EPI
MADAM AURALIA IGUNZA
Introduction
• EPI stands for Expanded Programme on Immunization.
• It is a global and national public health initiative aimed at ensuring
that all children and eligible populations receive timely and
complete vaccination against vaccine-preventable diseases.
Purpose
• To protect populations especially children against vaccine-
preventable diseases.
• To reduce morbidity, mortality, and disability caused by infectious
diseases.
Core components
•Vaccine schedule (immunization schedule indicating age, vaccine,
and dose)
•Cold chain system for proper storage and handling of vaccines
•Vaccination delivery strategies
•Routine immunization
•Outreach services
•Mass campaigns
•Monitoring and reporting of coverage and adverse events
•Health worker training
•Community mobilization
•Surveillance of VPDs
Diseases covered by EPI in Kenya
• Tuberculosis (BCG)
• Polio(OPV)
• Diphtheria, Tetanus, Pertussis(DTP)
• Hepatitis B
• Haemophilus influenzae type b
• Pneumococcal Disease
• Measles and Rubella
• Rotavirus
• Human Papillomavirus (HPV) for adolescents
Importance of EPI in Epidemiology
• Helps track immunity levels in the population.
• Supports disease surveillance, outbreak detection and control
• Provides data for epidemiological analysis(drop-out rates, coverage
and risk rates)
• Contributes to herd immunity reducing disease transmission
• Informs national and global public health policy
Outcomes of a strong EPI Program
• Reduced child mortality
• Elimination of diseases
• Improved life expectancy
• Strengthened health systems
• Better emergency preparedness
Factors associated with increased risk of human
disease
• Disease occurrence in a population is influenced by multiple
interacting factors.
• These factors increase an individual’s or community’s susceptibility,
exposure, and likelihood of developing disease.
Examples of factors
• Host factors
• Environmental factors
• Agent factors
• Health System Fctors
1. Host factors(Individual Characteristics)
• These are characteristics of the person that affect susceptibility to
disease.
• Include Biological, behavioral and socio-economic factors
CONT….
• Biological Factors
– Age (infants and elderly more vulnerable)
– Sex (e.g., males at higher risk for certain infections)
– Genetic predisposition
– Immunity status (vaccination, previous infection)
– Pregnancy status
CONT…..
• Behavioral/Lifestyle factors
– Poor personal hygiene
– Risky sexual behavior
– Smoking, alcohol, drug use
– Poor diet and physical inactivity
– Unsafe water handling and food preparation
CONT…
• Socio-economic factors
– Low income / poverty
– Low education level
– Poor housing and overcrowding
– Limited access to healthcare
2. Agent Factors
• Characteristics of the disease-causing organism or substance.
– Virulence (severity of disease it causes)
– Infectivity (ability to invade and multiply)
– Pathogenicity (ability to cause disease)
– Dose of exposure (infectious dose)
– Resistance to drugs or disinfection
– Mode of transmission (airborne, vector-borne, contact, etc.)
3. Environmental Factors
• Conditions that facilitate disease transmission.
• Include
– Physical environment
– Biological environment
– Social/Cultural Environment
CONT….
• Physical Environment
– Climate and weather
– Water quality
– Sanitation levels
– Air pollution
– Poor waste disposal
CONT………
• Biological Environment
– Presence of vectors (mosquitoes, ticks, flies)
– Reservoirs (animals, contaminated surfaces)
– Overcrowding
CONT…….
• Social/ Cultural Environment
– Cultural beliefs and practices
– Population movement (migration, travel)
– Urbanization and slum growth
– Occupational exposures
4. Health System Factors
• Weaknesses in health systems increase disease risk.
– Inadequate vaccination coverage
– Poor disease surveillance
– Delayed outbreak detection
– Shortage of trained health workers
– Limited diagnostic capacity
– Weak infection prevention and control (IPC)
– Poor emergency response systems
Summary
• Human disease risk increases when host susceptibility, agent
characteristics, environmental conditions, and health system
weaknesses combine to promote exposure, transmission, and
reduced immunity.
THE END