EPI Review- 2014

MOH Area:…………………………….

Background information 1-MOH area

2-DPDHS area

3-Estimated Population for the year 2014

4-Actual Population for the year 2014

5-Reasons for differences in actual and estimated populations

6-Crude Birth Rate for District 2014

7-Crude Birth Rate for Province 2014

8-Estimated Number of Births in the year 2014

Based on the Actual Population

Based on the Estimated Population

District BR

Provincial BR

9-Number of Immunizations performed in the year 2013 (institutions and field) (Sum of relevant data from four Q/ EPI returns, 2014)

PVV1 PVV2 PVV3

10-Number of pregnant mothers registered for the area in 2013

11-Number of actual births reported for the area in 2014

12- Number of infants registered for the area in 2014

13-The most probable number of births for the MOH area*

Background information……cont Approved number

Number available

Average Population covered by each category / clinic

Population Range

12-PHMs

13-PHIs

14-SPHMs

15-PHNS

16-SPHI

17-MOHs/AMOHs

18. MCH Clinics

Area Map indicating access to immunization(Please present a map indicating immunization clinics and population served by each clinic )

Coverage of BCG vaccination among infants born between 1st of January 2014 to 31st of December 2014 and the protection of their mothers from Tetanus and Rubella vaccination at the time of delivery

Number of registered infants under care*

(A)

A = (V+W+X) - (Y+-Z)

Number of infants born between 1st of January 2014 to 31st of December 2014

Registered within 3 months of birth

(V)****

Registered after 3 months of birth to date^^

(W)****

Came newly into the area & registered to date^^

(X)

Left the areato date^^

(Y)

Died to date^^

(Z)

Coverage of OPV1 /PVV 1 vaccination among infants born between 01st of November 2013 to 31st of October 2014

Number of registered infants under care*

(A)

A = (V+W+X) - (Y+-Z)

Number of infants born between 1st of November 2013 to 31st of October 2014

registered within 3 months of birth

(V)****

registered after 3 months of birth to

date^^

(W)****

came newly into the area registered to

date^^(X)

left the areato date^^

(Y)

Died to date^^

(Z)

Coverage of OPV3 /PVV 3 vaccination among infants born between 01st of July 2013 to 31st of June 2014

Number of registered infants under care*

(A)

A = (V+W+X) - (Y+-Z)

Number of infants born between 01st of July 2013 to 31st of June 2014

registered within 3 months of birth

(V)****

registered after 3 months of birth to

date^^

(W)****

came newly into the area registered to

date^^(X)

left the areato date^^

(Y)

Died to date^^

(Z)

Coverage of LJEV vaccination among infants born between 01st of April 2013 to 31st of March 2014

Number of registered infants under care*

(A)

A = (V+W+X) - (Y+-Z)

Number of infants born between 1st of April 2013 to 31st of March 2014

registered within 3 months of birth

(V)****

registered after 3 months of birth to

date^^

(W)****

came newly into the area registered to

date^^(X)

left the areato date^^

(Y)

Died to date^^

(Z)

Coverage of MMR1 vaccination among infants born between 1st of January 2013 to 31st of December 2013

Number of registered infants under care*

(A)

A = (V+W+X) - (Y+-Z)

Number of infants born between 1st of January 2013 to 31st of December 2013 registered within 3

months of birth

(V)****

registered after 3 months of birth to

date^^ (W)****

came newly into the area registered to

date^^(X)

left the areato date^^

(Y)

Died to date^^

(Z)

Coverage of DPT4/OPV4 vaccination among infants born between 1st of July 2012 to 30th June 2013

Number of registered infants under care*

(A)

A = (V+W+X) - (Y+-Z)

Number of infants born between 1st of July 2012 to 30th of June 2013registered within 3

months of birth

(V)****

registered after 3 months of birth to date^^

(W)****

came newly into the area registered to

date^^(X)

left the areato date^^

(Y)

Died to date^^

(Z)

