Risk characterization of maternal and neonatal tetanus in view of tetanus vaccination campaigns in Pakistan

Ejaz A. Khan, Rownak Khan, Muhammad T.ariq Iqbal, Quamrul Hasan, Saadia Farrukh, Muhammad S.afdar Rana, Wasiq M.ehmood Khan

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Pakistan is one of the remaining 24 countries which have not yet achieved Maternal and Neonatal Tetanus Elimination (MNTE), The country adopted high-risk approach for 56 out of 119 districts with country-wide Tetanus Toxoid (TT) provision in Routine Immunization (RI) during early 2000-2003. The TT's mass campaigns could only cover 13% of high risk districts for 2009- 2011, and mostly for the Punjab province. To achieve MNT elimination, the country needs risk mapping for cost-effective intervention.

METHODS: We used both the quantitative and qualitative methods to conduct risk characterization. All the three available data sets (Reported EPI coverage data, PDHS 2012-13, and PSLM 2010-11) were assessed. A mix of core and surrogate indicators-for risk categorization was used through ranking and scoring the aggregated data and considering the past tetanus campaigns' coverage. Tetanus Toxoid (TT2+)-coverage of pregnant women and delivery in health facility, both received more weightage in scoring. We based the higher and lower cuts off points for each indicator on data ranges. The districts with higher scores, i.e., 10.5 and above were ranked good followed by medium (5.5-10.4) and low performing (less than 5.5). Consultations with the national and provincial field officers were utilized to understand the local context.

RESULTS: In Pakistan, there are 139 districts out of which, 60 are the high risk districts for tetanus. Highest percentage is for Baluchistan (83%) followed by Sindh (52%), and Khyber Pakhtunkhwa (40%). Most of the Punjab is at medium risk (55%), followed by KP (52%), and Sindh (39%).

CONCLUSION: Pakistan is at medium to high risk of MNT with a great variation at the sub-national level. Campaigns aiming to these districts may bring the country closer to MNT elimination target.

Original languageEnglish
Pages (from-to)220-222
Number of pages3
JournalJournal of Ayub Medical College, Abbottabad
Volume27
Issue number1
Publication statusPublished - 1 Jan 2015

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Risk characterization of maternal and neonatal tetanus in view of tetanus vaccination campaigns in Pakistan. / Khan, Ejaz A.; Khan, Rownak; Iqbal, Muhammad T.ariq; Hasan, Quamrul; Farrukh, Saadia; Rana, Muhammad S.afdar; Khan, Wasiq M.ehmood.

In: Journal of Ayub Medical College, Abbottabad , Vol. 27, No. 1, 01.01.2015, p. 220-222.

Research output: Contribution to journalArticle

Khan, Ejaz A. ; Khan, Rownak ; Iqbal, Muhammad T.ariq ; Hasan, Quamrul ; Farrukh, Saadia ; Rana, Muhammad S.afdar ; Khan, Wasiq M.ehmood. / Risk characterization of maternal and neonatal tetanus in view of tetanus vaccination campaigns in Pakistan. In: Journal of Ayub Medical College, Abbottabad . 2015 ; Vol. 27, No. 1. pp. 220-222.
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title = "Risk characterization of maternal and neonatal tetanus in view of tetanus vaccination campaigns in Pakistan",
abstract = "BACKGROUND: Pakistan is one of the remaining 24 countries which have not yet achieved Maternal and Neonatal Tetanus Elimination (MNTE), The country adopted high-risk approach for 56 out of 119 districts with country-wide Tetanus Toxoid (TT) provision in Routine Immunization (RI) during early 2000-2003. The TT's mass campaigns could only cover 13{\%} of high risk districts for 2009- 2011, and mostly for the Punjab province. To achieve MNT elimination, the country needs risk mapping for cost-effective intervention.METHODS: We used both the quantitative and qualitative methods to conduct risk characterization. All the three available data sets (Reported EPI coverage data, PDHS 2012-13, and PSLM 2010-11) were assessed. A mix of core and surrogate indicators-for risk categorization was used through ranking and scoring the aggregated data and considering the past tetanus campaigns' coverage. Tetanus Toxoid (TT2+)-coverage of pregnant women and delivery in health facility, both received more weightage in scoring. We based the higher and lower cuts off points for each indicator on data ranges. The districts with higher scores, i.e., 10.5 and above were ranked good followed by medium (5.5-10.4) and low performing (less than 5.5). Consultations with the national and provincial field officers were utilized to understand the local context.RESULTS: In Pakistan, there are 139 districts out of which, 60 are the high risk districts for tetanus. Highest percentage is for Baluchistan (83{\%}) followed by Sindh (52{\%}), and Khyber Pakhtunkhwa (40{\%}). Most of the Punjab is at medium risk (55{\%}), followed by KP (52{\%}), and Sindh (39{\%}).CONCLUSION: Pakistan is at medium to high risk of MNT with a great variation at the sub-national level. Campaigns aiming to these districts may bring the country closer to MNT elimination target.",
author = "Khan, {Ejaz A.} and Rownak Khan and Iqbal, {Muhammad T.ariq} and Quamrul Hasan and Saadia Farrukh and Rana, {Muhammad S.afdar} and Khan, {Wasiq M.ehmood}",
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T1 - Risk characterization of maternal and neonatal tetanus in view of tetanus vaccination campaigns in Pakistan

