Bangladesh 1993-1994 Demographic and Health ... - Measure DHS

Trends in Vaccination CoverageA general idea of the trend in vaccination coverage can be obtained by comparing coverage amongchildren age 12-23 months and those age 24-35 months, since those in the latter age group received theirvaccinations roughly one year prior to those in the former age group. In order to be comparable, the data referonly to vaccinations received before age 12 months. The data imply that vaccination coverage has improvedslightly in the recent past, with 41 percent of children age 24-35 months being fully vaccinated, comparedto 46 percent of those age 12-23 months (data not shown). Of course, retrospective reporting has flaws, sincevaccination cards are less likely to be available for older children and mothers' recall may be less accurate.The level of vaccination coverage from the BDHS is considerably lower than the level estimated fromthe 1993 EPI Coverage Evaluation Survey. The latter produced an estimate that 74 percent of children age12-23 months were fully immunized (GB, 1993:11). The discrepancy for particular antigens was greatest forDPT3: the EPI survey shows that 80 percent of children age 12-23 months received the third dose of DPT,compared to the estimate of 67 percent from the BDHS. The two surveys give identical coverage rates forRajshahi Division, but very different rates for the other two comparable divisions (Chittagong and Dhaka).Differences in survey methodology may account for some of the differences in results.However, both surveys show a vast increase from the levels of coverage reported in the 1989 BFS.In that survey, only 19 percent of children born in 1987 received 3 doses of DPT, while 26 percent werevaccinated against TB and 19 percent against measles (Huq and Cleland, 1990:113).8.4 Childhood Illness and TreatmentTwo illnesses that are of major importance for infant and child survival in Bangladesh are discussedin this section. They are acute respiratory infection and diarrhea. Estimates of the prevalence of theseillnesses, as well as data concerning types of treatment, are presented. Data are also presented on the extentof use of Vitamin A capsules, given to children to prevent deficiency in this important vitamin.Acute Respiratory InfectionAcute respiratory infection (ARI) is one of the major causes of morbidity and mortality amongchildren in Bangladesh. One-fourth of the deaths to children under five are reportedly caused by ARI(UNICEF, 1991:39). Almost all children with pneumonia have a cough and short, rapid breathing. Earlydiagnosis and treatment with antibiotics can prevent a large proportion of deaths from ARI. 3The prevalence of symptoms of ARI was estimated in the BDHS by asking mothers if their childrenunder age three had been ill with coughing accompanied by short, rapid breathing during the two weekspreceding the survey. Mothers whose children had experienced these symptoms were asked what they haddone to treat the illness. It bears mentioning that information on disease prevalence is more subjective thanmany other topics covered in the BDHS; it is highly dependent on what symptoms the mother considersserious. Similarly, reporting of treatment practices depends on how much mothers know about the medicinestheir children may receive. Mothers may not know whether the pills or syrups their children receive containantibiotics or not. Thus, reporting may vary widely within the country, due to cultural differences inreporting. Information on the prevalence and treatment of ARI is presented in Table 8.8.3 Cough and short, rapid breathing are signs and symptoms of pneumonia. The BDHS estimate of ARI prevalenceprovides an estimate of the prevalence of children who need to be evaluated for presumed pneumonia.110