Expanded programme on Immunization (EPI) factsheet 2023: Timor-Leste

World Health Organization • SEARO/CDS/IVD • 31 October 2023 VACCINES PROTECT SUSTAIN. ACCELERATE. INNOVATE. EXPANDED PROGRAMME ON IMMUNIZATION (EPI) Table 1: EPI History Year Milestone 1978 EPI started 2000 EPI re-structured in March 2007 DTP-HepB vaccine introduced 2012 DTP-Hib-HepB vaccine introduced 2016 MR vaccine introduced in Feb 2016 Second dose of MR introduced in Feb 2016 HepB birth dose introduced in Feb 2016 DPT/DT vaccine (booster dose) introduced in Feb 2016 IPV introduced in Feb 2016 tOPV to bOPV switched on 18 April 2019 Rotavirus vaccine introduced in Dec Source: cMYP 2016-2022 and EPI/MOH Table 3: Immunization schedule, 2022 Vaccine Age of administration BCG Birth HepB Birth within 24 hours DTP-Hib-HepB 6 weeks, 10 weeks and 14 weeks OPV Birth, 6 weeks, 10 weeks and 14 weeks IPV 14 weeks MR 9 months and 18 months Td Females 15 to 49 years (1st pregnancy contact, +1 months, +6 months, +1 year, +1 year) DT 6 years DTP 18 months Rotavirus 6 weeks, 10 weeks and 14 weeks Vitamin A 6-36 months (with 6 months interval) Source: WHO/UNICEF JRF, 2022 Table 4: Immunization system highlights cMYP for immunization 2016-2022 NITAG-TL fully functional Spending on vaccines financed by the government 100% Spending on routine immunization programme financed by the government 64% Updated micro-plans that include activities to improve immunization coverage 13 districts (100%) National policy for health care waste management including waste from immunization activities in place National system to monitor AEFI in place Most recent EPI CES EPI Coverage survey 2018 >80% coverage for DTP-Hib- HepB3 13 districts (100%) >90% coverage for MCV1 5 districts (38%) >90% coverage for MCV2 4 districts (31%) >10% drop-out rate for DTP- Hib-HepB1 to DTP-Hib-HepB3 5 districts (36%) Source: WHO/UNICEF JRF, 2022 Table 2: Basic information 2022 Total population1 1,318,445 Live births1 31,832 Children <1 year1 31,832 Children <5 years1 157,324 Children <15 years1 474,368 Pregnant women1 36,586 WCBA1 (15-49 years) 332,107 Neonatal mortality rate2 22.23 (per 1,000 LB) Infant mortality rate2 43.08 (per 1,000 LB) Under-five mortality rate2 50.55 (per 1,000 LB) Maternal mortality ratio2 204 (per 100,000 LB) Division/Province/State/Region 13 Municipality 13 Postos/Sub-district 72 Sucos/Village 452 Population density1 (per sq. km) 89 Population living in urban areas2 35.80% Population using at least basic drinking- water services2 87% Population using at least basic sanitation services2 58% Total expenditure on health as % of GDP2 5.45% Births attended by skilled health personnel 57% Neonates protected at birth against NT2 83% Children not covered by immunization programme (zero dose children)3 4,184 1 SEAR annual EPI reporting form, 2022 2 WHO, Global Health Observatory (GHO) data http://apps.who.int/gho/data accessed on 03 August 2023 3 DTP1 coverage from WHO and UNICEF estimates of immunization coverage and UN estimated under one population Figure 1: National immunization coverage, 2013-2022 Figure 16: Immunity against measles - immunity profile by age in 2022* Figure 20: Vaccination status of confirmed (laboratory, Epi linked and clinically compatible) measles cases, by age in 2021 and 2022 Figure 21: Vaccination status of confirmed (laboratory and Epi linked) rubella cases, by age in 2021 and 2022 Table 9: Summary of measles surveillance indicators, 2020-2022 Figure 22 : Network of WHO supported