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World Health Organization• SEARO/FGL/IVD • 31 August 2016World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development
South-East Asia Region
Immunization andVaccine Development
South-East Asia Region
Bangladesh 2016
Immunization system highlights
� There is a comprehensive multi-year plan (cMYP) for immunization covering 2014-2018.
� A standing national technical advisory group on immunization (NTAGI) fully functional.
� A national policy for health care waste management including waste from immunization activities exists.
� A national system to monitor adverse events following immunization (AEFI) exists.
� An EPI coverage evaluation survey (CES) was conducted in 2015. Another CES is planned in the next 24 months.
� 27% spending on vaccines financed by the government.
� 29% spending on routine immunization programme financed by the government.
� All 64 districts have updated micro-plans that include activities to raise immunization coverage.
� All 64 districts had >80% coverage for DTP-Hib-HepB3 and >90% coverage for MCV1.
� HPV demonstration launched on 16 April 2016 in 4 Upzila and 1 Zone under Gazipur district targeting school going girls of grade 5 and out of school girls of the age 10 years.
Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
Table 1: Basic information1 2015Division/Province/State/Region 7
District 64
Upazilla/Sub-district 489
City Corporation 11
Union 4 498
Ward 13 494
Sub-Block 108 000
Population density (per sq. km) 1 074
Population living in urban areas 33%
Population using improved drinking-water sources
85%
Population using improved sanitation 57%
Total expenditure on health as % of GDP 3.5%
Births attended by skilled health personnel 44%
Neonates protected at birth against NT 94%
Total population 158 435 598
Live births (LB) 3 228 362
Children <1 year 3 089 542
Children <5 years 15 686 321
Children <15 years 50 916 899
Pregnant women 3 551 198
Women of child bearing age (15-49 years)
43 380 414
Neonatal mortality rate 24.2 (per 1 000 LB)
Infant mortality rate 33.2 (per 1 000 LB)
Under-five mortality rate 41.1 (per 1 000 LB)
Maternal mortality ratio 170 (per 100 000 LB)
1 SEAR annual EPI reporting form, 2015 and WHO, World Health Statistics 2015
Vaccine Age of administration
BCG At birth
DTP-Hib-HepB 6 weeks, 10 weeks, 14 weeks
OPV 6 weeks, 10 weeks, 14 weeks, 38 weeks
PCV 6 weeks, 10 weeks, 18 weeks
IPV 14 weeks
MR 38 weeks, 15 months
Measles 15 months
TT Females 15 to 49 years (5 doses with an interval of + 1 month, + 6 months, + 1 year and + 1 year with preceding dose)
EPI history � EPI Launched on 07 April 1979. � TT5 dose for WCBA started in 1993. � HepB vaccine introduced in 2003. � AD syringes introduced in 2004. � Hib Pentavalent (DTP-Hib-HepB) vaccine
introduced in 2009. � MR vaccine and measles second dose
introduced in 2012. � Pneumococcal conjugate vaccine introduced
in 2015. � IPV introduced in 2015. � Type 2 component of OPV withdrawn on 23
April 2016 by switching from tOPV to bOPV.
Table 2: Immunization schedule, 2015
Source: cMYP 2011-2016 and EPI/MOHFWSource: WHO/UNICEF joint reporting form (JRF) 2015
Source: WHO/UNICEF joint reporting form (JRF) 2015
E P I F a c t S h E E t
Figure 12: Confirmed (Lab and Epi linked) measles outbreak associated cases, by age, 2010–2015
Figure 10: Immunity against measles: Immunity profile by age in 2015*
Figure 13: Unimmunized confirmed (Lab and Epi linked)measles outbreak associated cases, by age, 2010–2015
Figure 14: Network of WHO supported surveillance medical officers and laboratories
Figure 11: Immunity against measles: Immunity profile by age in 2016*
*Modeled using MSP tool ver 2 based on coverage data up to 2015.
Source: SEAR annual EPI reporting form (multiple years)
*Modeled using MSP tool ver 2 assuming the schedule and measles containing vaccine (MCV) coverage remain unchanged and no SIAs in 2015 & 2016.
Source: SEAR annual EPI reporting form (multiple years)
Routine/sporadic cases Outbreak associated cases
Year No. of suspected
case
No. of death
No. of lab-confirmed
measles cases
No. of lab-confirmed
rubella cases
No. of suspected
outbreak
No. of Outbreak
Investigated
No. of case
No. of death
No. of measles
outbreak*
No. of confirmed
measles case*
No. of confirmed
rubella outbreak*
No. of confirmed
rubella cases*
2010 1 534 5 43 496 217 217 13 666 0 0 0 193 12 467
2011 2 993 1 1 445 267 333 333 11 863 11 91 2 802 89 4 744
2012 1 764 0 560 161 185 185 6 756 1 33 1 092 66 2 683
2013 1 095 0 55 230 146 146 4 230 0 7 156 87 2 787
2014 1 668 0 97 176 71 71 1 368 0 9 178 11 166
2015 2 470 0 129 130 68 68 922 0 4 78 3 48
Source: Monthly VPD Reporting to WHO/SEARO * Laboratory confirmed & epidemiologically- linked
Table 8: Suspected sporadic and Outbreak associated measles and rubella cases, 2010–2015
Table 9: Quality of field and laboratory surveillance for measles and rubella, 2012–2015
Year
No. o
f Sus
pect
ed M
easl
es
Case classification (number) Indicators
Measles Rubella
Disc
arde
d no
n-m
easl
es n
on-
rube
lla c
ases
Annu
al in
cide
nce
of
confi
rmed
Mea
sles
cas
es p
er
mill
ion
tota
l pop
ulat
ion
Annu
al in
cide
nce
of
confi
rmed
Rub
ella
cas
es p
er
mill
ion
tota
l pop
ulat
ion
Prop
ortio
n of
all
susp
ecte
d m
easl
es a
nd ru
bella
cas
es
that
hav
e ha
d an
ade
quat
e in
vest
igat
ion
initi
ated
with
in
48 h
ours
of n
otifi
catio
n
Disc
arde
d no
n-m
easl
es
non-
rube
lla in
cide
nce
per
100,
000
tota
l pop
ulat
ion
Prop
ortio
n of
sub
natio
nal
adm
inis
trativ
e un
its re
porti
ng
at le
ast t
wo
disc
arde
d no
n-m
easl
es n
on-r
ubel
la c
ases
pe
r 100
,000
tota
l pop
ulat
ion
Prop
ortio
n of
