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J Pak Med Assoc. 2007 Aug;57(8):391-5.

Assessment of EPI (expanded program of immunization) vaccine coverage in a peri-urban area.

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  • 1Department of Epidemiology, Michigan State University, USA.



To determine the age-appropriate EPI coverage of under one year old children and Tetanus Toxoid (TT) coverage of their mothers (15-49 years) in peri-urban Karachi and to determine the factors associated with low coverage.


A cross-sectional study was carried out by utilizing WHO thirty-cluster sampling technique, seven households with infants, were randomly selected per cluster. Child's mother was interviewed by using a structured pre-tested questionnaire, regarding the EPI coverage of her child, her own TT coverage and other demographic and potential risk factors for low vaccination coverage.


Forty five percent of the infants were age-appropriately vaccinated. The TT coverage of mothers for the index pregnancy was 57.3% for both doses of the vaccine. In the multivariate model four factors i.e., type of house construction (proxy indicator of socio-economic status), mother's TT vaccination status, years since marriage and parents' educational status were found to be significantly associated with children's immunization status.


We concluded that the EPI coverage of Gadap town, Karachi is quite low. Education of both parents plays a significant role in child's immunization coverage. Improving the educational status of parents can potentially improve the immunization coverage.

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