Coverage of MMR2 vaccination among infants born between 1st of January 2011 to 31st of December 2011

Number of registered infants under care*

(A)

A = (V+W+X) - (Y+-Z)

Number of infants born between 1st of January 2011 to 31st of December 2011registered within 3

months of birth

(V)****

registered after 3 months of birth to date^^

(W)****

came newly into the area registered to

date^^(X)

left the areato date^^

(Y)

Died to date^^

(Z)

Coverage of DT/OPV5 vaccination among infants born between 1st of January 2009 to 31st of December 2009

Number of registered infants under care*

(A)

A = (V+W+X) - (Y+-Z)

Number of infants born between 1 st of January 2009 to 31st of December 2009registered within 3

months of birth

(V)****

registered after 3 months of birth to date^^

(W)****

came newly into the area registered to

date^^(X)

left the areato date^^

(Y)

Died to date^^

(Z)

Vaccine PHMM areas with low immunization coverages (%) according to

estimated births registered infants under care age appropriate immunizationsPHM area % PHM area % PHM area %

BCG (ex.) 12 3

%%%

123

%%%

123

%%%

TT( Maternal)

Rubella(Maternal)

PVV1/OPV1

LJEV

MMR1

DPT4/OPV4

MMR2

DT/OPV5

PHM areas with low immunization coverages(Please include the data for the 3 PHMM areas where the lowest immunization coverages have been reported

under each category)

Vaccine PHMM areas with high immunization coverages (%) according to

estimated births registered infants under care age appropriate immunizations

PHM area % PHM area % PHM area %BCG (ex.) 1

2 3

%%%

123

%%%

123

%%%

TT( Maternal)

Rubella(Maternal)

PVV1/OPV1

LJEV

MMR1

DPT4/OPV4

MMR2

DT/OPV5

PHM areas with High immunization coverages(Please include the data for the 3 PHMM areas where the highest immunization coverages have been reported

under each category)

Identified PHMM areas with low immunization coverages for estimated births

Action taken

PHM area 1………………………………….

PHM area2…………………………………….

PHM area3 …………………………………..

Action taken to overcome the low immunization coverages according to estimated births & according to low age appropriate immunizations

(Based on previous year EPI review)

Identified PHMM areas with low immunization coverages for age appropriate immunizations

Action taken

PHM area 1……………………………………

PHM area2……………………………………….

PHM area3 ……………………………………….

Coverage of aTd vaccination among school children in grade 7 & other grades during 2014 by PHI areas & clinics

No PHI area Number on roll in

grade 7

Number of children

immunized ingrade 7

% of immunized children in

grade 7

Number of children

immunized inother grades( or from other areas)

Total number immunized in

year 2014

1

2

3

4

5

6

7

8

9

10

Clinics

Total

Comparison of coverage’s of antigens according to the advancing birth cohorts

Number of immunizations performed and difference against the antigen which ever has the highest number of immunizations(PVV1, PVV2, PVV3) during

infancy ( 1st year of life) in MOH area by antigen in 2014(Please include another bar for number of LJEV given to the children who have completed one year in the current cohort)

Antigen Book balance

as of 31st December

2013

(A)

Total receipts during 2014

(B)

Book balance as of 31st

of December

2014

(C )

No of doses

discarded due to expiry or

cold chain failure during 2014(D)

Total number of doses

used during 2014 for

vaccination

( E)=(A+B)-(C +D)

Highest book balance in a given time during the year 2014 (F)

No. ofImmunizationsPerformed by

clinics/ schools/ estates/GPs

( Based on the four EPI quarterly

Returns for year 2014)

( G )

No. of dosesDistributed to

Clinics/schools/GPs

(Based on the MOH Office

vaccine movement register for year 2014)

( H )

Usage %

( I )=G/E * 100

Wastage %

( J )=(100- I )

B.C.G

Penta

DPT

OPV

LJEV

DT

TT

aTd

MMR

Other

Form 11 Status of vaccine wastage in the MOH area by antigen in 2014

Antigen Book balance as of 31st December 2013

(A)

