By Jonathan F Mosser, MD, William Gagne-Maynard, MS, Puja C Rao, MPH, Aaron Osgood-Zimmerman, MS, Nancy Fullman, MPH, Nicholas Graetz, MPH, et al.
The Lancet, May 2019
Estimated third-dose (DPT3) coverage increased in 72·3% (95% uncertainty interval [UI] 64·6–80·3) of second-level administrative units in Africa from 2000 to 2016, but substantial geographical inequalities in DPT coverage remained across and within African countries. In 2016, DPT3 coverage at the second administrative (ie, district) level varied by more than 25% in 29 of 52 countries, with only two (Morocco and Rwanda) of 52 countries meeting the Global Vaccine Action Plan target of 80% DPT3 coverage or higher in all second-level administrative units with high confidence (posterior probability ≥95%). Large areas of low DPT3 coverage (≤50%) were identified in the Sahel, Somalia, eastern Ethiopia, and in Angola. Low first-dose (DPT1) coverage (≤50%) and high relative dropout (≥30%) together drove low DPT3 coverage across the Sahel, Somalia, eastern Ethiopia, Guinea, and Angola.
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Also read the associated editorial “Local trends in immunisation coverage across Africa,” by Alexandre de Figueiredo and Fredrick Were
“Despite the growth in DPT coverage across Africa, Mosser and colleagues found that only two countries met GVAP's subnational immunisation target of 80% coverage in all second-level administrative units in 2016: Morocco and Rwanda. Although this number has improved from zero in 2000, it still represents suboptimal progress given that emphasis is now shifting from reaching every district to reaching every child.”
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