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J Keja

Publications and source records attributed to J Keja.

8 recordsLinked to original sources
PubMed1985

A computer simulation of the EPI survey strategy.

A Monte Carlo simulation study was designed to evaluate the sample survey technique currently used by the Expanded Programme on Immunization (EPI) of the World Health Organization. Of particular interest was how the EPI strategy compared to a more traditional sampling strategy with respect to bias and variability of estimates. It was also of interest to investigate whether the estimates of population vaccination coverage were accurate to within 10 percentage points of the actual levels. It was found that within particular clusters, the EPI method was particularly sensitive to pocketing of vaccinated individuals, but the more traditional method gave more accurate and less variable results under a variety of conditions. However, the stated goal of the EPI, of being able to produce population estimates accurate to within 10 percentage points of the true levels in the population, was satisfied in the artificially created populations studied.

Child, Preschool↗
PubMed1984

Indications and contraindications for vaccines used in the Expanded Programme on Immunization.

The aim of the Expanded Programme on Immunization is to reduce morbidity and mortality from six diseases that can be prevented by immunization. In many countries the immunization coverage is still less than optimal; one of the reasons for this is the fact that frequently health workers are faced with long lists of contraindications to immunization.The present review discusses the risks of adverse reactions after immunization and compares these risks with the complication rates following natural disease. It is concluded that the decision to withhold the benefits of immunization from an eligible child should not be taken lightly, particularly in areas where access to immunization services is limited and the incidence of the vaccine-preventable diseases is still high.Malnutrition should be a prime indication for immunization. Low-grade fever, mild respiratory infection, or diarrhoea should not be considered a contraindication to immunization. Measles immunization of children who have to be admitted to hospital has been shown to reduce the overall mortality rates in paediatric wards. It is recommended that all countries should formulate their own national policy, carefully considering the risks of disease as well as the benefits and potential risks of immunization.

BCG Vaccine↗
PubMed1980

Clinical survey techniques to estimate prevalence and annual incidence of poliomyelitis in developing countries.

Recent epidemiological data suggest that poliomyelitis is a more important public health problem in developing countries than was originally suspected. Because of the availability of a cheap, effective, but labile oral vaccine, it is important that countries determine the incidence of poliomyelitis in order to determine the necessity and speed with which a vaccination programme should be introduced.Sequelae of poliomyelitis are distinctive and can be used to study the incidence of residual paralysis in children above the age of 5 years. Prevalence data for lameness due to poliomyelitis can then be translated into rates of annual incidence of paralytic disease. Lameness surveys can be efficiently done in schools and data are reliable as long as a similar search for lame children is done amongst children of the same age group who do not attend school but are in the geographical area served by the school. House-to-house surveys, while more time-consuming, are more reliable.

Adolescent↗
PubMed1976

Large-scale use of freeze-dried smallpox vaccine prepared in primary cultures of rabbit kidney cells.

A lyophilized smallpox vaccine made from infected monolayer cultures of primary rabbit kidney cells was used together with a calf lymph vaccine in a field trial in Lombok, Indonesia, in 1973. About 60 000 children below 15 years of age were vaccinated: some 50 000 with the tissue culture vaccine and about 10 000 with calf lymph vaccine. Similar results were obtained with both vaccines in primary vaccinees and in revaccinees as regards the take rate, pock reactions, and serious secondary reactions.

Adolescent↗
PubMedDate not supplied

Global control of vaccine-preventable diseases: how progress can be evaluated.

In the developing world, excluding China, less than 40% of infants receive a third dose of diphtheria-tetanus-pertussis or poliovirus vaccines. More than 3 million children still die annually from measles, neonatal tetanus, and pertussis, while more than a quarter of a million children are crippled by poliomyelitis. Acceleration of existing efforts, with the use of approaches that must differ according to the requirements of individual countries, constitutes the overriding priority for the Expanded Programme on Immunization (EPI). In evaluating immunization programs, priority should be placed on monitoring immunization coverage and disease incidence. Routine reports are essential for this purpose, although they may usefully be supplemented by surveys. The problems revealed by an evaluation of immunization programs can be taken as being generic to the health services as a whole, until proven otherwise. Therefore, in remedying these problems, approaches that improve the health services as a whole should be sought.

Communicable Disease Control↗