Journal article
Immunization Coverage Surveys and Linked Biomarker Serosurveys in Three Regions in Ethiopia
OBJECTIVE:
Demographic and health surveys, immunization coverage surveys and administrative data often divergently estimate vaccination coverage, which hinders pinpointing districts where immunization services require strengthening. We assayed vaccination coverage in three regions in Ethiopia by coverage surveys and linked serosurveys.
METHODS:
Households with children aged 12-23 (N = 300) or 6-8 months (N = 100) in each of three districts (woredas) were randomly selected for immunization coverage surveys (inspection of vaccination cards and immunization clinic records and maternal recall) and linked serosurveys. IgG-ELISA serologic biomarkers included tetanus antitoxin ≥ 0.15 IU/ml in toddlers (receipt of tetanus toxoid) and Haemophilus influenzae type b (Hib) anti-capsular titers ≥ 1.0 mcg/ml in infants (timely receipt of Hib vaccine).
FINDINGS:
Coverage surveys enrolled 1,181 children across three woredas; 1,023 (87%) also enrolled in linked serosurveys. Administrative data over-estimated coverage compared to surveys, while maternal recall was unreliable. Serologic biomarkers documented a hierarchy among the districts. Biomarker measurement in infants provided insight on timeliness of vaccination not deducible from toddler results.
CONCLUSION:
Neither administrative projections, vaccination card or EPI register inspections, nor parental recall, substitute for objective serological biomarker measurement. Including infants in serosurveys informs on vaccination timeliness.
Authors
- Mark A Travassos
- Myron M Levine
-
Robert Steinglass
View profile | More articles - Marcela F. Pasetti
- Samba O Sow
- Jaya Goswami
- Inna Ruslanova
- Yukun Wu
- William C. Blackwelder
- Mardi Reymann
- Jenny Sequeira
-
Lisa Oot
View profile | More articles - Tassew Kassa
- Seydou S Diarra
- Nigisti Mulholland
- James D Campbell
- Zenaw Adam
- Berhane Beyene
- Amha Kebede
Languages
- English
Publication year
2016
Journal
PLoS One
Volume
2016 Mar 2;11(3):e0149970. doi: 10.1371/journal.pone.0149970. eCollection 2016.
Type
Categories
Countries
COV-METH-PUB
This resource appears in the following Hot Topic page:
The resource is included in the following table:
| Title | Author | Year | Type | Language |
|---|---|---|---|---|
| A computer simulation of the EPI survey strategy. | Alexandre G. Tserkovnyi, Jacobus Keja, James Leonard Tulloch, John E. Dowd, Stanley Lemeshow, Steven K. Lwanga | Journal article | English | |
| A not quite as quick but much cleaner alternative to the Expanded Programme on Immunization (EPI) Cluster Survey design. | Anthony G. Turner , Muhammad Shuaib, Robert J. Magnani | Journal article | English | |
| Assessing and monitoring vaccination coverage levels: lessons from the Americas. | Edgar Monterroso, Elizabeth R Zell, George Stroh, Gina Tambini, Héctor Izurieta, Linda Venczel, Vance Dietz | 2004 | Journal article | English |
| Assessing equivalence: an alternative to the use of difference tests for measuring disparities in vaccination coverage. | Elizabeth T. Luman, Lawrence E. Barker, Mary M. McCauley, Susan Y Chu | 2002 | Journal article | English |
| Choosing a Cluster Sampling Design for Lot Quality Assurance Sampling Surveys | Edward J. Bedrick, Lauren Hund, Marcello Pagano | Journal article | English | |