sub
-nat
iona
l su
rvei
llanc
e un
its re
porti
ng
to th
e na
tiona
l lev
el o
n tim
e
Lab-
confi
rmed
Epi-L
inke
d
Clin
ical
ly-c
onfir
med
Lab-
confi
rmed
Epi-L
inke
d
Target – – 80% 2 80% 80%
2012 8 289 715 1 077 599 481 2 592 2 825 11.8 20.2 87 1.9 30 85
2013 5 229 77 123 325 633 2 337 1 728 1.3 19.3 88 1.1 19 85
2014 3 039 143 143 175 223 158 2 138 1.8 2.4 90 1.4 17 89
2015 3 415 158 80 64 152 37 2 880 1.5 1.2 92 1.8 37 92
Source: SEAR Annual EPI Reporting Form, 2015 ND=No data
Table 10: Performance of Laboratory Surveillance, 2012–2015
Year
% Serum specimen collected from
suspected measles cases
Total Serum Specimen
received in Laboratory
% serum specimens
tested
Specimen Positive for Measles IgM
Specimen Positive for Rubella IgM
% Results within 4 of
receipt
% Outbreak tested for
viral detection
Genotypes detected
No. % No. % Measles Rubella
2012 31 2 590 99 714 28% 481 26% 32 ND ND ND
2013 33 1 748 99 77 4% 634 38% 82 ND ND ND
2014 67 2 042 99 143 7% 223 12% 99 0 B3 ND
2015 83 2 839 100 158 6% 152 6% 87 ND ND ND
Source: SEAR Annual EPI Reporting Form, 2015 ND=No data
For contact or feedback: Expanded Program on ImmunizationMinistry of Health and Family Welfare, Dhaka, BangladeshTel: +880-2-9880530, 8821910-03, Fax: +880-2-8821914Email: [email protected], www.dghs.gov.bd
Immunization and Vaccine Development (IVD)WHO-SEARO, IP Estate, MG Marg, New Delhi 110002, IndiaTel: +91 11 23370804, Fax: +91 11 23370251Email: [email protected], www.searo.who.int/entity/immunization
0%10%20%30%40%50%60%70%80%90%
100%
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Perce
nt of
popu
lation
Age (in years)Susceptible Immune due to past infectionProtected by SIAs Protected by routine vaccination with 2nd doseProtected by routine vaccination with 1st dose Protected by maternal antibodies
0%10%20%30%40%50%60%70%80%90%
100%
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Perce
nt of
popu
lation
Age (in years)Protected by maternal antibodies Protected by routine vaccination with 1st doseProtected by routine vaccination with 2nd dose Protected by SIAsImmune due to past infection Susceptible
050
100150200250300350400450500
2010 2011 2012 2013 2014 2015<1 year 1-4 years 5-9 years 10-14 years 15+ years
n=0 n=2802 n=1092 n=156 n=178 n=78956 949
050
100150200250300350400450500
2010 2011 2012 2013 2014 2015<1 year 1-4 years 5-9 years 10-14 years 15+ years
n=0 n=1212 n=459 n=57 n=78 n=12(0%) (43%) (42%) (37%) (44%) (15%)
Institute of Public Health - National polio laboratory
- National measles/rubella laboratory
- National Japanese encephalitis laboratory
- Dhaka Shishu Hospital- Chittagong Maa-O-Shishu Hospital- Kumudini Women’s Medical College
Invasive Bacteria
Surveillance Medical Officer (SMO) = 30Divisional Coordinator (DC) = 5
Data WHO-IVD Bangladesh (as of May 2016)
E P I F a c t S h E E t
World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development
South-East Asia Region
Table 3: OPV supplementary immunization activities (SIA)
Figure 3: DTP-Hib-HepB3 valid coverage by 23 months by district, 2015
Figure 5: Non-polio AFP rate by district, 2015
Table 6: MCV supplementary immunization activities
Figure 7: MCV1 & MCV2 coverage1 and measles cases2, 1980–2015
Figure 9: Sporadic and outbreak associated measles cases* by month and MR SIA coverage, 2010–2015
Figure 4: TT2+ coverage1 and NT cases2, 1980–2015
Figure 6: Adequate stool specimen collection percentage by district, 2015
Table 7: Districts with more than 95% MCV1 coverage
Figure 8: MCV1 valid coverage by 23 months by district, 2015
Year Activity Target population (<5 years)
Date of 1st round Date of 2nd round 1st round coverage (%) 2nd round coverage (%)
2007 NID 23 860 574 3-Mar-07 8-Apr-07 101 101
2007 SNID 1 865 659 20-May-07 1-Jul-07 101 101
2007 NID 23 918 744 27-Oct-07 8-Dec-07 102 101
2008-2009 NID 24 043 956 29-Nov-08 3-Jan-09 101 101
2010 NID 21 252 571 10-Jan-10 – 102 –
2010 NID* 20 924 847 14-Feb-10 – 100 –
2011 NID 22 151 269 8-Jan-11 – 102 –
2011 NID 22 320 803 – 12-Feb-11 – 101
2012 NID 22 019 556 7-Jan-12 – 101 –
2012 NID 22 073 699 – 11-Feb-12 – 101
2013 NID 20 530 418 21-Dec-13 – 101 –
2014 NID* 20 631 077 25-Jan-14 – 99 –
2016 Mop-up 114 979 23-Jan-16 – 101 –
2016 Mop-up 115 355 – 27-Feb-16 – 101
Source: WHO/UNICEF JRF * One dose OPV given during MCV campaign
Indicator 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
AFP cases 1 619 1 844 1 790 1 502 1 537 1 610 1 567 1 412 1 478 1 413
Wild poliovirus confirmed cases 18 0 0 0 0 0 0 0 0 0
Compatible cases 2 0 0 0 0 0 0 0 0 0
AFP rate 2.91 3.25 3.1 2.61 2.63 3.11 2.98 2.65 2.74 2.78
Non-polio AFP rate1 2.87 3.25 3.1 2.61 2.63 3.11 2.98 2.65 2.74 2.78
Adequate stool specimen collection percentage2 93% 92% 92% 94% 95% 95% 96% 96% 98% 97%
Total stool samples collected 3 185 3 611 4 276 3 403 3 412 3 578 3 412 3 132 3 094 3 008
% NPEV isolation 14.8 15.0 23.1 19.4 19.4 18.0 13.8 18.8 22.6 20.4
% Timeliness of primary result reported3 98 100 95 97 98 93 88 97 97 98
Year Vaccine, geographic coverage, target group
Target Coverage Achieved
2005 M, two districts, 9 months to 10 years 1 481 321 93%
2006 M, nationwide, 9 months to 10 years 34 199 590 100%
2010 M, nationwide, 9 months to 5 years 18 136 066 100%
2014 MR, nationwide, 9 months to 15 years 52 745 231 102%
Year Number of districts %
2010 28 44
2011 26 41
2012 54 84
2013 49 77
2014 49 77
2015 64 100
1 Number of discarded AFP cases per 100,000 children under 15 years of age.2 Percent with 2 specimens, 24 hours apart and within 14 days of paralysis onset.3 2005 to 2007 result reported within 28 days and 2008 onwards result reported within 14 days of sample received at laboratory.
