboratory- Regional reference measles & rubella laboratory

Sub-national measles & rubella laboratories (13)


World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development


Table 3: OPV supplementary immunization activities (SIA)

Figure 3: DTP-HepB3 coverage

Figure 5: Non-polio AFP rate by province, 2015Table 6: MCV supplementary immunization activities

Figure 7: MCV1 & MCV2 coverage1 and measles cases2, 1980–2015

Figure 9: Sporadic and outbreak associated measles cases* by month, 2010–2015

Figure 4: TT2+ coverage1 and NT cases2, 1980–2015

Figure 6: Adequate stool specimen collection percentage by province, 2015

Table 7: Districts with more than 95% MCV1 coverage

Figure 8: MCV1 coverage by district

Year Target (<5 years) children by round Dates by SIA round Coverage (%) by round

First Second First Second First Second

2000 5 320 365 5 350 859 21-Dec-00 18-Jan-01 >95 >95

2001 4 228 841 4 235 472 21-Dec-01 18-Jan-02 >95 >95

2002 3 253 754 3 259 466 18-Dec-02 21-Jan-03 >95 >95

2003 3 090 113 3 104 156 16-Dec-03 13-Jan-04 >95 >95

2004 3 202 447 3 085 319 21-Dec-04 18-Jan-05 >95 >95

2006 2 275 235 2 279 229 13-Dec-06 17-Jan-07 >95 >95

2007 2 385 009 2 385 460 26-Dec-07 23-Jan-08 >93 >93

2008 2 356 691 2 374 596 17-Dec-08 14-Jan-09 >95 >95

2009 2 465 626 2 481 614 23-Dec-09 27-Jan-10 >95 >95

2010 1 976 446 2 012 534 15-Dec-10 19-Jan-11 97 96

2011 1 173 775 1 181 487 14-Dec-11 18-Jan-12 94 >95

2012 951 795 819 037 14-Nov-12 12-Dec-12 95 95

2013 269 903 278 345 23-Jan-13 20-Feb-13 96 97

2014* 613 939 – Jan-2014 – 94 –

2015* 617 027 – Apr-2015 – 87 –

Source: NCCPE reports and WHO/UNICEF JRF* Thai children <5 yrs and foreign children (migrant) <15 yrs.

Indicator 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

AFP cases 305 225 261 212 272 249 289 235 238 183

Wild poliovirus confirmed cases 0 0 0 0 0 0 0 0 0 0

Compatible cases 0 0 0 0 0 0 0 0 0 0

AFP rate 2.26 1.67 1.95 1.65 2.08 1.90 2.21 1.80 1.97 1.52

Non-polio AFP rate1 2.26 1.67 1.95 1.64 2.08 1.90 2.21 1.80 1.97 1.36

Adequate stool specimen collection percentage2 81% 77% 79% 75% 70% 67% 74% 70% 79% 65%

Total stool samples collected 598 443 494 401 506 496 576 444 450 345

% NPEV isolation 5 3 5 3 5 6 5 5 5 3

% Timeliness of primary result reported3 100 99 100 98 100 100 100 100 100 100

Year Vaccine, geographic coverage, target group

Target Coverage Achieved

2002 M, sub-national, outbreak response & campaign

ND ND

2015 MR, nationwide, 2.5 to 7 years 2 541 544 88%

Year Number of districts %

2010 ND –

2011 ND –

2012 ND –

2013 ND –

2014 ND –

2015 ND –

1 Number of discarded AFP cases per 100,000 children under 15 years of age.2 Percent with 2 specimens, 24 hours apart and within 14 days of paralysis onset.3 2005 to 2007 result reported within 28 days and 2008 onwards result reported within 14 days of sample received at laboratory.

*Includes laboratory confirmed and epidemiologically linked casesSource: SEAR Monthly VPD reports

Source: WHO/UNICEF JRF

Source: WHO/UNICEF JRF

Table 4: AFP surveillance performance indicators, 2006–2015

• The last laboratory confirmed polio case due to wild polio virus (WPV) was reported in April 1997.

• Thailand achieved maternal and neonatal tetanus (MNT) elimination status in 1995.

Figure 1: National immunization coverage, 1980–2015 Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980–2015

Year Polio Diphtheria Pertussis Neonatal Tetanus (% of all Tetanus)