surveillance and immunization medical officers and laboratories Figure 18: Confirmed measles cases* by month 2020-2022 Figure 17: Immunity against rubella through vaccination - immunity profile by age in 2022* Figure 19: Confirmed rubella cases* by month 2020-2022 *Modelled using WHO and UNICEF estimates and JRF (multiple years) and does not include immunity due to natural infection *Includes laboratory confirmed, epidemiologically linked and clinically compatible cases Source: SEAR measles case-based data *Includes laboratory confirmed and epidemiologically linked cases Source: SEAR measles case-based data *Modelled using MSP tool ver 2 Source: SEAR measles case-based data Source: SEAR Annual EPI Reporting Form (multiple years) ND=No data Source: SEAR measles case-based data Source: WHO and UNICEF estimates of immunization coverage Indicator Target 2020 2021 2022 Number of suspected measles cases 109 43 47 Confirmed measles cases 0 4 3 0 Lab confirmed 0 0 0 0 Epi-Linked 0 0 0 0 Clinically-compatible 0 4 3 0 Confirmed rubella cases 0 5 4 0 Lab confirmed 0 5 2 0 Epi-Linked 0 0 2 0 Discarded non-measles non-rubella cases 100 38 47 Percentage of suspected cases with adequate investigation initiated within 48 hours of notification ≥ 80% ND 100 100 Reporting rate of non-measles non-rubella cases to national level per 100,000 population ≥ 2 ND 0.83 6.1 Percentage of second-level administrative units reporting at least 2 non-measles non-rubella cases per 100,000 population per 100,00 population ≥ 80% ND ND 54 Percentage of surveillance units reporting measles and rubella data to the national level on time, even in the absence of cases ≥ 80% ND 100 ND Percentage of specimens received at the laboratory within 5 days of collection ≥ 80% 100 80 100 Percentage of IgM results reported to the national public health authorities by the laboratory within 4 days of receipt of specimens ≥ 80% ND 97.5 36 Genotypes detected Measles ND ND Rubella ND ND For contact or feedback: Expanded Programme on Immunization Ministry of Health, Dilli, Timor Leste Tel: +670-77351964, Fax: +670-7250097 Email: mmausiry@gmail.com www.moh.gov.tl Immunization and Vaccine Development (IVD) WHO-SEARO, IP Estate, MG Marg, New Delhi 110002, India Tel: +91 11 23370804, Fax: +91 11 23370251 Email: SearEpidata@who.int www.who.int/southeastasia/health-topics/immunization National Health Laboratory, Dili • National measles and rubella laboratory • National Japanese encephalitis laboratory Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. FACTSHEET 2023 TIMOR LESTE World Health Organization • SEARO/CDS/IVD • 31 October 2023 VACCINES PROTECT SUSTAIN. ACCELERATE. INNOVATE. Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980-2022 Table 5: Reported cases of vaccine preventable diseases, 2016-2022 Table 6: AFP surveillance performance indicators, 2016-2022 Figure 10: HepB3 and HepB birth dose immunization coverage1, 2000-2022 Figure 11: MCV1 & MCV2 coverage1 and measles, rubella cases2, 1980-2022 Table 7: OPV SIAs Table 8: MCV/MR SIAs Figure 3: TT2+ coverage1 and NT cases2, 1980-2022 1 WHO and UNICEF estimates of immunization coverage 2 WHO vaccine-preventable diseases: monitoring system 2022 1 Country official estimates, 1980-2022 2 WHO vaccine-preventable diseases: monitoring system 2022 Figure 4: 2021 DTP-Hib-HepB3 coverage by district Non-polio AFP rate by district Adequate stool specimen collection % by district MR1 coverage by district MR2 coverage by district Figure 5: 2022 Source: WHO/UNICEF