Children in Egypt 2014 A STATISTICAL DIGEST CHAPTER 4 IMMUNIZATION AND HEALTH
Children in Egypt 2014 is a statistical digest produced by UNICEF Egypt to present updated and quality data on major dimensions of child wellbeing. This chapter contains statistics on immunization coverage and health in Egypt including information on child immunization trends and access to medical treatment among children experiencing diarrhoeal diseases and ARI symptoms. The statistics featured in this chapter are from national official sources. The appendix displays data from international databases. Data presented in this chapter are those available to UNICEF Egypt up to June 2014 and refer to 2014 and/or previous years. The data may be used for private study, research and teaching purposes, or for use in noncommercial products or services, using the following citation: UNICEF (2014) Children in Egypt: a statistical digest, June 2014, UNICEF Egypt, Cairo, Egypt United Nations Children's Fund, Egypt June 2014 United Nations Children's Fund, Egypt 87, Misr Helwan Agricultural Road, Maadi, Cairo, Egypt Telephone: (202) 252650837 Fax: (202) 25264218 Website: www.unicef.org/egypt Cover Photo: UNICEF/2012/Yousri Aql Design and layout: Above and Below
Children in Egypt 2014 LIST OF TABLES Immunization Figure 1: Immunization schedule in Egypt. Table 4.01: Proportion of children aged 1223 months who are fully immunized, by background characteristics 20002008. Table 4.02: Proportion of children aged 1223 months who received BCG vaccine (against tuberculosis), by background characteristics, 20002008. Table 4.03: Proportion of children aged 1223 months who received the first dose of DPT vaccine (DPT1, against diphtheria, pertussis and tetanus), by background characteristics, 20002008. Table 4.04: Proportion of children aged 1223 months who received all three doses of DPT vaccine (DPT3, against diphtheria, pertussis and tetanus), by background characteristics, 20002008. Table 4.05: Proportion of children aged 1223 months who have received all 3 doses of hepatitis B vaccine, by background characteristics, 20002008. Table 4.06: Proportion of children aged 1223 months who have received the measles vaccine, by background characteristics, 20002008. Table 4.07: Proportion of children aged 1223 months who have received the MMR vaccine (against measles, mumps and rubella), by background characteristics, 20052008. Table 4.08: Proportion of children aged 1223 months who have received all three doses of the Polio vaccine, by background characteristics, 20002008. Table 4.09: Estimated national coverage rates of BCG, DPT1, DPT3, HepB3, MCV, MCV2, Pol3, Rubella, TT2+ and VAD1 vaccines for 20002012. Treatment of Pneumonia and Diarrhea Table 4.10: Treatment of pneumonia: Among children underfive who were ill and experiencing acute respiratory infection symptoms, proportion receiving medical care by any health provider and proportion receiving antibiotic by residence, 20052008. Table 4.11: Treatment of diarrhea: among underfive children who were ill with diarrhea, proportion who received medical care by any provider and who received oral rehydration solution by residence, 2005 2008. Appendix: Data from international sources Table 4.12: Estimated national coverage rates of BCG, DPT1, DPT3, HepB3, MCV, Pol3 and PAB vaccines for 20002012. Table 4.13: Reported district coverage of DPT3 and reported coverage of measles control activities (MCV and MCV2), 2011 and 2012. 1