| Cluster Lot Quality Assurance Sampling: Effect of Increasing the Number of Clusters on Classification Precision and Operational Feasibility | Roland W. Sutter, Steven G. F. Wassilak, Pascal Mkanda, Marina Takane, Alex N. Gasasira, Michael M. Nzioki, Alexandra E. Brown, Hiromasa Okayasu | Journal article | English | |
| Comments on ‘‘Monitoring vaccination coverage: Defining the role of surveys” | Robert Pond, Sandra Mounier-Jack | Journal article | English | |
| Consultancy services for conducting an evaluation of immunisation coverage monitoring methodology and process | Wolfgang Weber, Xavier Bosch-Capblanch | Guidance | English | |
| Does adjusting for recall in trend analysis affect coverage estimates for maternal and child health indicators? An analysis of DHS and MICS survey data | Donela Besada, Nicholas P. Oliphant, Nobubelo K. Ngandu, Samuel Manda, Sarah Rohde, Tanya Doherty | Journal article | English | |
| Effectiveness of Using Mobile Phone Image Capture for Collecting Secondary Data: A Case Study on Immunization History Data Among Children in Remote Areas of Thailand | Amnat Khamsiriwatchara, Jaranit Kaewkungwal, Kasemsak Jandee, Peerawat Wansatid, Saranath Lawpoolsri, Waranya Wongwit | 2015 | Journal article | English |
| Evaluating Confidence Interval Methods for Binomial Proportions in Clustered Surveys | Natalie Dean, Marcello Pagano | 2015 | Journal article | English |
| Immunization Coverage Surveys and Linked Biomarker Serosurveys in Three Regions in Ethiopia | Mark A Travassos, Myron M Levine, Robert Steinglass, Marcela F. Pasetti, Samba O Sow, Jaya Goswami, Inna Ruslanova, Yukun Wu, William C. Blackwelder, Mardi Reymann, Jenny Sequeira, Lisa Oot, Tassew Kassa, Seydou S Diarra, Nigisti Mulholland, James D Campbell, Zenaw Adam, Berhane Beyene, Amha Kebede | 2016 | Journal article | English |
| Issues and considerations in the use of serologic biomarkers for classifying vaccination history in household surveys | Adam MacNeil, Chung-won Lee, Vance Dietz | 1960 | Journal article | English |
| Lot Quality Assurance Sampling to Monitor Supplemental Immunization Activity Quality: An Essential Tool for Improving Performance in Polio Endemic Countries | Alexandra E. Brown, Arshad Quddus, George Walker, Guillaume Chabot-Couture, Hiromasa Okayasu, Michael M. Nzioki, Mufti Z. Wadood, Roland W. Sutter | Journal article | English | |
| LQAS: User Beware | Dale A. Rhoda, David J. Fitch, Soledad A. Fernandez, Stanley Lemeshow | Journal article | English | |
| Measurement of immunisation coverage | Jean-Marie Okwo-Bele, Maryanne Neil, Peter Salama, Tessa Wardlaw, Tony Burton | Journal article | English | |
| Measuring Coverage in MNCH: A Validation Study Linking Population Survey Derived Coverage to Maternal, Newborn, and Child Health Care Records in Rural China | Biqin Tan, Harry Campbell, Jennifer Bryce, Li Liu, Li Yang, Lirong Ju, Mengying Li, Neff Walker, Robert E. Black, Yan Guo | 2013 | Journal article | English |
| Measuring coverage in MNCH: total survey error and the interpretation of intervention coverage estimates from household surveys. | Aluisio J. D. Barros, Dale A. Rhoda, Felicity T. Cutts, Fred Arnold, Joseph Keating, Ruilin Ren, Thomas P. Eisele | Journal article | English | |