JRF (multiple years) * Imported/ Import related ND=No data Source: SEAR annual EPI reporting form, 2021 and 2022 (administrative data) Source: SEAR annual EPI reporting form, 2021 and 2022 (administrative data) Source: WHO/UNICEF JRF (multiple years) Source: WHO/UNICEF JRF (multiple years) Year Polio Diphtheria Pertussis NT (% of all tetanus) Measles Rubella Mumps JE CRS 2016 0 0 6 0 2 8 0 1 0 2017 0 0 1 1 (100%) 0 3 21 7 0 2018 0 0 0 1 (100%) 0 8 26 0 0 2019 0 0 7 0 22* 21 ND 23 0 2020 0 0 5 2 (100%) 2 5 0 0 0 2021 0 0 0 ND 3 4 0 ND 0 2022 0 0 0 1 (50%) 8 41 0 1 0 Indicator 2016 2017 2018 2019 2020 2021 2022 AFP cases 10 5 0 5 1 0 0 Wild poliovirus confirmed cases 0 0 - 0 0 - - Compatible cases 0 0 - 0 0 - - Non-polio AFP rate1 2.16 1.08 - 0.83 0.21 - - Adequate stool specimen collection percentage2 0.5 60% - 0.2 0% - - Total stool samples collected - 8 - 2 1 - - % NPEV isolation - 13 - 0 0 - - % Timeliness of primary result reported3 - 100 - 100 100 - - • The last laboratory confirmed polio case due to WPV was reported in November 1993 1 Number of discarded AFP cases per 100,000 children under 15 years of age. 2 Percent with 2 specimens, 24 hours apart and within 14 days of paralysis onset. 3 Results reported within 14 days of sample received at laboratory. 1 WHO and UNICEF estimates of immunization coverage 1 WHO and UNICEF estimates of immunization coverage 2 WHO vaccine-preventable diseases: monitoring system 2022 Figure 6: 2021 Figure 8: 2021 Figure 9: 2022 Figure 12: 2021 Figure 15: 2022 <70% 70% - 79% 80% - 89% >90% <1 1 – 1.99 >2 No non-polio AFP case <60% 60% - 79% >80% No AFP Year Antigen Geographic coverage Target age Target population Coverage (%) Round 1 Round 2 Round 1 Round 2 2005 OPV NID <5 years 177,713 93 102 2015* OPV NID <5 years 522,943 96 - 2018* OPV NID <5 years 165,013 111 - 2020 OPV - - <80% 80% - 89% 90% - 94% > 95% Year Antigen Geographic coverage Target group Target Coverage % 2003 M nationwide 9 to 59 months 128,318 99 2006 M nationwide 6 months to 14 years 390,687 40 2009 M nationwide 9 to 59 months 167,136 76 2011 M nationwide 6 months to 14 years 494,427 92 2015 MR nationwide 6 months to 14 years 501,832 97 2018 MR nationwide 6 to 59 months 142,935 110 Figure 7: 2022 No AFP case reported No AFP case reported No AFP case reported No AFP case reported Figure 13: 2022 Figure 14: 2021 World Health Organization • SEARO/CDS/IVD • 31 October 2023 VACCINES PROTECT SUSTAIN. ACCELERATE. INNOVATE. Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980-2022 Table 5: Reported cases of vaccine preventable diseases, 2016-2022 Table 6: AFP surveillance performance indicators, 2016-2022 Figure 10: HepB3 and HepB birth dose immunization coverage1, 2000-2022 Figure 11: MCV1 & MCV2 coverage1 and measles, rubella cases2, 1980-2022 Table 7: OPV SIAs Table 8: MCV/MR SIAs Figure 3: TT2+ coverage1 and NT cases2, 1980-2022 1 WHO and UNICEF estimates of immunization coverage 2 WHO vaccine-preventable diseases: monitoring system 2022 1 Country official estimates, 1980-2022 2 WHO vaccine-preventable diseases: monitoring system 2022 Figure 4: 2021 DTP-Hib-HepB3 coverage by district Non-polio AFP rate by district Adequate stool specimen collection % by district MR1 coverage by district MR2 coverage by district Figure 5: 2022 Source: WHO/UNICEF JRF (multiple years) * Imported/ Import related ND=No data Source: SEAR annual EPI reporting form, 2021 and 2022 (administrative data) Source: SEAR annual EPI reporting form, 2021 and 2022 (administrative