The impact of expanded programme on immunization "EPI" on admission rate to IBN-EL-Khateeb hospital Baghdad-Iraq

Expanded Programme on Immunization, (EPI), implemented in Iraq, was accelerated on the 1st. of September,1985. Since then and soon after EPI
acceleration activities,a change in the nuaber of patients with EPI target diseases began.The aim of this study, is to cast alight on the nature and magnitude of this change, as an attempt to evaluate the EPI, through its end results. A total of 33524 cases below 15 years of age of different infectious diseases admitted to Ibn El-Khateeb Hospital-Baghdad in 11 years. (1980-1990) , were studied, regarding the admission rate, aumber of death, and CFR. A sizable proportion (37.2%) of the total admitted cases were those due to EPI target diseases. A significant decrease in the number of admitted cases was observed in the post EPI 5 years (1986-1990), (p<0.01), as an indirect result of the highly significant decrease in the admitted cases of EPI target diseases (p<0.001). No significant difference was found between the pre and post EPI 5 years, regarding the mean annual adtoiission with non EPI target diseases. Cases of all EPI target diseases, except TB meningitis, showed significant differences between the 2 periods (p<0.05-0.001), being much lower in the post EPI 5 years. The total number of EPI target diseases cases, recorded allover the country in these 11 years was 301991 showing the same pattern of rates of record. The decrease in the post EPI 5 years, was significantly high (p<0.001). These findings show clearly that this phenomenon is not limitted to Baghdad area, but it is a general one, due to the comprehensive activities of immunization. Cases with AVH, both admitted and recorded, (as aprototype of non EPI target diseases) were analysed, and they showed a completely different pattern. A significant increase in the number of cases was found in the post EPI 5 years (p<0.01) the fact that adds another support to the conclusion : The dicrease in the number of admitted and recorded cases of EPI target diseases can be. specifically attributed to the EPI and is a natural end result of the relatively high coverage rate with vaccines^, acheived by EPI, which can be evaluated as a successful national programme.