Clustered lot quality assurance sampling: a pragmatic tool for timely assessment of vaccination coverage

Trop Med Int Health. 2011 Jul;16(7):863-8. doi: 10.1111/j.1365-3156.2011.02770.x. Epub 2011 Apr 11.

Abstract

Objectives: To evaluate oral poliovirus vaccine (OPV) coverage of the November 2009 round in five Northern Nigeria states with ongoing wild poliovirus transmission using clustered lot quality assurance sampling (CLQAS).

Methods: We selected four local government areas in each pre-selected state and sampled six clusters of 10 children in each Local Government Area, defined as the lot area. We used three decision thresholds to classify OPV coverage: 75-90%, 55-70% and 35-50%. A full lot was completed, but we also assessed in retrospect the potential time-saving benefits of stopping sampling when a lot had been classified.

Results: We accepted two local government areas (LGAs) with vaccination coverage above 75%. Of the remaining 18 rejected LGAs, 11 also failed to reach 70% coverage, of which four also failed to reach 50%. The average time taken to complete a lot was 10 h. By stopping sampling when a decision was reached, we could have classified lots in 5.3, 7.7 and 7.3 h on average at the 90%, 70% and 50% coverage targets, respectively.

Conclusions: Clustered lot quality assurance sampling was feasible and useful to estimate OPV coverage in Northern Nigeria. The multi-threshold approach provided useful information on the variation of IPD vaccination coverage. CLQAS is a very timely tool, allowing corrective actions to be directly taken in insufficiently covered areas.

Publication types

  • Evaluation Study

MeSH terms

  • Child, Preschool
  • Cluster Analysis
  • Female
  • Humans
  • Immunization Programs
  • Infant
  • Lot Quality Assurance Sampling* / methods
  • Male
  • Nigeria
  • Poliovirus Vaccine, Oral / administration & dosage*
  • Quality Assurance, Health Care
  • Vaccination / standards
  • Vaccination / statistics & numerical data*

Substances

  • Poliovirus Vaccine, Oral