1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016
1 Country official estimates, 1980-20152 WHO vaccine-preventable diseases: monitoring system 2016
Source: WHO and UNICEF estimates of national immunization coverage, July 2016 revision
Source: CES 2015 (provisional data)
*Includes laboratory confirmed and epidemiologically linked casesSource: SEAR Monthly VPD reports
Source: WHO/UNICEF JRFs
1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016
Source: WHO/UNICEF JRF (multiple years)
Source: CES 2015 (provisional data)
Table 4: AFP surveillance performance indicators, 2006–2015• Last polio case due to indigenous wild polio virus (WPV) was reported from Dhaka district in August 2000.• Last polio case due to imported wild polio virus (WPV) was reported from Sunamganj district in November 2006
• Bangladesh achieved the status of maternal neonatal tetanus (MNT) elimination in 2008.
Figure 1: National immunization coverage, 1980–2015 Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980–2015
Year Polio Diphtheria Pertussis Neonatal Tetanus (% of all Tetanus)
Measles Rubella Mumps Japanese Encephalitis
Congenital Rubella Syndrome
2006 18 35 46 257 (21%) 6 192 3 418 ND ND ND
2007 0 86 87 206 (20%) 2 924 13 226 ND 204 ND
2008 0 43 33 152 (16%) 2 660 5 526 ND 702 ND
2009 0 23 16 121 (15%) 718 13 076 ND 15 ND
2010 0 27 17 117 (16%) 788 12 963 ND 15 ND
2011 0 11 44 98 (15%) 5 625 5 631 ND 103 ND
2012 0 16 13 109 (18%) 1 986 3 245 ND 52 20
2013 0 2 1 108 (21%) 237 3 034 ND 23 34
2014 0 13 12 105 (19%) 289 381 ND 183 98
2015 0 6 11 117(21%) 240 189 ND 76 89
Table 5: Reported cases of vaccine preventable disease, 2006–2015
Source: WHO/UNICEF JRF ND=No data
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015BCG 2 86 93 94 97 98 99 98 98 98 98DTP3 2 69 69 82 93 94 96 94 94 94 94Pol3 2 69 69 83 94 94 96 94 94 94 94MCV 1 65 79 74 88 88 93 88 88 88 88
0
20
40
60
80
100
% C
over
age
0
20
40
60
80
100
0200400600800
100012001400160018002000
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearDiphtheria Cases Pertussis Cases DTP3 Coverage
12436 23897 4879
<70% 70%–79% 80%–89% > 90%
0
20
40
60
80
100
0
200
400
600
800
1000
1200
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearNT cases TT2+ Coverage
<1 1–1.99 > No non-polio AFP case 2 <60% 60%–79% > No AFP 80
0
20
40
60
80
100
0
2000
4000
6000
8000
10000
12000
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearMeasles Cases MCV1 Coverage MCV2 Coverage
25934
<70% 70%–79% 80%–89% > 90%
0
100
200
300
400
500
600
700
800
900
Jan-
10Ma
r-10
May-1
0Ju
l-10
Sep-
10No
v-10
Jan-
11Ma
r-11
May-1
1Ju
l-11
Sep-
11No
v-11
Jan-
12Ma
r-12
May-1
2Ju
l-12
Sep-
12No
v-12
Jan-
13Ma
r-13
May-1
3Ju
l-13
Sep-
13No
v-13
Jan-
14Ma
r-14
May-1
4Ju
l-14
Sep-
14No
v-14
Jan-
15Ma
r-15
May-1
5Ju
l-15
Sep-
15No
v-15
No. o
f cas
es
Sporadic measles Outbreak associated measles
M SIA (100%) MR SIA (102%)
E P I F a c t S h E E t
World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development
South-East Asia Region
Table 3: OPV supplementary immunization activities (SIA)
Figure 3: DTP-Hib-HepB3 valid coverage by 23 months by district, 2015
Figure 5: Non-polio AFP rate by district, 2015
Table 6: MCV supplementary immunization activities
Figure 7: MCV1 & MCV2 coverage1 and measles cases2, 1980–2015
Figure 9: Sporadic and outbreak associated measles cases* by month and MR SIA coverage, 2010–2015
Figure 4: TT2+ coverage1 and NT cases2, 1980–2015
Figure 6: Adequate stool specimen collection percentage by district, 2015
Table 7: Districts with more than 95% MCV1 coverage
Figure 8: MCV1 valid coverage by 23 months by district, 2015
Year Activity Target population (<5 years)
Date of 1st round Date of 2nd round 1st round coverage (%) 2nd round coverage (%)
2007 NID 23 860 574 3-Mar-07 8-Apr-07 101 101
2007 SNID 1 865 659 20-May-07 1-Jul-07 101 101
2007 NID 23 918 744 27-Oct-07 8-Dec-07 102 101
2008-2009 NID 24 043 956 29-Nov-08 3-Jan-09 101 101
2010 NID 21 252 571 10-Jan-10 – 102 –
2010 NID* 20 924 847 14-Feb-10 – 100 –
2011 NID 22 151 269 8-Jan-11 – 102 –
2011 NID 22 320 803 – 12-Feb-11 – 101
2012 NID 22 019 556 7-Jan-12 – 101 –
2012 NID 22 073 699 – 11-Feb-12 – 101
2013 NID 20 530 418 21-Dec-13 – 101 –
2014 NID* 20 631 077 25-Jan-14 – 99 –
2016 Mop-up 114 979 23-Jan-16 – 101 –
2016 Mop-up 115 355 – 27-Feb-16 – 101
Source: WHO/UNICEF JRF * One dose OPV given during MCV campaign
Indicator 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
AFP cases 1 619 1 844 1 790 1 502 1 537 1 610 1 567 1 412 1 478 1 413
Wild poliovirus confirmed cases 18 0 0 0 0 0 0 0 0 0
Compatible cases 2 0 0 0 0 0 0 0 0 0
AFP rate 2.91 3.25 3.1 2.61 2.63 3.11 2.98 2.65 2.74 2.78
Non-polio AFP rate1 2.87 3.25 3.1 2.61 2.63 3.11 2.98 2.65 2.74 2.78
Adequate stool specimen collection percentage2 93% 92% 92% 94% 95% 95% 96% 96% 98% 97%
Total stool samples collected 3 185 3 611 4 276 3 403 3 412 3 578 3 412 3 132 3 094 3 008
% NPEV isolation 14.8 15.0 23.1 19.4 19.4 18.0 13.8 18.8 22.6 20.4
% Timeliness of primary result reported3 98 100 95 97 98 93 88 97 97 98
Year Vaccine, geographic coverage, target group
Target Coverage Achieved
2005 M, two districts, 9 months to 10 years 1 481 321 93%
2006 M, nationwide, 9 months to 10 years 34 199 590 100%
2010 M, nationwide, 9 months to 5 years 18 136 066 100%
2014 MR, nationwide, 9 months to 15 years 52 745 231 102%
Year Number of districts %
2010 28 44
2011 26 41
2012 54 84
2013 49 77
2014 49 77
2015 64 100
1 Number of discarded AFP cases per 100,000 children under 15 years of age.2 Percent with 2 specimens, 24 hours apart and within 14 days of paralysis onset.3 2005 to 2007 result reported within 28 days and 2008 onwards result reported within 14 days of sample received at laboratory.