data) Source: WHO/UNICEF JRF (multiple years) Source: WHO/UNICEF JRF (multiple years) Year Polio Diphtheria Pertussis NT (% of all tetanus) Measles Rubella Mumps JE CRS 2016 0 0 6 0 2 8 0 1 0 2017 0 0 1 1 (100%) 0 3 21 7 0 2018 0 0 0 1 (100%) 0 8 26 0 0 2019 0 0 7 0 22* 21 ND 23 0 2020 0 0 5 2 (100%) 2 5 0 0 0 2021 0 0 0 ND 3 4 0 ND 0 2022 0 0 0 1 (50%) 8 41 0 1 0 Indicator 2016 2017 2018 2019 2020 2021 2022 AFP cases 10 5 0 5 1 0 0 Wild poliovirus confirmed cases 0 0 - 0 0 - - Compatible cases 0 0 - 0 0 - - Non-polio AFP rate1 2.16 1.08 - 0.83 0.21 - - Adequate stool specimen collection percentage2 0.5 60% - 0.2 0% - - Total stool samples collected - 8 - 2 1 - - % NPEV isolation - 13 - 0 0 - - % Timeliness of primary result reported3 - 100 - 100 100 - - • The last laboratory confirmed polio case due to WPV was reported in November 1993 1 Number of discarded AFP cases per 100,000 children under 15 years of age. 2 Percent with 2 specimens, 24 hours apart and within 14 days of paralysis onset. 3 Results reported within 14 days of sample received at laboratory. 1 WHO and UNICEF estimates of immunization coverage 1 WHO and UNICEF estimates of immunization coverage 2 WHO vaccine-preventable diseases: monitoring system 2022 Figure 6: 2021 Figure 8: 2021 Figure 9: 2022 Figure 12: 2021 Figure 15: 2022 <70% 70% - 79% 80% - 89% >90% <1 1 – 1.99 >2 No non-polio AFP case <60% 60% - 79% >80% No AFP Year Antigen Geographic coverage Target age Target population Coverage (%) Round 1 Round 2 Round 1 Round 2 2005 OPV NID <5 years 177,713 93 102 2015* OPV NID <5 years 522,943 96 - 2018* OPV NID <5 years 165,013 111 - 2020 OPV - - <80% 80% - 89% 90% - 94% > 95% Year Antigen Geographic coverage Target group Target Coverage % 2003 M nationwide 9 to 59 months 128,318 99 2006 M nationwide 6 months to 14 years 390,687 40 2009 M nationwide 9 to 59 months 167,136 76 2011 M nationwide 6 months to 14 years 494,427 92 2015 MR nationwide 6 months to 14 years 501,832 97 2018 MR nationwide 6 to 59 months 142,935 110 Figure 7: 2022 No AFP case reported No AFP case reported No AFP case reported No AFP case reported Figure 13: 2022 Figure 14: 2021 World Health Organization • SEARO/CDS/IVD • 31 October 2023 VACCINES PROTECT SUSTAIN. ACCELERATE. INNOVATE. Figure 2: DTP3 coverage1, diphtheria and pertussis cases2, 1980-2022 Table 5: Reported cases of vaccine preventable diseases, 2016-2022 Table 6: AFP surveillance performance indicators, 2016-2022 Figure 10: HepB3 and HepB birth dose immunization coverage1, 2000-2022 Figure 11: MCV1 & MCV2 coverage1 and measles, rubella cases2, 1980-2022 Table 7: OPV SIAs Table 8: MCV/MR SIAs Figure 3: TT2+ coverage1 and NT cases2, 1980-2022 1 WHO and UNICEF estimates of immunization coverage 2 WHO vaccine-preventable diseases: monitoring system 2022 1 Country official estimates, 1980-2022 2 WHO vaccine-preventable diseases: monitoring system 2022 Figure 4: 2021 DTP-Hib-HepB3 coverage by district Non-polio AFP rate by district Adequate stool specimen collection % by district MR1 coverage by district MR2 coverage by district Figure 5: 2022 Source: WHO/UNICEF JRF (multiple years) * Imported/ Import related ND=No data Source: SEAR annual EPI reporting form, 2021 and 2022 (administrative data) Source: SEAR annual EPI reporting form, 2021 and 2022 (administrative data) Source: WHO/UNICEF JRF (multiple years) Source: WHO/UNICEF JRF (multiple years) Year Polio Diphtheria Pertussis NT (% of all tetanus) Measles Rubella Mumps JE CRS 2016 0 0 6 0 2 8 0 