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2005
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METHODOLOGY
Rothenberg RB, Lobanov A, Singh KB, and Stroh G Jr: Observations on the
application of EPI Cluster Survey Methods for estimating disease incidence.
Bulletin of the World Health Organization 63, 93-99, 1985.
The present study attempted to assess the incidence of target
diseases of the Expanded Programme on Immunization (poliomyelitis, tetanus,
measles, pertussis, neonatal tetanus, diphtheria), using cluster samples and a
household interview form. The results suggest that this method can indeed serve
to estimate the Incidence of these diseases with reasonable precision and may
also be used to demonstrate reduction in incidence for the more common diseases.
Analysis of 37 surveys for poliomyelitis and neonatal tetanus in India revealed
a relative uniformity in the design effect (i.e., the ratio of the variance for
the cluster estimate to the variance for the binomial estimate) for diseases
with low incidence and prevalence. Diseases with higher prevalence tend to have
a larger design effect, which may be indicative of the epidemic and "clustered"
nature of the disease. A large design effect, therefore, does not necessarily
indicate a need for a larger sample size, particularly if precision is
acceptable, There is no one single design that is ideal for all surveys of
disease incidence and decisions must be made in the light of local conditions
and available resources.
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