1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016
1 Country official estimates, 1980-20152 WHO vaccine-preventable diseases: monitoring system 2016
Source: WHO and UNICEF estimates of national immunization coverage, July 2016 revision
Source: CES 2015 (provisional data)
*Includes laboratory confirmed and epidemiologically linked casesSource: SEAR Monthly VPD reports
Source: WHO/UNICEF JRFs
1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016
Source: WHO/UNICEF JRF (multiple years)
Source: CES 2015 (provisional data)
Table 4: AFP surveillance performance indicators, 2006–2015• Last polio case due to indigenous wild polio virus (WPV) was reported from Dhaka district in August 2000.• Last polio case due to imported wild polio virus (WPV) was reported from Sunamganj district in November 2006
• Bangladesh achieved the status of maternal neonatal tetanus (MNT) elimination in 2008.
Figure 1: National immunization coverage, 1980–2015 Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980–2015
Year Polio Diphtheria Pertussis Neonatal Tetanus (% of all Tetanus)
Measles Rubella Mumps Japanese Encephalitis
Congenital Rubella Syndrome
2006 18 35 46 257 (21%) 6 192 3 418 ND ND ND
2007 0 86 87 206 (20%) 2 924 13 226 ND 204 ND
2008 0 43 33 152 (16%) 2 660 5 526 ND 702 ND
2009 0 23 16 121 (15%) 718 13 076 ND 15 ND
2010 0 27 17 117 (16%) 788 12 963 ND 15 ND
2011 0 11 44 98 (15%) 5 625 5 631 ND 103 ND
2012 0 16 13 109 (18%) 1 986 3 245 ND 52 20
2013 0 2 1 108 (21%) 237 3 034 ND 23 34
2014 0 13 12 105 (19%) 289 381 ND 183 98
2015 0 6 11 117(21%) 240 189 ND 76 89
Table 5: Reported cases of vaccine preventable disease, 2006–2015
Source: WHO/UNICEF JRF ND=No data
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015BCG 2 86 93 94 97 98 99 98 98 98 98DTP3 2 69 69 82 93 94 96 94 94 94 94Pol3 2 69 69 83 94 94 96 94 94 94 94MCV 1 65 79 74 88 88 93 88 88 88 88
0
20
40
60
80
100
% C
over
age
0
20
40
60
80
100
0200400600800
100012001400160018002000
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearDiphtheria Cases Pertussis Cases DTP3 Coverage
12436 23897 4879
<70% 70%–79% 80%–89% > 90%
0
20
40
60
80
100
0
200
400
600
800
1000
1200
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearNT cases TT2+ Coverage
<1 1–1.99 > No non-polio AFP case 2 <60% 60%–79% > No AFP 80
0
20
40
60
80
100
0
2000
4000
6000
8000
10000
12000
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearMeasles Cases MCV1 Coverage MCV2 Coverage
25934
<70% 70%–79% 80%–89% > 90%
0
100
200
300
400
500
600
700
800
900
Jan-
10Ma
r-10
May-1
0Ju
l-10
Sep-
10No
v-10
Jan-
11Ma
r-11
May-1
1Ju
l-11
Sep-
11No
v-11
Jan-
12Ma
r-12
May-1
2Ju
l-12
Sep-
12No
v-12
Jan-
13Ma
r-13
May-1
3Ju
l-13
Sep-
13No
v-13
Jan-
14Ma
r-14
May-1
4Ju
l-14
Sep-
14No
v-14
Jan-
15Ma
r-15
May-1
5Ju
l-15
Sep-
15No
v-15
No. o
f cas
es
Sporadic measles Outbreak associated measles
M SIA (100%) MR SIA (102%)
E P I F a c t S h E E t
World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development
South-East Asia Region
Table 3: OPV supplementary immunization activities (SIA)
Figure 3: DTP-Hib-HepB3 valid coverage by 23 months by district, 2015
Figure 5: Non-polio AFP rate by district, 2015
Table 6: MCV supplementary immunization activities
Figure 7: MCV1 & MCV2 coverage1 and measles cases2, 1980–2015
Figure 9: Sporadic and outbreak associated measles cases* by month and MR SIA coverage, 2010–2015
Figure 4: TT2+ coverage1 and NT cases2, 1980–2015
Figure 6: Adequate stool specimen collection percentage by district, 2015
Table 7: Districts with more than 95% MCV1 coverage
Figure 8: MCV1 valid coverage by 23 months by district, 2015
Year Activity Target population (<5 years)
Date of 1st round Date of 2nd round 1st round coverage (%) 2nd round coverage (%)
2007 NID 23 860 574 3-Mar-07 8-Apr-07 101 101
2007 SNID 1 865 659 20-May-07 1-Jul-07 101 101
2007 NID 23 918 744 27-Oct-07 8-Dec-07 102 101
2008-2009 NID 24 043 956 29-Nov-08 3-Jan-09 101 101
2010 NID 21 252 571 10-Jan-10 – 102 –
2010 NID* 20 924 847 14-Feb-10 – 100 –
2011 NID 22 151 269 8-Jan-11 – 102 –
2011 NID 22 320 803 – 12-Feb-11 – 101
2012 NID 22 019 556 7-Jan-12 – 101 –
2012 NID 22 073 699 – 11-Feb-12 – 101
2013 NID 20 530 418 21-Dec-13 – 101 –
2014 NID* 20 631 077 25-Jan-14 – 99 –
2016 Mop-up 114 979 23-Jan-16 – 101 –
2016 Mop-up 115 355 – 27-Feb-16 – 101
Source: WHO/UNICEF JRF * One dose OPV given during MCV campaign
Indicator 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
AFP cases 1 619 1 844 1 790 1 502 1 537 1 610 1 567 1 412 1 478 1 413
Wild poliovirus confirmed cases 18 0 0 0 0 0 0 0 0 0
Compatible cases 2 0 0 0 0 0 0 0 0 0
AFP rate 2.91 3.25 3.1 2.61 2.63 3.11 2.98 2.65 2.74 2.78
