Loevinsohn B P
Expanded Programme on Immunization, Ministry of Health, Sudan.
Bull World Health Organ. 1990;68(3):353-7.
During an outbreak of diphtheria in Khartoum, Sudan, in 1988, only 19.1% of patients admitted to hospital were under 5 years of age. This is considerably less than the proportion of such patients seen during a similar outbreak in Khartoum in 1978 (49.5%) and also less than the proportion (55.2%) of under-5-year-olds reported for all inpatients with diphtheria in the Sudan during 1979-86. Cluster surveys carried out between 1981 and 1989 demonstrate that vaccination coverage was much higher for under-5-year-olds (about 65% for the third dose of diphtheria-pertussis-tetanus vaccine (DPT3] than for children of school age (less than 20% for DPT3) at the time of the 1988 outbreak. These results indicate that improved vaccination coverage led to the shift in the age distribution of diphtheria patients seen during the 1988 outbreak. It is unlikely that these data are affected by the type of biases that usually plague disease surveillance systems and can therefore be used as a simple way of assessing the effectiveness of the Expanded Programme on Immunization (EPI).
1988年，苏丹喀土穆爆发白喉疫情，入院患者中仅有19.1%为5岁以下儿童。这一比例远低于1978年喀土穆类似疫情期间此类患者的比例（49.5%），也低于1979 - 1986年苏丹所有白喉住院患者中5岁以下儿童的比例（55.2%）。1981年至1989年期间进行的整群调查表明，在1988年疫情爆发时，5岁以下儿童的疫苗接种覆盖率（白喉 - 百日咳 - 破伤风疫苗第三剂（DPT3）约为65%）远高于学龄儿童（DPT3覆盖率低于20%）。这些结果表明，疫苗接种覆盖率的提高导致了1988年疫情期间所见白喉患者年龄分布的变化。这些数据不太可能受到通常困扰疾病监测系统的各类偏差的影响，因此可作为评估扩大免疫规划（EPI）有效性的一种简单方法。