IMMUNIZATION AND HEALTH IMMUNIZATION Figure 1 Immunization schedule in Egypt Immunization Schedule, Egypt BCG Pentavalent (DPTHep BHib I) DPT (4th dose) OPV MMR Td Meningococcal TT Yellow fever Meningococcal Seasonal Influenza At birth 2, 4, 6 and 18 months 18 months At birth; 2, 4, 6, 9, 12 and 18 months 12 and 18 months 7 and 10 years 4, 6, 12, 15 years Pregnant women (2 doses), Postpartum (3 dosesone year apart between) Travelers Travelers Pilgrimage Source: Ministry of Health and Population, Immunization Schedule at February 2014. Note: BCG: (Bacillus CalmetteGuérin) a vaccine against tuberculosis. Pentavalent: A combination of vaccines against diphtheria, tetanus, whooping cough, hepatitis B and Haemophilus influenzae type b (Hib). DPT: diphtheria and tetanus toxoid with pertussis vaccine. OPV: oral polio vaccine. MMR: a vaccine against measles, mumps and rubella. Td: tetanus toxoid with reduced amount of diphtheria toxoid. Meningococcal: a vaccine against meningococcal disease and meningitis caused by the bacterium Neisseria meningitides. TT: tetanus toxoid. DT: diphtheria toxoid. 2
Children in Egypt 2014 Table 4.01 Proportion of children aged 1223 months who are fully immunized, by background characteristics 20002008 2000 2005 2008 92.2 88.7 91.7 92.8 91.8 89.1 88.5 93.7 90.5 91.9 92.5 92.6 92.5 92.3 95.0 91.3 85.6 90.3 90.9 89.5 91.2 86.3 87.5 85.9 85.6 94.3 93.7 95.9 93.1 88.4 90.9 87.5 86.2 91.4 92.6 92.2 92.9 86.2 88.5 88.7 90.4 91.4 86.9 90.4 92.8 85.0 87.5 90.1 90.0 91.3 89.4 89.5 92.8 92.5 94.4 Source: Egypt Demographic and Health Surveys, 2000, 2005 and 2008. Note: Children are considered to be fully immunized if the child has received BCG, measles or MMR vaccination, three DPT vaccinations, and three doses of polio vaccine. BCG (Bacillus CalmetteGuérin) is a vaccine against tuberculosis; MMR is a vaccine against measles, mumps and rubella; DPT is a combination of vaccines against diphtheria, pertussis (whooping cough) and tetanus. Information on vaccinations is derived from the child s birth certificate and/or health card or the mother s report. 3
IMMUNIZATION AND HEALTH Table 4.02 Proportion of children aged 1223 months who received BCG vaccine (against tuberculosis), by background characteristics, 20002008 2000 2005 2008 99.3.0 99.0 99.7.8.6 99.5.6 99.4 99.6 99.4.8.5 99.0.4.0.3.7.1.9 99.6.9 99.4.8.8 99.6.5.2.9.7 99.8.9.5.4.5 99.5.5.0 99.2.4.3.1.7.8.8 99.8 Source: Egypt Demographic and Health Surveys, 2000, 2005 and 2008. Note: BCG (Bacillus CalmetteGuérin) is a vaccine against tuberculosis. Information on vaccination coverage is derived from the child s birth certificate and/or health card or the mother s report. 4
Children in Egypt 2014 Table 4.03 Proportion of children aged 1223 months who received the first dose of DPT vaccine (DPT1, against diphtheria, pertussis and tetanus), by background characteristics, 20002008 2000 2005 2008 99.2 99.8 99.6.9 99.2 99.8 99.8 99.3 99.4 99.6 99.4.9.5.0 99.0 99.3 99.2 99.3.2 99.6 99.8 99.7.2.8.3 99.7 99.4.4.9 99.2 99.7.4 99.0.8 99.6.9 99.4 99.7 99.5 Source: Egypt Demographic and Health Surveys, 2000, 2005 and 2008. Note: Data refer to the percentage of children aged 1223 months at the time of the survey who are immunized with one dose of DPT. DPT1 refers to the first dose of DPT vaccine; a combination of vaccines against diphtheria, pertussis (whooping cough) and tetanus. Information on vaccination coverage is derived from the child s birth certificate and/or health card or the mother s report. 5