Non-polio AFP rate1 2.87 3.25 3.1 2.61 2.63 3.11 2.98 2.65 2.74 2.78
Adequate stool specimen collection percentage2 93% 92% 92% 94% 95% 95% 96% 96% 98% 97%
Total stool samples collected 3 185 3 611 4 276 3 403 3 412 3 578 3 412 3 132 3 094 3 008
% NPEV isolation 14.8 15.0 23.1 19.4 19.4 18.0 13.8 18.8 22.6 20.4
% Timeliness of primary result reported3 98 100 95 97 98 93 88 97 97 98
Year Vaccine, geographic coverage, target group
Target Coverage Achieved
2005 M, two districts, 9 months to 10 years 1 481 321 93%
2006 M, nationwide, 9 months to 10 years 34 199 590 100%
2010 M, nationwide, 9 months to 5 years 18 136 066 100%
2014 MR, nationwide, 9 months to 15 years 52 745 231 102%
Year Number of districts %
2010 28 44
2011 26 41
2012 54 84
2013 49 77
2014 49 77
2015 64 100
1 Number of discarded AFP cases per 100,000 children under 15 years of age.2 Percent with 2 specimens, 24 hours apart and within 14 days of paralysis onset.3 2005 to 2007 result reported within 28 days and 2008 onwards result reported within 14 days of sample received at laboratory.
1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016
1 Country official estimates, 1980-20152 WHO vaccine-preventable diseases: monitoring system 2016
Source: WHO and UNICEF estimates of national immunization coverage, July 2016 revision
Source: CES 2015 (provisional data)
*Includes laboratory confirmed and epidemiologically linked casesSource: SEAR Monthly VPD reports
Source: WHO/UNICEF JRFs
1 WHO and UNICEF estimates of national immunization coverage, July 2016 revision2 WHO vaccine-preventable diseases: monitoring system 2016
Source: WHO/UNICEF JRF (multiple years)
Source: CES 2015 (provisional data)
Table 4: AFP surveillance performance indicators, 2006–2015• Last polio case due to indigenous wild polio virus (WPV) was reported from Dhaka district in August 2000.• Last polio case due to imported wild polio virus (WPV) was reported from Sunamganj district in November 2006
• Bangladesh achieved the status of maternal neonatal tetanus (MNT) elimination in 2008.
Figure 1: National immunization coverage, 1980–2015 Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980–2015
Year Polio Diphtheria Pertussis Neonatal Tetanus (% of all Tetanus)
Measles Rubella Mumps Japanese Encephalitis
Congenital Rubella Syndrome
2006 18 35 46 257 (21%) 6 192 3 418 ND ND ND
2007 0 86 87 206 (20%) 2 924 13 226 ND 204 ND
2008 0 43 33 152 (16%) 2 660 5 526 ND 702 ND
2009 0 23 16 121 (15%) 718 13 076 ND 15 ND
2010 0 27 17 117 (16%) 788 12 963 ND 15 ND
2011 0 11 44 98 (15%) 5 625 5 631 ND 103 ND
2012 0 16 13 109 (18%) 1 986 3 245 ND 52 20
2013 0 2 1 108 (21%) 237 3 034 ND 23 34
2014 0 13 12 105 (19%) 289 381 ND 183 98
2015 0 6 11 117(21%) 240 189 ND 76 89
Table 5: Reported cases of vaccine preventable disease, 2006–2015
Source: WHO/UNICEF JRF ND=No data
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015BCG 2 86 93 94 97 98 99 98 98 98 98DTP3 2 69 69 82 93 94 96 94 94 94 94Pol3 2 69 69 83 94 94 96 94 94 94 94MCV 1 65 79 74 88 88 93 88 88 88 88
0
20
40
60
80
100
% C
over
age
0
20
40
60
80
100
0200400600800
100012001400160018002000
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearDiphtheria Cases Pertussis Cases DTP3 Coverage
12436 23897 4879
<70% 70%–79% 80%–89% > 90%
0
20
40
60
80
100
0
200
400
600
800
1000
1200
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearNT cases TT2+ Coverage
<1 1–1.99 > No non-polio AFP case 2 <60% 60%–79% > No AFP 80
0
20
40
60
80
100
0
2000
4000
6000
8000
10000
12000
1980 1985 1990 1995 2000 2005 2010 2011 2012 2013 2014 2015
% C
over
age
No. o
f cas
es
YearMeasles Cases MCV1 Coverage MCV2 Coverage
25934
<70% 70%–79% 80%–89% > 90%
0
100
200
300
400
500
600
700
800
900
Jan-
10Ma
r-10
May-1
0Ju
l-10
Sep-
10No
v-10
Jan-
11Ma
r-11
May-1
1Ju
l-11
Sep-
11No
v-11
Jan-
12Ma
r-12
May-1
2Ju
l-12
Sep-
12No
v-12
Jan-
13Ma
r-13
May-1
3Ju
l-13
Sep-
13No
v-13
Jan-
14Ma
r-14
May-1
4Ju
l-14
Sep-
14No
v-14
Jan-
15Ma
r-15
May-1
5Ju
l-15
Sep-
15No
v-15
No. o
f cas
es
Sporadic measles Outbreak associated measles
M SIA (100%) MR SIA (102%)
World Health Organization• SEARO/FGL/IVD • 31 August 2016World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development
South-East Asia Region
Immunization andVaccine Development
South-East Asia Region
Bangladesh 2016
Immunization system highlights
� There is a comprehensive multi-year plan (cMYP) for immunization covering 2014-2018.
� A standing national technical advisory group on immunization (NTAGI) fully functional.
� A national policy for health care waste management including waste from immunization activities exists.
� A national system to monitor adverse events following immunization (AEFI) exists.