Measles Rubella Mumps Japanese Encephalitis

Congenital Rubella Syndrome

2006 0 2 72 3 (2%) 3 588 498 7 838 49 ND

2007 0 3 23 4 (3%) 3 893 341 9 299 43 ND

2008 0 8 16 3 (3%) 7 790 621 13 861 64 ND

2009 0 12 25 1 (1%) 6 071 594 20 383 36 ND

2010 0 77 6 3 (2%) 2 583 387 15 885 40 ND

2011 0 28 12 1 (1%) 3 156 517 10 077 52 ND

2012 0 63 14 4 (4%) 5 197 493 7 431 54 2

2013 0 28 24 2 (2%) 2 641 539 5 907 59 0

2014 0 19 14 2 (2%) 146 152 3 704 31 ND

2015 0 19 51 0 154 240 3 121 23 0

TableTable 5: Reported cases of vaccine preventable disease, 2006–2015

Source: WHO/UNICEF JRF ND=No data

Source: SEAR annual EPI reporting form

1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016

1 Country official estimates, 1980–2015.2 WHO vaccine-preventable diseases: monitoring system 2016

Source: SEAR annual EPI reporting form

Source: WHO and UNICEF estimates of national immunization coverage, July 2016 revision

1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016

1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015BCG 68 80 99 98 99 99 99 99 99 99 99 99DTP3 49 62 92 96 97 98 99 99 99 99 99 99OPV3 19 61 92 96 97 98 99 99 99 99 99 99MCV1 26 80 91 94 96 98 98 98 99 99 99

0

20

40

60

80

100

% C

over

age

0

20

40

60

80

100

0

200

400

600

800

1000

1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015

% C

over

age

No. o

f cas

es

YearDiphtheria Cases Pertussis Cases DTP3 Coverage

1918 4820 2533

2004 5,329 (99%) of 5386 sub-districts had >90% DTP3 coverage

2005–2015 Sub-national immunization coverage data not available.

0

20

40

60

80

100

0

100

200

300

400

500

600

700

1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015

% C

over

age

No. o

f cas

es

YearNT cases TT2+ coverage

<1 1–1.99 > No non-polio AFP case2 <60% 60%–79% > No AFP80

0

20

40

60

80

100

0

2000

4000

6000

8000

10000

1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015

% C

over

age

No. o

f cas

es

YearMeasles Cases MCV1 Coverage MCV2 Coverage

16795 32156 29244 11112

2004 5 299 (98%) of 5386 sub-districts had >90% MCV1 coverage

2005–2015 Sub-national immunization coverage data not available.