IMMUNIZATION AND HEALTH Table 4.04 Proportion of children aged 1223 months who received all three doses of DPT vaccine (DPT3, against diphtheria, pertussis and tetanus), by background characteristics, 20002008 2000 2005 2008 94.0 93.5.6 93.5 94.3 93.5 93.5.5.1 92.7 94.6 93.8 94.9 94.2 95.0 93.9 87.4 94.6 94.4 92.3 95.0 92.5 93.1 92.2 90.9.7.2.8.1.6.2.0 93.3 93.6 93.8 93.3 94.7 92.3 94.0 92.2 94.7.0 93.9.4.7 91.6 93.1 94.1 93.6 95.5.6.2.8.6.9 Source: Egypt Demographic and Health Surveys, 2000, 2005 and 2008. Note: Data refer to the percentage of children aged 1223 months at the time of the survey who are immunized with three doses of DPT. DPT3 refers to the third dose of DPT vaccine (a combination of vaccines against diphtheria, pertussis (whooping cough) and tetanus. Information on vaccination coverage is derived from the child s birth certificate and/or health card or the mother s report. 6
Children in Egypt 2014 Table 4.05 Proportion of children aged 1223 months who have received all 3 doses of hepatitis B vaccine, by background characteristics, 20002008 2000 2005 2008 93.0 79.8.1 92.7 93.1 83.6 77.7.3 95.4 92.4 93.4 92.0 93.9 93.1 94.8 92.6 83.9 85.6 83.0 84.3 82.6 74.7 79.9 72.8 88.4.3.0.2.9 93.9.0 92.8 85.5 91.9 93.5 93.3 93.8 75.8 77.3 79.4 83.0 94.9 91.9 94.0.8 72.5 78.3 79.5 82.9 87.3 93.5 93.9.1.4.7 Source: Egypt Demographic and Health Surveys, 2000, 2005 and 2008. Note: Data refer to the percentage of children aged 1223 months at the time of the survey who are immunized with three doses of Hepatitis B vaccine. Information on vaccination coverage is according to the child s birth certificate and/or health card or the mother s report. 7
IMMUNIZATION AND HEALTH Table 4.06 Proportion of children aged 1223 months who have received the measles vaccine, by background characteristics, 20002008 2000 2005 2008.9.6.3.8.2.8.5.3.3.9.3.5.2.4 99.6 95.3 95.6.0.6.1.7 95.7.6 95.3 92.7.9 99.2 99.4.6.3.4.7 95.4.7.4.3.0 94.3 95.8.6.7 95.3 99.3.7 95.1 95.4.8.4.2.5.0.0 99.0 99.2 Source: Egypt Demographic and Health Surveys, 2000, 2005 and 2008. Note: Data refer to the percentage of children aged 1223 months at the time of the survey who are immunized against measles. Information on vaccination coverage is derived from the child s birth certificate and/or health card or the mother s report. 8
Children in Egypt 2014 Table 4.07 Proportion of children aged 1223 months who have received the MMR vaccine (against measles, mumps and rubella), by background characteristics, 20052008 2005 2008 22.6 24.5 21.5 45.6 46.0 45.3 24.0 25.5 33.3 23.3 19.7 19.2 19.9 14.4 48.3 46.9 50.0 46.0 43.0 39.2 44.4 39.5 20.0 19.6 21.8 25.0 45.9 38.9 44.5 46.5 20.9 17.1 24.8 22.9 28.3 40.8 47.4 44.2 46.3 49.5 Source: Egypt Demographic and Health Surveys, 2005 and 2008. Note: Data refer to the percentage of children aged 1223 months at the time of the survey who are immunized with MMR. MMR is a vaccine against measles, mumps and rubella. At the time of the 2005 and 2008 Egyptian Demographic and Health Surveys (EDHS), the MMR vaccine was administered at 18 months. This explains why a large part of children aged 1223 months had not yet been immunized. Information on vaccination coverage is derived from the child s birth record and/or health card or the mother s report. 9