| Measuring Coverage in MNCH: Tracking Progress in Health for Women and Children Using DHS and MICS Household Surveys | Attila Hancioglu, Fred Arnold | Journal article | English | |
| Measuring populations to improve vaccination coverage | Ali Djibo, Andrew J. Tatem, Bryan T. Grenfell, Matthew J. Ferrari, Nita Bharti | 2016 | Journal article | English |
| Measuring the performance of vaccination programs using cross-sectional surveys: a likelihood framework and retrospective analysis. | Bryan T. Grenfell, C. Jessica E. Metcalf, Derek A. T. Cummings, Francisco J. Luquero, Justin Lessler, Rebecca F. Grais | Journal article | English | |
| Monitoring vaccination coverage: Defining the role of surveys | Dale A. Rhoda, Felicity T. Cutts, M. Carolina Danovaro-Holliday, Pierre Claquin | Journal article | English | |
| Reply to comments on Monitoring vaccination coverage: Defining the role of surveys. | Dale A. Rhoda, Felicity T. Cutts, M. Carolina Danovaro-Holliday, Pierre Claquin | Journal article | English | |
| Seroepidemiology: an underused tool for designing and monitoring vaccination programmes in low- and middleincome countries | Felicity T. Cutts, Matt Hanson | Journal article | English | |
| Use and abuse of rapid monitoring to assess coverage during mass vaccination campaigns. | Elizabeth T. Luman, K. Lisa Cairns, Robert Perry, Vance Dietz | Guidance | English | |
| Validity of reported vaccination coverage in 45 countries. | Christopher J. L. Murray, Bakhuti Shengelia, Neeru Gupta, Saba Moussavi, Ajay Tandon, Michel Thieren | 2003 | Journal article | English |
| Validity of vaccination cards and parental recall to estimate vaccination coverage: a systematic review of the literature. | Elizabeth T. Luman, Elizabeth Zell, Melody Miles, Tove K. Ryman, Vance Dietz | Journal article | English |
IRMMA
The resource is included in the following table:
| Title | Author | Year | Type | Language |
|---|---|---|---|---|
| About the Zero-Dose Learning Hub | Gavi, the Vaccine Alliance, IIHMR, Delhi, JSI, The Geneva Learning Foundation, Zero-Dose Learning Hub | 2025 | Repository | English |
| Application des connaissances pour la recherche sur la vaccination zéro-dose | Zero-Dose Learning Hub | 2024 | Tool | French, English |
| Assessing the Governance and Political-Economy Landscape for Evidence-Based Zero-Dose Programming and Policies in Bangladesh | Gavi, the Vaccine Alliance, JSI, IIHMR, Delhi, The Geneva Learning Foundation, Zero-Dose Learning Hub | 2025 | Repository | English |
| Assessing the Use of Mapping for Health (M4H) Data for Immunization Program Implementation and Associated Impact on Coverage and Equity in the Democratic Republic of the Congo | HealthEnabled, Gavi, the Vaccine Alliance, Kinshasa School of Public Health | 2023 | Case study | English |
| Assessment of the Political Economy Context Surrounding Evidence Use for Zero-Dose Programming and Policies in Nigeria | JSI, The Geneva Learning Foundation, Gavi, the Vaccine Alliance, IIHMR, Delhi, Zero-Dose Learning Hub | 2024 | Repository | English |
| Bangladesh Zero-Dose Landscape | JSI, The Geneva Learning Foundation, IIHMR, Delhi, Gavi, the Vaccine Alliance, Zero-Dose Learning Hub | 2023 | Repository | English |
| Burden of Zero-Dose Children in Pastoralist, Hard-to-Reach and Underserved Communities: A Case Study of Mubende District, Uganda | Infectious Diseases Research Collaboration (IDRC), PATH, Makerere University School of Public Health (MakSPH) | 2024 | Repository | English |