Total receipts during 2014

(B)

Book balance as of 31st of

December 2014

(C )

No of doses

discarded due to

expiry or cold chain

failure during 2014

(D)

Total number of doses

used during 2014 for

vaccination

( E)=(A+B)-(C+D)

Highest & Lowest book balances

in agiven time during the

year 2014

No. ofImmunizatio

nsPerformed by clinics/ schools/

estates/GPs ( Based on the four EPI

quarterly Returns for year 2014)

( G )

No. of doses

Distributed to Clinics/schools/

GPs(Based on the MOH

Office vaccine

movement register

2014( H )

Usage%

( I )=G/E * 100

Wastage%

( J )=(100- I )

Highest(F1)

Lowest(F2)

B.C.G

Penta

DPTOPVLJEVDTTTaTdMMR

Form 11 Status of vaccine wastage in the MOH area by antigen in 2014

Adverse events following immunization (A.E.F.I.)No. of Monthly AEFI Returns expected to be sent to the Epidemiological Unit during 2014 12

No. of Monthly AEFI Returns sent

No. of Monthly AEFI Returns sent in time

No of “Nil” returns sent

Type of AEFI Number Reported No Investigated % Investigated

Injection site abscess

BCG lymphadenitis

Severe local reactions

Encephalitis/Encephalopathy

Meningitis

Seizures (Febrile + Afebrile)

Anaphylaxis

Persistent Screaming

HHE

Types of AEFIs reported during 2014

Antigen Type of AEFI Number of AEFI

Reported (A)

No of doses administered†

(B)

AEFI Rate

( C ) (C

=(A)/(B)*100000

National Rates for 2014

BCG BCG lymphadenitisPenta Seizures (Febrile +

Afebrile)AnaphylaxisPersistent ScreamingHHEAllergic reaction

Measles Seizures (Febrile + Afebrile)

AnaphylaxisAllergic reaction

MMR Seizures (Febrile + Afebrile)

AnaphylaxisAllergic reaction

ParotitisJE Seizures (Febrile +

Afebrile)AnaphylaxisAllergic reactionEncephalitis/Encephalopathy

MeningitisOther*

Rates of AEFIs reported during 2014

Information regarding cold chain equipment in MOH office in 2014

Please bring the temperature charts and printouts of data lodger recordings for year 2014 to the review.

Refrigerator Working order

(Yes/No)

Year of manufacture

Capacity

(liters)

Thermometer in working Order

(Yes/No)

Data lodger in working Order

(Yes/No)

Freeze tag in working order

(Yes/No)

Temp. Chart maintained daily during the reporting

period (12 months)(Yes/No)

Refrigerator 1

Refrigerator 2

Freezer

1 Were there any cold chain breakdowns during the reporting period?(If yes, please describe such situations)

2 Who is in charge of the refrigerator and vaccine?

3 Who is in charge of the daily recording of temperature?

4 How often data lodger printout are being taking?

6 How many print outs available in the file for the year under review?

7 Were there situations vaccines exposed to sub zero temperatures?

8 Were there any mismatch in temperature recordings and data lodger recordings?(If yes, please describe such situations with possible reasons)

Calculation of minimum refrigerator capacity required for storage of vaccines for MOH area

Incidence of infant deaths, neo natal deaths and their causes – 2014 **Please use national Infant mortality rate 9.9 per 1000 live births to calculate the estimated number of infant deaths for year 2014 ( 7.4 Neonatal mortality rate-75% of Infant mortality )

Notification and investigation of EPI target diseases- 2014

Disease No. Reported

(A)

No. Investigated*

(B)

No, confirmed

(C)

% Investigated

(D)

(D)=(B)/(A)*100

No. of special investigation forms sent

(E)

% of special investigation forms sent

(F)

(F)=(E)/(C)*100Whooping Cough

Tetanus

NNT

Measles

Rubella

CRS

AFP

Encephalitis

Meningitis

Mumps

Total