Use of the revised World Health Organization cluster survey methodology to classify measles-rubella vaccination campaign coverage in 47 counties in Kenya 2016.

Monday, 6th of August 2018 Print

PLoS One. 2018 Jul 2;13(7):e0199786. doi: 10.1371/journal.pone.0199786. eCollection 2018.

Use of the revised World Health Organization cluster survey methodology to classify measles-rubella vaccination campaign coverage in 47 counties in Kenya 2016.

Subaiya S12 Tabu C3 Nganga J4 Awes AA4 Sergon K5 Cosmas L5 Styczynski A2 Thuo S3 Lebo E1 Kaiser R6 Perry R7 Ademba P3 Kretsinger K7 Onuekwusi I5 Gary H1 Scobie HM1.

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To achieve measles elimination two doses of measles-containing vaccine (MCV) are provided through routine immunization services or vaccination campaigns. In May 2016 Kenya conducted a measles-rubella (MR) vaccination campaign targeting 19 million children aged 9 months-14 years with a goal of achieving ≥95% coverage. We conducted a post-campaign cluster survey to estimate national coverage and classify coverage in Kenyas 47 counties.


The stratified multi-stage cluster survey included data from 20011 children in 8253 households sampled using the recently revised World Health Organization coverage survey methodology (2015). Point estimates and 95% confidence intervals (95% CI) of national campaign coverage were calculated accounting for study design. County vaccination coverage was classified as pass fail or intermediate using one-sided hypothesis tests against a 95% threshold.


Estimated national MR campaign coverage was 95% (95% CI: 94%-96%). Coverage differed significantly (p < 0.05) by childs school attendance mothers education household wealth and other factors. In classifying coverage 20 counties passed (≥95%) two failed (<95%) and 25 were intermediate (unable to classify either way). Reported campaign awareness among caretakers was 92%. After the 2016 MR campaign an estimated 93% (95% CI: 92%-94%) of children aged 9 months to 14 years had received ≥2 MCV doses; 6% (95% CI: 6%-7%) had 1 MCV dose; and 0.7% (95% CI: 0.6%-0.9%) remained unvaccinated.


Kenya reached the MR campaign target of 95% vaccination coverage representing a substantial achievement towards increasing population immunity. High campaign awareness reflected the comprehensive social mobilization strategy implemented in Kenya and supports the importance of including strong communications platforms in future vaccination campaigns. In counties with sub-optimal MR campaign coverage further efforts are needed to increase MCV coverage to achieve the national goal of measles elimination by 2020.

PMID: 29965975 PMCID: PMC6028100 DOI: 10.1371/journal.pone.0199786


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