| Cameroon Increases Reach to Zero-Dose Children through Microplanning and Communication | Gavi, the Vaccine Alliance, fhi360 | 2023 | Case study | English |
| Cartographie SIG : Une Approche Prometteuse Pour Identifier et Atteindre des Enfants Zéro Dose en Zambie | Gavi, the Vaccine Alliance, fhi360 | 2023 | Case study | French |
| Closing The Immunization Gap: Enhancing Routine Immunization in Nigeria by Reaching Zero-Dose and Under-Immunized Children in Marginalized Communities: Report of a Rapid Assessment | Gavi, the Vaccine Alliance, Africa Health Budget Network (AHBN), African Field Epidemiology Network (AFENET), Zero-Dose Learning Hub | 2024 | Repository | English |
| Collaborating with Women’s Groups: A Promising Approach to Identify and Reach Zero-Dose Children in Urban Mali | Gavi, the Vaccine Alliance, fhi360 | 2023 | Case study | English, French |
| Collaboration Avec des Groupes de Femmes : Une Approche Prometteuse pour Identifier et Atteindre les Enfants Zéro Dose dans les Zones Urbaines du Mali | Gavi, the Vaccine Alliance, fhi360 | 2023 | Case study | French, English |
| Contribution of Health Information System to Child Immunization Services in Ethiopia: Baseline Study of 33 Woredas | Abebaw Worku, Hibret Alemu, Hiwot Belay, Afrah Mohammedsanni, Wubshet Denboba, Frehiwot Mulugeta, Shemsedin Omer, Biruk Abate, Mesoud Mohammed, Mohammed Ahmed, Yakob Wondarad, Meskerem Abebaw | 2022 | Journal article | English |
| Country Learning Hub for Immunization Equity in Bangladesh: Findings from Rapid Assessment | Gavi, the Vaccine Alliance, icddr,b, redorange communications, Jhpiego | 2023 | Repository | English |
| Crossing Lanes: Forecasting for Zero Dose | JSI | 2022 | Case study | English |
| Decentralized Immunization Monitoring: Lessons Learnt from a Pilot Implementation in Kumbotso LGA, Kano State, Nigeria | Zero-Dose Learning Hub | 2025 | Journal article | English |
| Early Learning from Zero-Dose Practitioners in Bangladesh and Mali: Gavi ZDLH Inter-Country Peer Exchange (ZDLH-X1) | Gavi, the Vaccine Alliance, JSI, The Geneva Learning Foundation, IIHMR, Delhi, Zero-Dose Learning Hub | 2023 | Repository | English |
| Early Learning from Zero-Dose Practitioners in Nigeria and Uganda: Gavi ZDLH Inter-Country Peer Exchange (ZDLH-X2) | The Geneva Learning Foundation, JSI, Gavi, the Vaccine Alliance, IIHMR, Delhi, Zero-Dose Learning Hub | 2023 | Repository | English |
| Early Lessons From Ethiopia in Establishing a Data Triangulation Process to Analyze Immunization Program and Supply Data for Decision Making | Disha Ali, Belayneh Dagnew, Wendy Prosser, Lisa Oot, Natasha Kanagat, Daniel Girma, Amare Bayeh, Adriana Almiñana | 2022 | Journal article | English |
| Electronic Immunization Information Systems: A Case Report of Lessons Learned from Implementation in Pakistan | Sullivan E, Masood Tariq, Javeed Wajiha, Katharine Bagshaw, Steve Ollis, Presha Regmi, Gardezi SMA | 2020 | Journal article | English |
| Elevating Immunization Demand: Harnessing Social Networks and Reminders | National Urban Health Mission, Haryana | 2024 | Case study | English |
