Immunisation with BCG in the Maringue District, Sofala Province, Mozambique

Objectives. We evaluated immunisation with Bacille Calmette-Guérin (BCG) among newborns in 2011 in the Maringue District, Sofala Province, Mozambique, which includes seven health units. The study was motivated by the fact that in official reports, immunisation coverage was unreliable (more than 100%). Methods. The office of maternal-child health of the central Maringué-Sede health unit provided the number of live newborns in 2011 at the maternal clinics of the seven health units and an estimate of the number of home deliveries. From vaccination registers, we abstracted records of BCG vaccinations administered in the period 01/01/2011–30/06/2012 to children born in 2011. Results. The number of live newborns was 3,353. Overall, the number of BCG vaccinations administered was 2,893, with a coverage of 86.3%. Conclusion. In this study, we could only calculate an approximate coverage estimate, because of unavailability of adequate individual information. Recording practices should be changed in order to allow use of individual information and linkage across different information sources and thus a more precise vaccination coverage assessment. 1. Introduction In Mozambique, a nationwide immunisation program (Extended Programme of Immunisation, EPI; in Portuguese: Programa Alargado de Vacina？ao, PAV) was started in 1979 [1]. Since performance was poor, in 2005, a comprehensive Multi Year Plan (cMYP) was launched with a view to devising strategies in line with the WHO/UNICEF Global Immunisation Vision and Strategy (GIVS) [2] with the objective to reach at least 90% national vaccination coverage and at least 80% coverage in every district. The current immunisation schedule includes Bacille Calmette-Guérin (BCG) at birth; oral polio vaccine (OPV) at birth, 6, 10, and 14 weeks; Diphtheria, Pertussis, Tetanus Hepatitis B (DTP-HepB) at 6, 10, and 14 weeks; measles, at 9 months [1]. In reports from the Ministry of Health (2004–2008), immunisation coverage percentages were largely variable across years and sometimes unreliable (>100%) [1]. The reasons for these anomalous figures are at least two. (1) The denominator (i.e., the number of children <1 year, so-called “grupo alvo,” target group) is only presumed. In fact, it is calculated by taking a fixed percentage (4%) of the whole population (almost 23 million people in 2011-2012) [2]. (2) The reference periods of immunisation and birth data are different; that is, part of the immunisation doses administered in a given year are given to infants born in the previous year. Also, the WHO website on Mozambique reports