1 0 2017 0 0 1 1 (100%) 0 3 21 7 0 2018 0 0 0 1 (100%) 0 8 26 0 0 2019 0 0 7 0 22* 21 ND 23 0 2020 0 0 5 2 (100%) 2 5 0 0 0 2021 0 0 0 ND 3 4 0 ND 0 2022 0 0 0 1 (50%) 8 41 0 1 0 Indicator 2016 2017 2018 2019 2020 2021 2022 AFP cases 10 5 0 5 1 0 0 Wild poliovirus confirmed cases 0 0 - 0 0 - - Compatible cases 0 0 - 0 0 - - Non-polio AFP rate1 2.16 1.08 - 0.83 0.21 - - Adequate stool specimen collection percentage2 0.5 60% - 0.2 0% - - Total stool samples collected - 8 - 2 1 - - % NPEV isolation - 13 - 0 0 - - % Timeliness of primary result reported3 - 100 - 100 100 - - • The last laboratory confirmed polio case due to WPV was reported in November 1993 1 Number of discarded AFP cases per 100,000 children under 15 years of age. 2 Percent with 2 specimens, 24 hours apart and within 14 days of paralysis onset. 3 Results reported within 14 days of sample received at laboratory. 1 WHO and UNICEF estimates of immunization coverage 1 WHO and UNICEF estimates of immunization coverage 2 WHO vaccine-preventable diseases: monitoring system 2022 Figure 6: 2021 Figure 8: 2021 Figure 9: 2022 Figure 12: 2021 Figure 15: 2022 <70% 70% - 79% 80% - 89% >90% <1 1 – 1.99 >2 No non-polio AFP case <60% 60% - 79% >80% No AFP Year Antigen Geographic coverage Target age Target population Coverage (%) Round 1 Round 2 Round 1 Round 2 2005 OPV NID <5 years 177,713 93 102 2015* OPV NID <5 years 522,943 96 - 2018* OPV NID <5 years 165,013 111 - 2020 OPV - - <80% 80% - 89% 90% - 94% > 95% Year Antigen Geographic coverage Target group Target Coverage % 2003 M nationwide 9 to 59 months 128,318 99 2006 M nationwide 6 months to 14 years 390,687 40 2009 M nationwide 9 to 59 months 167,136 76 2011 M nationwide 6 months to 14 years 494,427 92 2015 MR nationwide 6 months to 14 years 501,832 97 2018 MR nationwide 6 to 59 months 142,935 110 Figure 7: 2022 No AFP case reported No AFP case reported No AFP case reported No AFP case reported Figure 13: 2022 Figure 14: 2021 World Health Organization • SEARO/CDS/IVD • 31 October 2023 VACCINES PROTECT SUSTAIN. ACCELERATE. INNOVATE. EXPANDED PROGRAMME ON IMMUNIZATION (EPI) Table 1: EPI History Year Milestone 1978 EPI started 2000 EPI re-structured in March 2007 DTP-HepB vaccine introduced 2012 DTP-Hib-HepB vaccine introduced 2016 MR vaccine introduced in Feb 2016 Second dose of MR introduced in Feb 2016 HepB birth dose introduced in Feb 2016 DPT/DT vaccine (booster dose) introduced in Feb 2016 IPV introduced in Feb 2016 tOPV to bOPV switched on 18 April 2019 Rotavirus vaccine introduced in Dec Source: cMYP 2016-2022 and EPI/MOH Table 3: Immunization schedule, 2022 Vaccine Age of administration BCG Birth HepB Birth within 24 hours DTP-Hib-HepB 6 weeks, 10 weeks and 14 weeks OPV Birth, 6 weeks, 10 weeks and 14 weeks IPV 14 weeks MR 9 months and 18 months Td Females 15 to 49 years (1st pregnancy contact, +1 months, +6 months, +1 year, +1 year) DT 6 years DTP 18 months Rotavirus 6 weeks, 10 weeks and 14 weeks Vitamin A 6-36 months (with 6 months interval) Source: WHO/UNICEF JRF, 2022 Table 4: Immunization system highlights cMYP for immunization 2016-2022 NITAG-TL fully functional Spending on vaccines financed by the government 100% Spending on routine immunization programme financed by the government 64% Updated micro-plans that include activities to improve immunization coverage 13 districts (100%) National policy for health care waste management including waste from immunization activities in place National system to monitor AEFI in place Most