| Evaluation Rapide Situation des Enfants Zéro-Dose et Sous-Vaccinés au Mali | PEV Mali, Gavi, the Vaccine Alliance, GaneshAID, Centre pour les Vaccins en Développement Mali (CVD-Mali), USTTB, Zero-Dose Learning Hub, Centre d'Apprentissage pour l'Equité en Vaccination - Mali (CAPEV) | 2024 | Repository | French |
| Exploring the Landscape of Routine Immunization in Nigeria: A Scoping Review of Barriers and Facilitators | Yahaya Mohammed, Heidi W. Reynolds, Hyelshilni Waziri, Adam Attahiru, Ahmed Olowo-okere, Moreen Kamateeka, Ndadilnasiya Endie Waziri, Aminu Magashi Garba, Gustavo C. Corrêa, Rufai Garba, Nancy Vollmer, Patrick Mboya Nguku | 2024 | Journal article | English |
| From Research to Action: Measuring Knowledge Translation Efforts | Gavi, the Vaccine Alliance, JSI, The Geneva Learning Foundation, IIHMR, Delhi, Zero-Dose Learning Hub | 2025 | Repository | English |
| Gavi's Zero-Dose Learning Week | Gavi, the Vaccine Alliance, JSI, Zero-Dose Learning Hub, IIHMR, Delhi, The Geneva Learning Foundation | 2024 | Repository | English |
| Gavi’s Zero-Dose Learning Hub IRMMA Aligned Interventions: Semiannual Update (May 2024) | Gavi, the Vaccine Alliance, JSI, The Geneva Learning Foundation, IIHMR, Delhi, Zero-Dose Learning Hub | 2024 | Repository | English |
| Gavi’s Zero-Dose Learning Hub IRMMA Aligned Interventions: Semiannual Update (October 2023) | Gavi, the Vaccine Alliance, JSI, The Geneva Learning Foundation, IIHMR, Delhi, Zero-Dose Learning Hub | 2023 | Repository | English |
| Gavi’s Zero-Dose Learning Hub IRMMA Aligned Interventions: Semiannual Update—Bangladesh (April 2025) | JSI, The Geneva Learning Foundation, IIHMR, Delhi, Gavi, the Vaccine Alliance, Zero-Dose Learning Hub | 2025 | Repository | English |
| Gavi’s Zero-Dose Learning Hub IRMMA Aligned Interventions: Semiannual Update—Bangladesh (May 2024) | IIHMR, Delhi, The Geneva Learning Foundation, JSI, Gavi, the Vaccine Alliance, Zero-Dose Learning Hub | 2024 | Repository | English |
| Gavi’s Zero-Dose Learning Hub IRMMA Aligned Interventions: Semiannual Update—Bangladesh (October 2025) | Gavi, the Vaccine Alliance, JSI, The Geneva Learning Foundation, IIHMR, Delhi, Zero-Dose Learning Hub | 2025 | Report | English |
| Gavi’s Zero-Dose Learning Hub IRMMA Aligned Interventions: Semiannual Update—Mali (April 2025) | JSI, The Geneva Learning Foundation, Gavi, the Vaccine Alliance, IIHMR, Delhi, Zero-Dose Learning Hub | 2025 | Repository | English |
| Gavi’s Zero-Dose Learning Hub IRMMA Aligned Interventions: Semiannual Update—Mali (May 2024) | Gavi, the Vaccine Alliance, JSI, IIHMR, Delhi, The Geneva Learning Foundation, Zero-Dose Learning Hub | 2024 | Repository | English |
| Gavi’s Zero-Dose Learning Hub IRMMA Aligned Interventions: Semiannual Update—Mali (October 2024) | JSI, The Geneva Learning Foundation, IIHMR, Delhi, Gavi, the Vaccine Alliance, Zero-Dose Learning Hub | 2024 | Repository | English |
| Gavi’s Zero-Dose Learning Hub IRMMA Aligned Interventions: Semiannual Update—Mali (October 2025) | Gavi, the Vaccine Alliance, JSI, Zero-Dose Learning Hub, The Geneva Learning Foundation, IIHMR, Delhi | 2025 | Report | English |
| Gavi’s Zero-Dose Learning Hub IRMMA Aligned Interventions: Semiannual Update—Nigeria (April 2025) | Gavi, the Vaccine Alliance, JSI, IIHMR, Delhi, The Geneva Learning Foundation, Zero-Dose Learning Hub | 2025 | Repository | English |