� An EPI coverage evaluation survey (CES) was conducted in 2015. Another CES is planned in the next 24 months.
� 27% spending on vaccines financed by the government.
� 29% spending on routine immunization programme financed by the government.
� All 64 districts have updated micro-plans that include activities to raise immunization coverage.
� All 64 districts had >80% coverage for DTP-Hib-HepB3 and >90% coverage for MCV1.
� HPV demonstration launched on 16 April 2016 in 4 Upzila and 1 Zone under Gazipur district targeting school going girls of grade 5 and out of school girls of the age 10 years.
Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
Table 1: Basic information1 2015Division/Province/State/Region 7
District 64
Upazilla/Sub-district 489
City Corporation 11
Union 4 498
Ward 13 494
Sub-Block 108 000
Population density (per sq. km) 1 074
Population living in urban areas 33%
Population using improved drinking-water sources
85%
Population using improved sanitation 57%
Total expenditure on health as % of GDP 3.5%
Births attended by skilled health personnel 44%
Neonates protected at birth against NT 94%
Total population 158 435 598
Live births (LB) 3 228 362
Children <1 year 3 089 542
Children <5 years 15 686 321
Children <15 years 50 916 899
Pregnant women 3 551 198
Women of child bearing age (15-49 years)
43 380 414
Neonatal mortality rate 24.2 (per 1 000 LB)
Infant mortality rate 33.2 (per 1 000 LB)
Under-five mortality rate 41.1 (per 1 000 LB)
Maternal mortality ratio 170 (per 100 000 LB)
1 SEAR annual EPI reporting form, 2015 and WHO, World Health Statistics 2015
Vaccine Age of administration
BCG At birth
DTP-Hib-HepB 6 weeks, 10 weeks, 14 weeks
OPV 6 weeks, 10 weeks, 14 weeks, 38 weeks
PCV 6 weeks, 10 weeks, 18 weeks
IPV 14 weeks
MR 38 weeks, 15 months
Measles 15 months
TT Females 15 to 49 years (5 doses with an interval of + 1 month, + 6 months, + 1 year and + 1 year with preceding dose)
EPI history � EPI Launched on 07 April 1979. � TT5 dose for WCBA started in 1993. � HepB vaccine introduced in 2003. � AD syringes introduced in 2004. � Hib Pentavalent (DTP-Hib-HepB) vaccine
introduced in 2009. � MR vaccine and measles second dose
introduced in 2012. � Pneumococcal conjugate vaccine introduced
in 2015. � IPV introduced in 2015. � Type 2 component of OPV withdrawn on 23
April 2016 by switching from tOPV to bOPV.
Table 2: Immunization schedule, 2015
Source: cMYP 2011-2016 and EPI/MOHFWSource: WHO/UNICEF joint reporting form (JRF) 2015
Source: WHO/UNICEF joint reporting form (JRF) 2015
E P I F a c t S h E E t
Figure 12: Confirmed (Lab and Epi linked) measles outbreak associated cases, by age, 2010–2015
Figure 10: Immunity against measles: Immunity profile by age in 2015*
Figure 13: Unimmunized confirmed (Lab and Epi linked)measles outbreak associated cases, by age, 2010–2015
Figure 14: Network of WHO supported surveillance medical officers and laboratories
Figure 11: Immunity against measles: Immunity profile by age in 2016*
*Modeled using MSP tool ver 2 based on coverage data up to 2015.
Source: SEAR annual EPI reporting form (multiple years)
*Modeled using MSP tool ver 2 assuming the schedule and measles containing vaccine (MCV) coverage remain unchanged and no SIAs in 2015 & 2016.
Source: SEAR annual EPI reporting form (multiple years)
Routine/sporadic cases Outbreak associated cases
Year No. of suspected
case
No. of death
No. of lab-confirmed
measles cases
No. of lab-confirmed
rubella cases
No. of suspected
outbreak
No. of Outbreak
Investigated
No. of case
No. of death
No. of measles
outbreak*
No. of confirmed
measles case*
No. of confirmed
rubella outbreak*
No. of confirmed
rubella cases*
2010 1 534 5 43 496 217 217 13 666 0 0 0 193 12 467
2011 2 993 1 1 445 267 333 333 11 863 11 91 2 802 89 4 744
2012 1 764 0 560 161 185 185 6 756 1 33 1 092 66 2 683
2013 1 095 0 55 230 146 146 4 230 0 7 156 87 2 787
2014 1 668 0 97 176 71 71 1 368 0 9 178 11 166
2015 2 470 0 129 130 68 68 922 0 4 78 3 48
Source: Monthly VPD Reporting to WHO/SEARO * Laboratory confirmed & epidemiologically- linked
Table 8: Suspected sporadic and Outbreak associated measles and rubella cases, 2010–2015
Table 9: Quality of field and laboratory surveillance for measles and rubella, 2012–2015
Year
No. o
f Sus
pect
ed M
easl
es
Case classification (number) Indicators
Measles Rubella
Disc
arde
d no
n-m
easl
es n
on-
rube
lla c
ases
Annu
al in
cide
nce
of
confi
rmed
Mea
sles
cas
es p
er
mill
ion
tota
l pop
ulat
ion
Annu
al in
cide
nce
of
confi
rmed
Rub
ella
cas
es p
er
mill
ion
tota
l pop
ulat
ion
Prop
ortio
n of
all
susp
ecte
d m
easl
es a
nd ru
bella
cas
es
that
hav
e ha
d an
ade
quat
e in
vest
igat
ion
initi
ated
with
in
48 h
ours
of n
otifi
catio
n
Disc
arde
d no
n-m
easl
es
non-
rube
lla in
cide
nce
per
100,
000
tota
l pop
ulat
ion
Prop
ortio
n of
sub
natio
nal
adm
inis
trativ
e un
its re
porti
ng
at le
ast t
wo
disc
arde
d no
n-m
easl
es n
on-r
ubel
la c
ases
pe
r 100
,000
tota
l pop
ulat
ion
Prop
ortio
n of
sub
-nat
iona
l su
rvei
llanc
e un
its re
porti
ng
to th
e na
tiona
l lev
el o
n tim
e
Lab-
confi
rmed
Epi-L
inke
d
Clin
ical
ly-c
onfir
med
Lab-
confi
rmed
Epi-L
inke
d
Target – – 80% 2 80% 80%
2012 8 289 715 1 077 599 481 2 592 2 825 11.8 20.2 87 1.9 30 85
2013 5 229 77 123 325 633 2 337 1 728 1.3 19.3 88 1.1 19 85
2014 3 039 143 143 175 223 158 2 138 1.8 2.4 90 1.4 17 89
2015 3 415 158 80 64 152 37 2 880 1.5 1.2 92 1.8 37 92