recent EPI CES EPI Coverage survey 2018 >80% coverage for DTP-Hib- HepB3 13 districts (100%) >90% coverage for MCV1 5 districts (38%) >90% coverage for MCV2 4 districts (31%) >10% drop-out rate for DTP- Hib-HepB1 to DTP-Hib-HepB3 5 districts (36%) Source: WHO/UNICEF JRF, 2022 Table 2: Basic information 2022 Total population1 1,318,445 Live births1 31,832 Children <1 year1 31,832 Children <5 years1 157,324 Children <15 years1 474,368 Pregnant women1 36,586 WCBA1 (15-49 years) 332,107 Neonatal mortality rate2 22.23 (per 1,000 LB) Infant mortality rate2 43.08 (per 1,000 LB) Under-five mortality rate2 50.55 (per 1,000 LB) Maternal mortality ratio2 204 (per 100,000 LB) Division/Province/State/Region 13 Municipality 13 Postos/Sub-district 72 Sucos/Village 452 Population density1 (per sq. km) 89 Population living in urban areas2 35.80% Population using at least basic drinking- water services2 87% Population using at least basic sanitation services2 58% Total expenditure on health as % of GDP2 5.45% Births attended by skilled health personnel 57% Neonates protected at birth against NT2 83% Children not covered by immunization programme (zero dose children)3 4,184 1 SEAR annual EPI reporting form, 2022 2 WHO, Global Health Observatory (GHO) data http://apps.who.int/gho/data accessed on 03 August 2023 3 DTP1 coverage from WHO and UNICEF estimates of immunization coverage and UN estimated under one population Figure 1: National immunization coverage, 2013-2022 Figure 16: Immunity against measles - immunity profile by age in 2022* Figure 20: Vaccination status of confirmed (laboratory, Epi linked and clinically compatible) measles cases, by age in 2021 and 2022 Figure 21: Vaccination status of confirmed (laboratory and Epi linked) rubella cases, by age in 2021 and 2022 Table 9: Summary of measles surveillance indicators, 2020-2022 Figure 22 : Network of WHO supported surveillance and immunization medical officers and laboratories Figure 18: Confirmed measles cases* by month 2020-2022 Figure 17: Immunity against rubella through vaccination - immunity profile by age in 2022* Figure 19: Confirmed rubella cases* by month 2020-2022 *Modelled using WHO and UNICEF estimates and JRF (multiple years) and does not include immunity due to natural infection *Includes laboratory confirmed, epidemiologically linked and clinically compatible cases Source: SEAR measles case-based data *Includes laboratory confirmed and epidemiologically linked cases Source: SEAR measles case-based data *Modelled using MSP tool ver 2 Source: SEAR measles case-based data Source: SEAR Annual EPI Reporting Form (multiple years) ND=No data Source: SEAR measles case-based data Source: WHO and UNICEF estimates of immunization coverage Indicator Target 2020 2021 2022 Number of suspected measles cases 109 43 47 Confirmed measles cases 0 4 3 0 Lab confirmed 0 0 0 0 Epi-Linked 0 0 0 0 Clinically-compatible 0 4 3 0 Confirmed rubella cases 0 5 4 0 Lab confirmed 0 5 2 0 Epi-Linked 0 0 2 0 Discarded non-measles non-rubella cases 100 38 47 Percentage of suspected cases with adequate investigation initiated within 48 hours of notification ≥ 80% ND 100 100 Reporting rate of non-measles non-rubella cases to national level per 100,000 population ≥ 2 ND 0.83 6.1 Percentage of second-level administrative units reporting at least 2 non-measles non-rubella cases per 100,000 population per 100,00 population ≥ 80% ND ND 54 Percentage of surveillance units reporting measles and rubella data to the national level on