IMMUNIZATION AND HEALTH Table 4.08 Proportion of children aged 1223 months who have received all three doses of the Polio vaccine, by background characteristics, 20002008 2000 2005 2008 94.9.6 94.5 94.3 95.3.7.5 95.3 94.0 93.7 95.4 94.4 95.8 95.1 95.4 95.0 88.6.1.1 95.7.7 95.4.2 94.4 95.5.5 95.8.6 95.5 92.4 92.6 92.3 88.7 95.6 94.5 94.1 94.6 95.6.1.0.2 94.6 90.3 93.8 95.1 94.4.0.2.7 99.0 93.9 93.4 95.4 93.7.1 Source: Egypt Demographic and Health Surveys, 2000, 2005 and 2008. Note: Data refer to the percentage of children aged 1223 months at the time of the survey who are immunized with three doses of polio vaccine. Information on vaccination coverage is derived from the child s birth record and/or health card or the mother s report. 10
Children in Egypt 2014 Table 4.09 Estimated national coverage rates of BCG, DPT1, DPT3, HepB3, MCV, MCV2, Pol3, Rubella, TT2+ and VAD1 vaccines for 20002012 2000 2005 2008 2010 2011 2012 BCG 95 DTP1 94 DTP3 93 HepB3 93 MCV 92 93 MCV2 92 Pol3 93 Rubella1 TT2+ 71 Source: WHO VaccinePreventable Diseases Monitoring System, 2013 Global Summary, Official Country Estimates. Accessed in May 2014. Note: BCG; data refer to the percentage of children immunized at birth with the Bacille CalmetteGuerin vaccine against tuberculosis. DPT is a combination of vaccines against diphtheria, pertussis (whooping cough) and tetanus; Data refer to the percentage of children aged 1223 months who are immunized with the first (DPT1) and third doses (DPT3) of the vaccine. MCV (measles containing vaccine) is a vaccine against measles; MCV2 refers to the second dose of MCV. Data refer to the percentage of children of appropriate age who are immunized with MCV and MCV2. Polio3 refers to the third dose of the polio vaccine; data refer to the percentage of children aged 1223 months who are immunized with polio 3 vaccine. TT2+ refers to the second or more doses of the tetanus toxoid vaccine (excludes first dose). Rubella 1 refers to the first dose of the vaccine against rubella. 11
IMMUNIZATION AND HEALTH TREATMENT OF PNEUMONIA AND DIARRHEA Table 4.10 Treatment of pneumonia: among children underfive who were ill and experiencing acute respiratory infection symptoms, proportion receiving medical care by any health provider and proportion receiving antibiotic by residence, 20052008 2005 2008 Percentage of children with ARI Symptoms Any health provider consulted Given antibiotic Percentage of children with ARI Symptoms Any health provider consulted Given antibiotic 9.0 73.2 52.0 7.8 73.0 57.9 10.7 8.1 79.8 68.2 58.9 46.8 9.1 7.0 78.1 69.2 63.1 53.9 10.3 6.8 8.6 6.3 10.7 13.1 9.8 4.9 77.4 72.7 74.3 72.0 72.6 85.1 66.3 56.6 56.0 59.1 64.8 56.7 46.9 58.8 40.9 44.9 9.4 4.8 5.4 4.7 10.5 12.1 9.9 7.2 83.9 73.4 74.0 73.2 68.7 73.1 66.6 84.2 63.7 62.7 56.6 64.7 53.1 65.2 47.5 67.6 8.4 12.4 10.2 8.4 75.7 67.4 74.0 72.9 50.1 46.9 41.5 59.0 8.5 9.6 7.7 7.2 70.8 70.8 74.6 74.3 50.4 50.0 57.1 63.8 9.5 8.6 9.2 9.6 8.2 66.2 70.6 73.2 78.4 79.4 42.5 45.6 58.0 56.6 58.6 9.8 6.8 6.9 8.0 7.5 69.6 70.8 66.4 78.5 80.9 52.4 51.4 63.9 62.8 60.0 Source: Egypt Demographic and Health Surveys, 2005 and 2008. Note: Data refer to underfive children who were ill and experiencing ARI symptoms in the two weeks before the survey. Symptoms of acute respiratory infectionssuch as a cough accompanied by short, rapid breathing that is chestrelated, are considered proxies for pneumonia. 12
