. ABSTRACTS AND REPORTS 101
dration Salts” (document WHO/CDD/SER/ Program, World Health Organization, 1211 80.3), which provides detailed information Geneva 27, Switzerland.
about the production of ORS-citrate. Ques-
tions about ORS-citrate should be addressed Source: Joint Statement by WHO and UNICEF as re- to the Director, Diarrhea1 Diseases Control printed in the World Health Organization Weekly E,vide- miological Record 59(44):337-338, 1984.
IMMUNIZATION COVERAGE INCREASED IN SURINAME
Legislation, combined with concerted ef- Figure 1. Immunization coverage with three forts by Suriname’s Expanded Program of doses of vaccine against poliomyelitis and DPT Immunization, resulted in a marked increase among Suriname children under one vear old. in completely vaccinated children during
1983. Specifically, the coverage of children under one year of age with three doses of DPT and poliomyelitis vaccines increased from 54% in 1982 to 85% in 1983 (see Figure 1).
19761983. * ’
Increased efforts by Suriname’s well-moti- vated staff members were bolstered by a Vac- cination Act proclamation that requires all children to be fully vaccinated (with three doses of vaccine) against diphtheria, tetanus, whooping cough, and poliomyelitis before s
d they are one year old. Children are not per- g mitted to attend nursery or primary school g without vaccination certification. The law B may be enforced with a penalty or fine.
Although the resulting 1983 coverage was high, there were a number of children under one year old who received initial doses of DPT and poliomyelitis vaccine but who did not re- turn for the two subsequent doses before their first birthday (see Figure 2). This “dropout rate” varied from region to region, ranging from 1 to 66%. The national dropout rate was 2.5%.
Suriname uses several methods to reduce the dropout rate. Some health centers have a callup system for children who do not return to the under-fives clinic as scheduled, and
100
90
60
70
60
50
40
30
20
10
76 77 76 79 60 61 62 63
YEAR
others arrange home visits to attend these improve coverage further. activities are
children. planned for the purpose of motivating parents
During 1983, 12,843 children under four to bring their children to the under-fives years of age were vaccinated against measles, clinic.
102 PAHO BULLETIN l vol. 19, no. 1, 1985
Figure 2. Numbers of Surinamese children under one year old receiving one and three doses of DPT vaccine in 1983, by month. The “dropout rate” is the difference between the “DPT-1” and “DPT-3” lines. The boxes at the bottom
give monthly totals and cumulative totals for the year.
ESTIMATED TARGET POPULATION 11.000
12456
9900
8600
7700
$ 6600 e s 5500 s.i 3 65 4400 El 22 5 3300
220(
OPT-' DPT-:
d
I ,’ **’ / ,.a’ , P’ .’ ,=’
-
1001 925 1046 1366 1354 1189 1055 1044 802 924 914 81 1926 2974 4340 5694 6663 7938 8982 9784 10708 11622 124E
627 1207 560 1652 645 2715 663 3459 744 4249 790 5168 939 6195 1007 6940 795 7826 636 82z 93':
JAN FE6 MAR APR MAY JUNE JULY AUG SEP OCT NOV DEC 00
30
10 70
CUM CUM
MONTH
that several schools had enrolled children who school principals. were not vaccinated. Improvement will re-
quire that regional medical doctors and
