Poliomyelitis vaccination status among children in the Federal Territory of Kuala Lumpur 2007

Abstract

Despite achieving a polio-free country status since 2000, there were still areas where polio vaccination coverage was low in Malaysia. In 2005, the reported polio vaccination coverage in the Federal Territory of Kuala Lumpur (FTKL) was only 29.3%, but with improved reporting from the private general practitioners, it increased to 61.2% the following year. The targeted polio vaccination coverage is 95%. A descriptive, cross sectional household survey was carried out in June-July 2007 to assess the actual polio vaccination status of children in the FTKL. The study population consisted of all children aged 9-24 months as of 1.6.2007, i.e those born from 1.6.2005 untill 31.8.2006, living in the Federal Territory of Kuala Lumpur at the time of the survey. The study was carried out from the first of June until the 15th of July 2007. A minimum sample size of 1644 was calculated based on an estimated 80% coverage, with a 95% confidence interval and a desired precision of two percent. This sample was then proportionately divided into the 11 parliamentary constituencies (based on the population of each parliamentary constituency). The population in each Parliamentary constituency was grouped into clusters, enumerated and then randomly selected for the study. All living quarters in the selected clusters were surveyed. A total of 1842 children between the ages of nine and 24 months (born between 1.6.2005 and 31.8.2006) were successfully surveyed. One thousand eight hundred and eight (1808) children (98.2 %) had completed their polio immunization; 25 children did not complete their immunizationand ; nine children were not immunized at all for polio. The Federal Territory of Kuala Lumpur had 20 430 live births in 2006 (estimated based on 11 months data) while the estimated live births by the Statistics Department was 28 400 for the same year. The vaccine coverage reported for 2006 was 61.2% when the estimated live births of 28 400 was used as the denominator, while the coverage was 85% when the denominator of 20 430 was used. The differences in vaccination coverage obtained for the year 2006 is largely due to the denominator used in the method of calculation of the vaccination coverage. The FTKL Health Department used estimated live births by the Statistics Department, while our study was based on the total number of respondents. When actual number of live births for the FTKL from the Federal Registration Department for 2006 was used as the denominator, the coverage improved to 85%, but was still short of the targeted 95% vaccine coverage. The main reason for this gap is due to under-reporting by the private practitioners. It is recommended that the estimation of live births by the Statistics Department be reviewed to match the actual live births, and enhance the reporting by the private general practitioners.