time, even in the absence of cases ≥ 80% ND 100 ND Percentage of specimens received at the laboratory within 5 days of collection ≥ 80% 100 80 100 Percentage of IgM results reported to the national public health authorities by the laboratory within 4 days of receipt of specimens ≥ 80% ND 97.5 36 Genotypes detected Measles ND ND Rubella ND ND For contact or feedback: Expanded Programme on Immunization Ministry of Health, Dilli, Timor Leste Tel: +670-77351964, Fax: +670-7250097 Email: mmausiry@gmail.com www.moh.gov.tl Immunization and Vaccine Development (IVD) WHO-SEARO, IP Estate, MG Marg, New Delhi 110002, India Tel: +91 11 23370804, Fax: +91 11 23370251 Email: SearEpidata@who.int www.who.int/southeastasia/health-topics/immunization National Health Laboratory, Dili • National measles and rubella laboratory • National Japanese encephalitis laboratory Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. FACTSHEET 2023 TIMOR LESTE World Health Organization • SEARO/CDS/IVD • 31 October 2023 VACCINES PROTECT SUSTAIN. ACCELERATE. INNOVATE. EXPANDED PROGRAMME ON IMMUNIZATION (EPI) Table 1: EPI History Year Milestone 1978 EPI started 2000 EPI re-structured in March 2007 DTP-HepB vaccine introduced 2012 DTP-Hib-HepB vaccine introduced 2016 MR vaccine introduced in Feb 2016 Second dose of MR introduced in Feb 2016 HepB birth dose introduced in Feb 2016 DPT/DT vaccine (booster dose) introduced in Feb 2016 IPV introduced in Feb 2016 tOPV to bOPV switched on 18 April 2019 Rotavirus vaccine introduced in Dec Source: cMYP 2016-2022 and EPI/MOH Table 3: Immunization schedule, 2022 Vaccine Age of administration BCG Birth HepB Birth within 24 hours DTP-Hib-HepB 6 weeks, 10 weeks and 14 weeks OPV Birth, 6 weeks, 10 weeks and 14 weeks IPV 14 weeks MR 9 months and 18 months Td Females 15 to 49 years (1st pregnancy contact, +1 months, +6 months, +1 year, +1 year) DT 6 years DTP 18 months Rotavirus 6 weeks, 10 weeks and 14 weeks Vitamin A 6-36 months (with 6 months interval) Source: WHO/UNICEF JRF, 2022 Table 4: Immunization system highlights cMYP for immunization 2016-2022 NITAG-TL fully functional Spending on vaccines financed by the government 100% Spending on routine immunization programme financed by the government 64% Updated micro-plans that include activities to improve immunization coverage 13 districts (100%) National policy for health care waste management including waste from immunization activities in place National system to monitor AEFI in place Most recent EPI CES EPI Coverage survey 2018 >80% coverage for DTP-Hib- HepB3 13 districts (100%) >90% coverage for MCV1 5 districts (38%) >90% coverage for MCV2 4 districts (31%) >10% drop-out rate for DTP- Hib-HepB1 to DTP-Hib-HepB3 5 districts (36%) Source: WHO/UNICEF JRF, 2022 Table 2: Basic information 2022 Total population1 1,318,445 Live births1 31,832 Children <1 year1 31,832 Children <5 years1 157,324 Children <15 years1 474,368 Pregnant women1 36,586 WCBA1 (15-49 years) 332,107 Neonatal mortality rate2 22.23 (per 1,000 LB) Infant mortality rate2 43.08 (per 1,000 LB) Under-five mortality rate2 50.55 (per 1,000 LB) Maternal mortality ratio2 204 (per 100,000 LB) Division/Province/State/Region 13 Municipality 13 Postos/Sub-district 72 Sucos/Village 452 Population density1 (per sq. km) 89 Population living in urban areas2 35.80% Population using at least basic drinking- water services2 87% Population using at least basic sanitation services2 58% Total expenditure on health as % of GDP2 5.45% Births attended