| Gavi’s Zero-Dose Learning Hub IRMMA Aligned Interventions: Semiannual Update—Nigeria (May 2024) | Gavi, the Vaccine Alliance, JSI, The Geneva Learning Foundation, IIHMR, Delhi, Zero-Dose Learning Hub | 2024 | Repository | English |
| Gavi’s Zero-Dose Learning Hub IRMMA Aligned Interventions: Semiannual Update—Nigeria (October 2024) | JSI, Gavi, the Vaccine Alliance, The Geneva Learning Foundation, IIHMR, Delhi, Zero-Dose Learning Hub | 2024 | Repository | English |
| Gavi’s Zero-Dose Learning Hub IRMMA Aligned Interventions: Semiannual Update—Nigeria (October 2025) | Gavi, the Vaccine Alliance, JSI, Zero-Dose Learning Hub, The Geneva Learning Foundation, IIHMR, Delhi | 2025 | Report | English |
| Gavi’s Zero-Dose Learning Hub IRMMA Aligned Interventions: Semiannual Update—Uganda (April 2025) | JSI, The Geneva Learning Foundation, IIHMR, Delhi, Gavi, the Vaccine Alliance, Zero-Dose Learning Hub | 2025 | Repository | English |
| Gavi’s Zero-Dose Learning Hub IRMMA Aligned Interventions: Semiannual Update—Uganda (May 2024) | Gavi, the Vaccine Alliance, JSI, IIHMR, Delhi, The Geneva Learning Foundation, Zero-Dose Learning Hub | 2024 | Repository | English |
| Gavi’s Zero-Dose Learning Hub IRMMA Aligned Interventions: Semiannual Update—Uganda (October 2025) | Gavi, the Vaccine Alliance, JSI, The Geneva Learning Foundation, IIHMR, Delhi, Zero-Dose Learning Hub | 2025 | Report | English |
| GIS Mapping: A Promising Approach to Identifying and Reaching Zero-Dose Children in Zambia | Gavi, the Vaccine Alliance, fhi360 | 2023 | Case study | English |
| Health Systems Strengthening to Reach Zero-Dose Children in Chad | Gavi, the Vaccine Alliance | 2023 | Case study | English |
| Identification des enfants zéro dose et sous-vaccinés au Mali en 2023 | Gavi, the Vaccine Alliance, GaneshAID, Centre pour les Vaccins en Développement Mali (CVD-Mali), USTTB, Zero-Dose Learning Hub, PEV Mali | 2024 | Repository | French |
| Identifying the Zero-dose and Under-immunized Children in Bangladesh: Approaches and Experiences | Mohammed Nizzam Uddin, Md. Wazed Ali, Nurul Alam, Zerin Jannat, Mahbub E. Elahi Khan Chowdhury, Bidhan Krishna Sarker, Hemel Das | 2024 | Journal article | English |
| Identifying the Zero-Dose Child: Insights from the UNICEF-Supported House-to-House Registration of Children by Village Health Teams in Uganda | Infectious Diseases Research Collaboration (IDRC), PATH, Makerere University School of Public Health (MakSPH) | 2025 | Repository | English |
| Immunization Coverage Surveys and Linked Biomarker Serosurveys in Three Regions in Ethiopia | Mark A Travassos, Myron M Levine, Robert Steinglass, Marcela F. Pasetti, Samba O Sow, Jaya Goswami, Inna Ruslanova, Yukun Wu, William C. Blackwelder, Mardi Reymann, Jenny Sequeira, Lisa Oot, Tassew Kassa, Seydou S Diarra, Nigisti Mulholland, James D Campbell, Zenaw Adam, Berhane Beyene, Amha Kebede | 2016 | Journal article | English |
| Immunization Data Triangulation Tool (IDTT) | JSI | 2020 | Tool | English |
| Implementing Quality Improvement Strategies: A Quick Reference Guide for Woreda & Health Facility Levels | JSI, Universal Immunization through Improving Family Health Services (UI-FHS) | 2020 | Tool | English |
| Improve Data Quality to Make the Most of Important Resources | Universal Immunization through Improving Family Health Services (UI-FHS), JSI | 2018 | Tool | English |