Source: SEAR Annual EPI Reporting Form, 2015 ND=No data
Table 10: Performance of Laboratory Surveillance, 2012–2015
Year
% Serum specimen collected from
suspected measles cases
Total Serum Specimen
received in Laboratory
% serum specimens
tested
Specimen Positive for Measles IgM
Specimen Positive for Rubella IgM
% Results within 4 of
receipt
% Outbreak tested for
viral detection
Genotypes detected
No. % No. % Measles Rubella
2012 31 2 590 99 714 28% 481 26% 32 ND ND ND
2013 33 1 748 99 77 4% 634 38% 82 ND ND ND
2014 67 2 042 99 143 7% 223 12% 99 0 B3 ND
2015 83 2 839 100 158 6% 152 6% 87 ND ND ND
Source: SEAR Annual EPI Reporting Form, 2015 ND=No data
For contact or feedback: Expanded Program on ImmunizationMinistry of Health and Family Welfare, Dhaka, BangladeshTel: +880-2-9880530, 8821910-03, Fax: +880-2-8821914Email: [email protected], www.dghs.gov.bd
Immunization and Vaccine Development (IVD)WHO-SEARO, IP Estate, MG Marg, New Delhi 110002, IndiaTel: +91 11 23370804, Fax: +91 11 23370251Email: [email protected], www.searo.who.int/entity/immunization
0%10%20%30%40%50%60%70%80%90%
100%
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Perce
nt of
popu
lation
Age (in years)Susceptible Immune due to past infectionProtected by SIAs Protected by routine vaccination with 2nd doseProtected by routine vaccination with 1st dose Protected by maternal antibodies
0%10%20%30%40%50%60%70%80%90%
100%
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Perce
nt of
popu
lation
Age (in years)Protected by maternal antibodies Protected by routine vaccination with 1st doseProtected by routine vaccination with 2nd dose Protected by SIAsImmune due to past infection Susceptible
050
100150200250300350400450500
2010 2011 2012 2013 2014 2015<1 year 1-4 years 5-9 years 10-14 years 15+ years
n=0 n=2802 n=1092 n=156 n=178 n=78956 949
050
100150200250300350400450500
2010 2011 2012 2013 2014 2015<1 year 1-4 years 5-9 years 10-14 years 15+ years
n=0 n=1212 n=459 n=57 n=78 n=12(0%) (43%) (42%) (37%) (44%) (15%)
Institute of Public Health - National polio laboratory
- National measles/rubella laboratory
- National Japanese encephalitis laboratory
- Dhaka Shishu Hospital- Chittagong Maa-O-Shishu Hospital- Kumudini Women’s Medical College
Invasive Bacteria
Surveillance Medical Officer (SMO) = 30Divisional Coordinator (DC) = 5
Data WHO-IVD Bangladesh (as of May 2016)
World Health Organization• SEARO/FGL/IVD • 31 August 2016World Health Organization• SEARO/FGL/IVD • 31 August 2016 Immunization andVaccine Development
South-East Asia Region
Immunization andVaccine Development
South-East Asia Region
Bangladesh 2016
Immunization system highlights
� There is a comprehensive multi-year plan (cMYP) for immunization covering 2014-2018.
� A standing national technical advisory group on immunization (NTAGI) fully functional.
� A national policy for health care waste management including waste from immunization activities exists.
� A national system to monitor adverse events following immunization (AEFI) exists.
� An EPI coverage evaluation survey (CES) was conducted in 2015. Another CES is planned in the next 24 months.
� 27% spending on vaccines financed by the government.
� 29% spending on routine immunization programme financed by the government.
� All 64 districts have updated micro-plans that include activities to raise immunization coverage.
� All 64 districts had >80% coverage for DTP-Hib-HepB3 and >90% coverage for MCV1.
� HPV demonstration launched on 16 April 2016 in 4 Upzila and 1 Zone under Gazipur district targeting school going girls of grade 5 and out of school girls of the age 10 years.
Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
Table 1: Basic information1 2015Division/Province/State/Region 7
District 64
Upazilla/Sub-district 489
City Corporation 11
Union 4 498
Ward 13 494
Sub-Block 108 000
Population density (per sq. km) 1 074
Population living in urban areas 33%
Population using improved drinking-water sources
85%
Population using improved sanitation 57%
Total expenditure on health as % of GDP 3.5%
Births attended by skilled health personnel 44%
Neonates protected at birth against NT 94%
Total population 158 435 598
Live births (LB) 3 228 362
Children <1 year 3 089 542
Children <5 years 15 686 321
Children <15 years 50 916 899
Pregnant women 3 551 198
Women of child bearing age (15-49 years)
43 380 414
Neonatal mortality rate 24.2 (per 1 000 LB)
Infant mortality rate 33.2 (per 1 000 LB)
Under-five mortality rate 41.1 (per 1 000 LB)
Maternal mortality ratio 170 (per 100 000 LB)
1 SEAR annual EPI reporting form, 2015 and WHO, World Health Statistics 2015
Vaccine Age of administration
BCG At birth
DTP-Hib-HepB 6 weeks, 10 weeks, 14 weeks
OPV 6 weeks, 10 weeks, 14 weeks, 38 weeks
PCV 6 weeks, 10 weeks, 18 weeks
IPV 14 weeks
MR 38 weeks, 15 months
Measles 15 months
TT Females 15 to 49 years (5 doses with an interval of + 1 month, + 6 months, + 1 year and + 1 year with preceding dose)
EPI history � EPI Launched on 07 April 1979. � TT5 dose for WCBA started in 1993. � HepB vaccine introduced in 2003. � AD syringes introduced in 2004. � Hib Pentavalent (DTP-Hib-HepB) vaccine
introduced in 2009. � MR vaccine and measles second dose
introduced in 2012. � Pneumococcal conjugate vaccine introduced
in 2015. � IPV introduced in 2015. � Type 2 component of OPV withdrawn on 23
April 2016 by switching from tOPV to bOPV.