by skilled health personnel 57% Neonates protected at birth against NT2 83% Children not covered by immunization programme (zero dose children)3 4,184 1 SEAR annual EPI reporting form, 2022 2 WHO, Global Health Observatory (GHO) data http://apps.who.int/gho/data accessed on 03 August 2023 3 DTP1 coverage from WHO and UNICEF estimates of immunization coverage and UN estimated under one population Figure 1: National immunization coverage, 2013-2022 Figure 16: Immunity against measles - immunity profile by age in 2022* Figure 20: Vaccination status of confirmed (laboratory, Epi linked and clinically compatible) measles cases, by age in 2021 and 2022 Figure 21: Vaccination status of confirmed (laboratory and Epi linked) rubella cases, by age in 2021 and 2022 Table 9: Summary of measles surveillance indicators, 2020-2022 Figure 22 : Network of WHO supported surveillance and immunization medical officers and laboratories Figure 18: Confirmed measles cases* by month 2020-2022 Figure 17: Immunity against rubella through vaccination - immunity profile by age in 2022* Figure 19: Confirmed rubella cases* by month 2020-2022 *Modelled using WHO and UNICEF estimates and JRF (multiple years) and does not include immunity due to natural infection *Includes laboratory confirmed, epidemiologically linked and clinically compatible cases Source: SEAR measles case-based data *Includes laboratory confirmed and epidemiologically linked cases Source: SEAR measles case-based data *Modelled using MSP tool ver 2 Source: SEAR measles case-based data Source: SEAR Annual EPI Reporting Form (multiple years) ND=No data Source: SEAR measles case-based data Source: WHO and UNICEF estimates of immunization coverage Indicator Target 2020 2021 2022 Number of suspected measles cases 109 43 47 Confirmed measles cases 0 4 3 0 Lab confirmed 0 0 0 0 Epi-Linked 0 0 0 0 Clinically-compatible 0 4 3 0 Confirmed rubella cases 0 5 4 0 Lab confirmed 0 5 2 0 Epi-Linked 0 0 2 0 Discarded non-measles non-rubella cases 100 38 47 Percentage of suspected cases with adequate investigation initiated within 48 hours of notification ≥ 80% ND 100 100 Reporting rate of non-measles non-rubella cases to national level per 100,000 population ≥ 2 ND 0.83 6.1 Percentage of second-level administrative units reporting at least 2 non-measles non-rubella cases per 100,000 population per 100,00 population ≥ 80% ND ND 54 Percentage of surveillance units reporting measles and rubella data to the national level on time, even in the absence of cases ≥ 80% ND 100 ND Percentage of specimens received at the laboratory within 5 days of collection ≥ 80% 100 80 100 Percentage of IgM results reported to the national public health authorities by the laboratory within 4 days of receipt of specimens ≥ 80% ND 97.5 36 Genotypes detected Measles ND ND Rubella ND ND For contact or feedback: Expanded Programme on Immunization Ministry of Health, Dilli, Timor Leste Tel: +670-77351964, Fax: +670-7250097 Email: mmausiry@gmail.com www.moh.gov.tl Immunization and Vaccine Development (IVD) WHO-SEARO, IP Estate, MG Marg, New Delhi 110002, India Tel: +91 11 23370804, Fax: +91 11 23370251 Email: SearEpidata@who.int www.who.int/southeastasia/health-topics/immunization National Health Laboratory, Dili • National measles and rubella laboratory • National Japanese encephalitis laboratory Disclaimer: The boundaries and names shown and the designations used on all the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. FACTSHEET 2023 TIMOR LESTE