Week 1 Assignment – Kwadwo Owusu Ansah

Task1

District 4 in May reported MR1 coverage (9008) which is way above the normal range. District 3 also reported coverage which are outside the normal range in April (1007), May (1189) and November (1351). District 13 in November reported 72 which is way below the normal range.

There was duplication of data (repetition) in February and March in all the districts except district 13 and then repetition of data in November and December for only district 1.

District 14 had repetition of data in April and may (509 each) and in October and November (303 each).

Task2

The national and subnational administrative MR1 coverage is quite high in almost all the regions except for Nemo (72%), Westtan (75%) and Chello (81%). From this data these three regions seem to have a lot of unvaccinated children which could lead to accumulation of susceptible children in the region and consequently possible occurrence of an outbreak.

Task 3

From the data, the regions such as Nemo, Westtan and Chello which recorded low administrative coverage rather recorded high evaluation survey coverage. Regions like Grandtown and Remo which recorded over 100% administrative coverage tend to have very low evaluation survey coverage. This means that Grandtown and Remo regions in reality have more unvaccinated children than that of Nemo, westtan and Chello which recorded lower administrative coverage.

Task 4

Measles cases occurred mostly among the age group of 0-9 and those 20 and above, which peaks at 1-4 and 30+. Those in the age groups of 10 – 19 were less affected. It is possible that with the accumulation of susceptible children in Grandtown region, the adults who are infected reinfect the children they most likely taking care of. It is possible that people at the ages of 20 and above who are possibly nursing or caring for babies and children from zero to 5 years are re-infecting the children and vice versa, leading to the peaks in the two age groups.

Task 5

There is unreliable administrative coverage data especially in Groundtown
The population used by the various regions may not be accurate which creates false impression that there is high immunization coverage
There is low population level (herd) immunity which has resulted in the accumulation of susceptible individuals leading the outbreak of measles in Grandtown.

Task 6

Organise mass MR vaccination campaign targeting children and adults of childbearing age
Develop surveillance case definitions to search for more cases and manage appropriately
Organise mass educational campaign across the region to educate the public about the disease and how it is transmitted.

Task 7

Organise monthly data validation and verification in all Districts
Conduct supportive supervision using quality improvement tools
Conduct regular data quality self-assessment in all facilities
Provide regular and timely feedbacks to reporting facilities
Organise training for data officers and managers on quality data management