Polio Eradication Activity and Data Management Division, National Immunization Program, and Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.

BACKGROUND: In 1995, Egypt continued to experience endemic wild poliovirus transmission despite achieving high routine immunization coverage with at least three doses of oral poliovirus vaccine (OPV3) and implementing National Immunization Days (NIDs) annually for several years. METHODS: Parents of 4188 children in 3216 households throughout Egypt were surveyed after the second round of the 1995 NIDs. RESULTS: Nationwide, 74% of children are estimated to have received both NID doses, 17% one NID dose, and 9% neither NID dose. Previously unimmunized (47%) or partially immunized (64%) children were less likely to receive two NID doses of OPV than were fully immunized children (76%) (P < 0.001). Other risk factors nationwide for failure to receive NID OPV included distance from residence to nearest NID site >10 minute walk (P < 0.001), not being informed about the NID at least one day in advance (P < 0.001), and residing in a household which does not watch television (P < 0.001). Based on these findings, subsequent NIDs in Egypt were modified to improve coverage, which has resulted in a marked decrease in the incidence of paralytic poliomyelitis in Egypt. CONCLUSIONS: In selected situations, surveys can provide important information that is useful for planning future NIDs.

PIP: In 1995, Egypt was experiencing endemic wild poliovirus transmission despite achieving high routine immunization coverage with at least 3 doses of oral poliovirus vaccine (OPV3) and implementing National Immunization Days (NIDs) annually for several years. The parents of 4188 children aged 0-47 months in 3216 households throughout Egypt were surveyed after the second round of the 1995 NID in an attempt to gain some insight into the extent of NID OPV coverage nationwide, why children were not immunized during the NIDs, and the effectiveness of the NID media campaign. Countrywide, an estimated 74% of children have received both NID doses, 17% 1 NID dose, and 9% neither NID dose. Previously unimmunized (47%) or partially immunized (64%) children were less likely to receive 2 NID doses of OPV than were fully immunized children (76%). Other risk factors nationwide for failing to receive NID OPV included living farther than 10 minutes by foot from the nearest NID site, not being informed about the NID at least 1 day in advance, and living in a household which does not watch television. Based upon these findings, subsequent NIDs in Egypt were changed to improve coverage, which has resulted in a marked decrease in the incidence of paralytic poliomyelitis in the country.