Children in Egypt 2014 Table 4.11 Treatment of diarrhea: among underfive children who were ill with diarrhea, proportion who received medical care by any provider and who received oral rehydration solution by residence, 20052008 2005 2008 Percentage of children who were ill with diarrhea Any health provider consulted ORS packets Percentage of children who were ill with diarrhea Any health provider consulted ORS packets 18.4 54.8 33.5 8.5 55.5 28.4 17.1 19.1 59.4 52.4 28.3 36.2 9.2 8.0 57.3 54.3 27.6 28.9 15.3 16.6 15.2 17.0 21.0 20.8 21.1 14.8 58.0 56.2 67.7 53.0 53.2 56.3 52.1 42.2 21.6 33.9 39.3 32.3 36.2 28.0 39.2 21.7 9.5 5.8 5.3 6.0 11.1 12.6 10.5 6.1 53.7 59.7 54.7 61.0 53.9 62.6 49.9 44.0 31.5 22.2 9.2 25.5 30.9 29.7 31.5 31.1 19.5 20.9 19.6 16.7 51.5 54.6 57.0 56.5 37.7 29.5 29.6 32.7 7.5 13.1 9.3 8.1 54.2 53.6 52.5 57.5 34.0 21.5 29.7 26.9 22.9 19.4 17.3 17.5 14.0 55.0 48.3 53.2 56.4 65.2 40.5 34.4 33.7 28.9 24.5 9.8 8.6 8.7 7.8 7.3 50.6 56.5 59.8 50.4 61.3 34.0 32.7 26.7 23.5 22.8 Source: Egypt Demographic and Health Surveys, 2005 and 2008. Note: ORS packets refer to Oral rehydration salts (containing sodium and glucose solutions) which are given to children suffering from dehydration as a result of severe diarrhea. Data refer to underfive children who were ill with diarrhea in the two weeks before the survey. 13
IMMUNIZATION AND HEALTH APPENDIX: Data from international sources Table 4.12 Estimated national coverage rates of BCG, DPT1, DPT3, HepB3, MCV, Pol3 and PAB vaccines for 20002012 2000 2005 2008 2010 2011 2012 (percentage BCG DTP1 DTP3 HepB3 MCV Pol3 PAB 80 85 92 85 86 86 95 94 93 93 93 93 86 Source: UNICEFWHO (2014), Immunization Summary: A statistical reference containing data through 2012, 2014 Edition. Accessed in May 2014. Note: BCG; data refer to the percentage of children immunized at birth with the Bacille CalmetteGuerin vaccine against tuberculosis. DPT is a combination of vaccines against diphtheria, pertussis (whooping cough) and tetanus; data refer to the percentage of children aged 1223 months who are immunized with the first (DPT1) and third doses (DPT3) of the vaccine. MCV: data refer to the percentage of children of appropriate age who are immunized with first (MCV) and second dose (MCV2) of measles containing vaccine. Polio3: data refer to the percentage of children aged 1223 months who are immunized with the third dose of polio vaccine. PAB refers to protection at birth against neonatal tetanus. Table 4.13 Reported district coverage of DPT3 and reported coverage of measles control activities (MCV and MCV2), 2011 and 2012 2011 2012 Number of districts in the country Percentage of districts reporting (numbers) 273 275 100 100 Proportion of districts with coverage of DPT3 < 50% Between 5079% At 80% or above DPT1DPT3 dropout rate (proportion of districts that achieved a rate of less than 10%) 0 3 100 1 4 94 Proportion of districts with coverage of MCV at 90% or above MCV2 routine coverage 94 95 92 Source: UNICEFWHO (2014), Immunization Summary: A statistical reference containing data through 2012, 2014 Edition. Note: DPT is a combination of vaccines against diphtheria, pertussis (whooping cough) and tetanus; DPT 3 refers to the third dose of the vaccine. MCV refers to measlescontaining vaccine and MCV2 refers to the second dose of the measlescontaining vaccine. 14