0

20

40

60

80

100

120

Jan-

10

Mar-1

0

May-1

0

Jul-1

0

Sep-

10

Nov-1

0

Jan-

11

Mar-1

1

May-1

1

Jul-1

1

Sep-

11

Nov-1

1

Jan-

12

Mar-1

2

May-1

2

Jul-1

2

Sep-

12

Nov-1

2

Jan-

13

Mar-1

3

May-1

3

Jul-1

3

Sep-

13

Nov-1

3

Jan-

14

Mar-1

4

May-1

4

Jul-1

4

Sep-

14

Nov-1

4

Jan-

15

Mar-1

5

May-1

5

Jul-1

5

Sep-

15

Nov-1

5

No. o

f cas

es

Sporadic measles Outbreak associated measles





Thailand 2016















District 928

Sub-district 7 427

Village 74 948




96%












17 284 706







BCG At birth

































case

No. of death


measles cases


rubella cases

No. of suspected

outbreak

No. of Outbreak

Investigated

No. of case

No. of death

No. of measles

outbreak*

No. of confirmed

measles case*

No. of confirmed

rubella outbreak*

No. of confirmed

rubella cases*

2010 2 273 0 ND ND 0 0 0 0 ND ND ND

2011 3 056 0 67 13 12 11 269 0 9 22 0 1

2012 5 195 0 799 69 12 10 147 0 9 46 0 0

2013 2 633 0 271 42 8 8 59 0 7 39 0 0

2014 1 191 0 70 19 0 0 0 0 0 0 0 0

2015 588 0 57 36 7 23 60 0 9 9 2 35




Year

No. o

f Sus

pect

ed M

easl

es


Measles Rubella

Disc

arde

d no

n-m

easl

es n

on-

rube

lla c

ases

Annu

al in

cide

nce

of

confi

rmed

Mea

sles

cas

es p

er

mill

ion

tota

l pop

ulat

ion

Annu

al in

cide

nce

of

confi

rmed

Rub

ella

cas

es p

er

mill

ion

tota

l pop

ulat

ion

Prop

ortio

n of

all

susp

ecte

d m

easl

es a

nd ru

bella

cas

es

that

hav

e ha

d an

ade

quat

e in

vest

igat

ion

initi

ated

with

in

48 h

ours

of n

otifi

catio

n

Disc

arde

d no

n-m

easl

es

non-

rube

lla in

cide

nce

per

100

000

tota

l pop

ulat

ion

Prop

ortio

n of

sub

natio

nal

adm

inis

trativ

e un

its re

porti

ng

at le

ast t

wo

disc

arde

d no

n-m

easl

es n

on-r

ubel

la c

ases

pe

r 100

000

tota

l pop

ulat

ion

Prop

ortio

n of

sub

-nat

iona

l su

rvei

llanc

e un

its re

porti

ng

to th

e na

tiona

l lev

el o

n tim

e

Lab-

confi

rmed

Epi-L

inke

d

Clin

ical

ly-c

onfir

med

Lab-

confi

rmed

Epi-L

inke

d

Target – – 80% 2 80% 80%

2012 5 207 976 0 3 491 90 0 485 15.19 1.4 31.36 0.75 9.21 ND

2013 2 641 325 2 1 819 50 0 405 5.07 0.78 26.98 0.63 6.58 ND

2014 1 184 75 3 68 21 1 300 1.2 0.34 ND 0.46 3.95 ND

2015 1015 59 3 92 34 14 377 0.95 0.73 ND 0.58 9.21 ND



Year




% serum specimens

tested




receipt


viral detection

Genotypes detected




2014 37.5 416 100 75 18 21 5.1 92.1 100 B3 ND

2015 54.7 506 100 61 12.1 36 7.1 94.5 100 H1 2B





0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Perc

ent o

f pop

ulat

ion

Age (in years)


0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Perc

ent o

f pop

ulat

ion

Age (in years)

0

20

40

60

80

100

120

2010 2011 2012 2013 2014 2015


ND n=94 n=180 n=50 n=1 n=10

0

20

40

60

80

100

120

2010 2011 2012 2013 2014 2015


ND n=94 n=180 n=46 n=1 n=10 (100%) (100%) (92%) (100%) (100%)







Thailand 2016















District 928

Sub-district 7 427

Village 74 948




96%












17 284 706







BCG At birth

































case

No. of death


measles cases


rubella cases

No. of suspected

outbreak

No. of Outbreak

Investigated

No. of case

No. of death

No. of measles

outbreak*

No. of confirmed

measles case*

No. of confirmed

rubella outbreak*

No. of confirmed

rubella cases*

2010 2 273 0 ND ND 0 0 0 0 ND ND ND

2011 3 056 0 67 13 12 11 269 0 9 22 0 1

2012 5 195 0 799 69 12 10 147 0 9 46 0 0

2013 2 633 0 271 42 8 8 59 0 7 39 0 0

2014 1 191 0 70 19 0 0 0 0 0 0 0 0

2015 588 0 57 36 7 23 60 0 9 9 2 35




Year

No. o

f Sus

pect

ed M

easl

es


Measles Rubella

Disc

arde

d no

n-m

easl

es n

on-

rube

lla c

ases

Annu

al in

cide

nce

of

confi

rmed

Mea

sles

cas

es p

er

mill

ion

tota

l pop

ulat

ion

Annu

al in

cide

nce

of

confi

rmed

Rub

ella

cas

es p

er

mill

ion

tota

l pop

ulat

ion

Prop

ortio

n of

all

susp

ecte

d m

easl

es a

nd ru

bella

cas

es

that

hav

e ha

d an

ade

quat

e in

vest

igat

ion

initi

ated

with

in

48 h

ours

of n

otifi

catio

n

Disc

arde

d no

n-m

easl

es

non-

rube

lla in

cide

nce

per

100

000

tota

l pop

ulat

ion

Prop

ortio

n of

sub

natio

nal

adm

inis

trativ

e un

its re

porti

ng

at le

ast t

wo

disc

arde

d no

n-m

easl

es n

on-r

ubel

la c

ases

pe

r 100

000

tota

l pop

ulat

ion

Prop

ortio

n of

sub

-nat

iona

l su

rvei

llanc

e un

its re

porti

ng

to th

e na

tiona

l lev

el o

n tim

e

Lab-

confi

rmed

Epi-L

inke

d

Clin

ical

ly-c

onfir

med

Lab-

confi

rmed

Epi-L

inke

dTarget – – 80% 2 80% 80%

2012 5 207 976 0 3 491 90 0 485 15.19 1.4 31.36 0.75 9.21 ND

2013 2 641 325 2 1 819 50 0 405 5.07 0.78 26.98 0.63 6.58 ND

2014 1 184 75 3 68 21 1 300 1.2 0.34 ND 0.46 3.95 ND

2015 1015 59 3 92 34 14 377 0.95 0.73 ND 0.58 9.21 ND



Year




% serum specimens

tested




receipt


viral detection

Genotypes detected




2014 37.5 416 100 75 18 21 5.1 92.1 100 B3 ND

2015 54.7 506 100 61 12.1 36 7.1 94.5 100 H1 2B





0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Perc

ent o

f pop

ulat

ion

Age (in years)


0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Perc

ent o

f pop

ulat

ion

Age (in years)

0

20

40

60

80

100

120

2010 2011 2012 2013 2014 2015


ND n=94 n=180 n=50 n=1 n=10

0

20

40

60

80

100

120

2010 2011 2012 2013 2014 2015


ND n=94 n=180 n=46 n=1 n=10 (100%) (100%) (92%) (100%) (100%)



EPI Fact ShEEt 74 948 Population density (per sq. km) 135 Population living in urban areas 48%...

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