AU - Khan, Ejaz A.

AU - Khan, Rownak

AU - Iqbal, Muhammad T.ariq

AU - Hasan, Quamrul

AU - Farrukh, Saadia

AU - Rana, Muhammad S.afdar

AU - Khan, Wasiq M.ehmood

PY - 2015/1/1

Y1 - 2015/1/1

N2 - BACKGROUND: Pakistan is one of the remaining 24 countries which have not yet achieved Maternal and Neonatal Tetanus Elimination (MNTE), The country adopted high-risk approach for 56 out of 119 districts with country-wide Tetanus Toxoid (TT) provision in Routine Immunization (RI) during early 2000-2003. The TT's mass campaigns could only cover 13% of high risk districts for 2009- 2011, and mostly for the Punjab province. To achieve MNT elimination, the country needs risk mapping for cost-effective intervention.METHODS: We used both the quantitative and qualitative methods to conduct risk characterization. All the three available data sets (Reported EPI coverage data, PDHS 2012-13, and PSLM 2010-11) were assessed. A mix of core and surrogate indicators-for risk categorization was used through ranking and scoring the aggregated data and considering the past tetanus campaigns' coverage. Tetanus Toxoid (TT2+)-coverage of pregnant women and delivery in health facility, both received more weightage in scoring. We based the higher and lower cuts off points for each indicator on data ranges. The districts with higher scores, i.e., 10.5 and above were ranked good followed by medium (5.5-10.4) and low performing (less than 5.5). Consultations with the national and provincial field officers were utilized to understand the local context.RESULTS: In Pakistan, there are 139 districts out of which, 60 are the high risk districts for tetanus. Highest percentage is for Baluchistan (83%) followed by Sindh (52%), and Khyber Pakhtunkhwa (40%). Most of the Punjab is at medium risk (55%), followed by KP (52%), and Sindh (39%).CONCLUSION: Pakistan is at medium to high risk of MNT with a great variation at the sub-national level. Campaigns aiming to these districts may bring the country closer to MNT elimination target.

AB - BACKGROUND: Pakistan is one of the remaining 24 countries which have not yet achieved Maternal and Neonatal Tetanus Elimination (MNTE), The country adopted high-risk approach for 56 out of 119 districts with country-wide Tetanus Toxoid (TT) provision in Routine Immunization (RI) during early 2000-2003. The TT's mass campaigns could only cover 13% of high risk districts for 2009- 2011, and mostly for the Punjab province. To achieve MNT elimination, the country needs risk mapping for cost-effective intervention.METHODS: We used both the quantitative and qualitative methods to conduct risk characterization. All the three available data sets (Reported EPI coverage data, PDHS 2012-13, and PSLM 2010-11) were assessed. A mix of core and surrogate indicators-for risk categorization was used through ranking and scoring the aggregated data and considering the past tetanus campaigns' coverage. Tetanus Toxoid (TT2+)-coverage of pregnant women and delivery in health facility, both received more weightage in scoring. We based the higher and lower cuts off points for each indicator on data ranges. The districts with higher scores, i.e., 10.5 and above were ranked good followed by medium (5.5-10.4) and low performing (less than 5.5). Consultations with the national and provincial field officers were utilized to understand the local context.RESULTS: In Pakistan, there are 139 districts out of which, 60 are the high risk districts for tetanus. Highest percentage is for Baluchistan (83%) followed by Sindh (52%), and Khyber Pakhtunkhwa (40%). Most of the Punjab is at medium risk (55%), followed by KP (52%), and Sindh (39%).CONCLUSION: Pakistan is at medium to high risk of MNT with a great variation at the sub-national level. Campaigns aiming to these districts may bring the country closer to MNT elimination target.

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M3 - Article

VL - 27

SP - 220

EP - 222

JO - Journal of Ayub Medical College, Abbottabad

JF - Journal of Ayub Medical College, Abbottabad

SN - 1025-9589

IS - 1

ER -