Table 2: Immunization schedule, 2015
Source: cMYP 2011-2016 and EPI/MOHFWSource: WHO/UNICEF joint reporting form (JRF) 2015
Source: WHO/UNICEF joint reporting form (JRF) 2015
E P I F a c t S h E E t
Figure 12: Confirmed (Lab and Epi linked) measles outbreak associated cases, by age, 2010–2015
Figure 10: Immunity against measles: Immunity profile by age in 2015*
Figure 13: Unimmunized confirmed (Lab and Epi linked)measles outbreak associated cases, by age, 2010–2015
Figure 14: Network of WHO supported surveillance medical officers and laboratories
Figure 11: Immunity against measles: Immunity profile by age in 2016*
*Modeled using MSP tool ver 2 based on coverage data up to 2015.
Source: SEAR annual EPI reporting form (multiple years)
*Modeled using MSP tool ver 2 assuming the schedule and measles containing vaccine (MCV) coverage remain unchanged and no SIAs in 2015 & 2016.
Source: SEAR annual EPI reporting form (multiple years)
Routine/sporadic cases Outbreak associated cases
Year No. of suspected
case
No. of death
No. of lab-confirmed
measles cases
No. of lab-confirmed
rubella cases
No. of suspected
outbreak
No. of Outbreak
Investigated
No. of case
No. of death
No. of measles
outbreak*
No. of confirmed
measles case*
No. of confirmed
rubella outbreak*
No. of confirmed
rubella cases*
2010 1 534 5 43 496 217 217 13 666 0 0 0 193 12 467
2011 2 993 1 1 445 267 333 333 11 863 11 91 2 802 89 4 744
2012 1 764 0 560 161 185 185 6 756 1 33 1 092 66 2 683
2013 1 095 0 55 230 146 146 4 230 0 7 156 87 2 787
2014 1 668 0 97 176 71 71 1 368 0 9 178 11 166
2015 2 470 0 129 130 68 68 922 0 4 78 3 48
Source: Monthly VPD Reporting to WHO/SEARO * Laboratory confirmed & epidemiologically- linked
Table 8: Suspected sporadic and Outbreak associated measles and rubella cases, 2010–2015
Table 9: Quality of field and laboratory surveillance for measles and rubella, 2012–2015
Year
No. o
f Sus
pect
ed M
easl
es
Case classification (number) Indicators
Measles Rubella
Disc
arde
d no
n-m
easl
es n
on-
rube
lla c
ases
Annu
al in
cide
nce
of
confi
rmed
Mea
sles
cas
es p
er
mill
ion
tota
l pop
ulat
ion
Annu
al in
cide
nce
of
confi
rmed
Rub
ella
cas
es p
er
mill
ion
tota
l pop
ulat
ion
Prop
ortio
n of
all
susp
ecte
d m
easl
es a
nd ru
bella
cas
es
that
hav
e ha
d an
ade
quat
e in
vest
igat
ion
initi
ated
with
in
48 h
ours
of n
otifi
catio
n
Disc
arde
d no
n-m
easl
es
non-
rube
lla in
cide
nce
per
100,
000
tota
l pop
ulat
ion
Prop
ortio
n of
sub
natio
nal
adm
inis
trativ
e un
its re
porti
ng
at le
ast t
wo
disc
arde
d no
n-m
easl
es n
on-r
ubel
la c
ases
pe
r 100
,000
tota
l pop
ulat
ion
Prop
ortio
n of
sub
-nat
iona
l su
rvei
llanc
e un
its re
porti
ng
to th
e na
tiona
l lev
el o
n tim
e
Lab-
confi
rmed
Epi-L
inke
d
Clin
ical
ly-c
onfir
med
Lab-
confi
rmed
Epi-L
inke
dTarget – – 80% 2 80% 80%
2012 8 289 715 1 077 599 481 2 592 2 825 11.8 20.2 87 1.9 30 85
2013 5 229 77 123 325 633 2 337 1 728 1.3 19.3 88 1.1 19 85
2014 3 039 143 143 175 223 158 2 138 1.8 2.4 90 1.4 17 89
2015 3 415 158 80 64 152 37 2 880 1.5 1.2 92 1.8 37 92
Source: SEAR Annual EPI Reporting Form, 2015 ND=No data
Table 10: Performance of Laboratory Surveillance, 2012–2015
Year
% Serum specimen collected from
suspected measles cases
Total Serum Specimen
received in Laboratory
% serum specimens
tested
Specimen Positive for Measles IgM
Specimen Positive for Rubella IgM
% Results within 4 of
receipt
% Outbreak tested for
viral detection
Genotypes detected
No. % No. % Measles Rubella
2012 31 2 590 99 714 28% 481 26% 32 ND ND ND
2013 33 1 748 99 77 4% 634 38% 82 ND ND ND
2014 67 2 042 99 143 7% 223 12% 99 0 B3 ND
2015 83 2 839 100 158 6% 152 6% 87 ND ND ND
Source: SEAR Annual EPI Reporting Form, 2015 ND=No data
For contact or feedback: Expanded Program on ImmunizationMinistry of Health and Family Welfare, Dhaka, BangladeshTel: +880-2-9880530, 8821910-03, Fax: +880-2-8821914Email: [email protected], www.dghs.gov.bd
Immunization and Vaccine Development (IVD)WHO-SEARO, IP Estate, MG Marg, New Delhi 110002, IndiaTel: +91 11 23370804, Fax: +91 11 23370251Email: [email protected], www.searo.who.int/entity/immunization
0%10%20%30%40%50%60%70%80%90%
100%
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Perce
nt of
popu
lation
Age (in years)Susceptible Immune due to past infectionProtected by SIAs Protected by routine vaccination with 2nd doseProtected by routine vaccination with 1st dose Protected by maternal antibodies
0%10%20%30%40%50%60%70%80%90%
100%
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Perce
nt of
popu
lation
Age (in years)Protected by maternal antibodies Protected by routine vaccination with 1st doseProtected by routine vaccination with 2nd dose Protected by SIAsImmune due to past infection Susceptible
050
100150200250300350400450500
2010 2011 2012 2013 2014 2015<1 year 1-4 years 5-9 years 10-14 years 15+ years
n=0 n=2802 n=1092 n=156 n=178 n=78956 949
050
100150200250300350400450500
2010 2011 2012 2013 2014 2015<1 year 1-4 years 5-9 years 10-14 years 15+ years
n=0 n=1212 n=459 n=57 n=78 n=12(0%) (43%) (42%) (37%) (44%) (15%)
Institute of Public Health - National polio laboratory
- National measles/rubella laboratory
- National Japanese encephalitis laboratory
- Dhaka Shishu Hospital- Chittagong Maa-O-Shishu Hospital- Kumudini Women’s Medical College
Invasive Bacteria
Surveillance Medical Officer (SMO) = 30Divisional Coordinator (DC) = 5
Data WHO-IVD Bangladesh (as of May 2016)