Effective Vaccine Management: The Case of a Rural District in Ghana

Background. The Effective Vaccine Management (EVM) initiative provides the platform needed to monitor and assess the vaccine supply chain system to identify strengths and weaknesses of the system at all levels to enhance the development of improvement plan to strengthen the system. This valuation was carried out in the Tolon District of the Northern Region, Ghana. Methods. A descriptive valuation of vaccine management was carried out in six vaccine stores in the Tolon District of Northern Ghana. We employed World Health Organization (WHO) assessment tools and procedures which consisted of desk reviews and interviews of cold chain managers to assess vaccine management practices in the district. Five out of the nine global assessment criteria were assessed and a minimum target level required for all criteria to meet the WHO standard was 80%. Results. None of the facilities assessed met the WHO benchmark of 80% for all but one criteria assessed. With regards to temperature control, the scores ranged from 42% at Kasuliyili CHPS Centre to 77% at the district store with an average district score of 60%. Stock management ranged between 11% at Wantugu Health Centre and 75% at Nyankpala Health Centre with district average score of 32%. Effective vaccine distribution scores ranged between 13% at Kasuliyili CHPS and 46% at Nyankpala Health Centre with an average district score of 27%. Only Nyankpala Health Centre had an acceptable score of 84% for vaccine management, whereas the lowest score for this indicator was 5% at Tolon Health Centre store with district average score of 53%. Information management and supportive functions scores ranged from 0% at Tolon Health Centre to 26% at the district store with the district average score of 16%. Nineteen (90.5%) of vaccine users had poor knowledge regarding temperature control and vaccine distribution. Conclusion. Effective vaccine management knowledge and practices are poor at Tonlon district and calls for urgent and pragmatic approaches such as training and re-training of vaccine users at all levels.

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The Implementation of Mass-Vaccination against SARS-CoV-2: A Systematic Review of Existing Strategies and Guidelines

Vaccines ◽

10.3390/vaccines9040326 ◽

2021 ◽

Vol 9 (4) ◽

pp. 326

Author(s):

Tasnim Hasan ◽

Justin Beardsley ◽

Ben J. Marais ◽

Thu Anh Nguyen ◽

Greg J. Fox

Keyword(s):

Systematic Review ◽

Real Life ◽

Mass Vaccination ◽

Vaccine Uptake ◽

Cold Chain ◽

World Health ◽

Effective Vaccine ◽

Limited Information ◽

Serious Adverse Events ◽

Roll Out

The global drive to vaccinate against severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) began in December 2020 with countries in Europe, Middle East, and North America leading the roll out of a mass-vaccination program. This systematic review synthesised all available English-language guidelines and research regarding mass-vaccination for COVID-19 until 1 March 2021—the first three months of the global mass-vaccination effort. Data were extracted from national websites, PubMed, Embase, Medline and medRxiv, including peer and non-peer review research findings. A total of 15 national policy documents were included. Policies were summarised according to the World Health Organisation (WHO) framework for mass vaccination. All included policies prioritised front-line health care workers and the elderly. Limited information was available regarding staffing, cold chain, communication strategies and infrastructure requirements for effective vaccine delivery. A total of 26 research studies were identified, reporting roll-out strategies, vaccine uptake and reasons for refusal, adverse effects, and real-life estimates of efficacy. Early data showed a reduction in SARS-CoV-2 cases, hospitalisation and deaths in settings with good coverage. Very low rates of vaccine-related serious adverse events were observed. These findings provide an overview of current practice and early outcomes of COVID-19 mass-vaccination, guiding countries where roll-out is yet to commence.

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Controlled temperature chain: Reaching the unreached in resource-limited settings

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v16i3.32880 ◽

2017 ◽

Vol 16 (3) ◽

pp. 477-479

Author(s):

Geetha Mani ◽

Raja Danasekaran ◽

Kalaivani Annadurai

Keyword(s):

Health Centre ◽

Medical Science ◽

Immunization Coverage ◽

Limited Resource ◽

Heat Stability ◽

Cold Chain ◽

World Health ◽

Immunization Programme ◽

Resource Limited ◽

Health Organization

Geographical distance from health centre and the costs and constraints involved in cold chain maintenance are important factors influencing poor immunization coverage in remote areas of resource-limited countries. Controlled temperature chain (CTC) is an approach which uses the innate heat stability specific to certain vaccines, to reduce the dependency on cold chain and has been accepted for potential use in situations where cold chain maintenance is not feasible and limits immunization programme effectiveness. In 2012, MenAfriVac, Meningitis A conjugate vaccine became the first vaccine to be pre-qualified by World Health Organization for use under CTC. Various existing vaccines are being approved for CTC use in low-resource settings. Proper CTC labelling and effective temperature monitoring are important considerations. While cold chain is critical and should be maintained as always, CTC is a useful alternate option which needs to be explored to reach the unreached in limited-resource settings.Bangladesh Journal of Medical Science Vol.16(3) 2017 p.477-479

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Critical Insight into the Attributes of Emerging Novel Coronavirus (COVID-19) in India and Across the World

Coronaviruses ◽

10.2174/2666796701999200623172631 ◽

2020 ◽

Vol 1 (1) ◽

pp. 49-56

Author(s):

Gaurav M. Doshi ◽

Hemen S. Ved ◽

Ami P. Thakkar

Keyword(s):

Review Article ◽

World Health ◽

Effective Vaccine ◽

Human Contact ◽

The World ◽

Critical Insight ◽

Novel Coronavirus ◽

Health Organization ◽

Insight Into ◽

Old Drugs

The World Health Organization (WHO) has recently announced the spread of novel coronavirus (nCoV) globally and has declared it a pandemic. The probable source of transmission of the virus, which is from animal to human and human to human contact, has been established. As per the statistics reported by the WHO on 11th April 2020, data has shown that more than sixteen lakh confirmed cases have been identified globally. The reported cases related to nCoV in India have been rising substantially. The review article discusses the characteristics of nCoV in detail with the probability of potentially effective old drugs that may inhibit the virus. The research may further emphasize and draw the attention of the world towards the development of an effective vaccine as well as alternative therapies. Moreover, the article will help to bridge the gap between the new researchers since it’s the current thrust area of research.

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Facility assessment and qualitative analysis of health worker perspectives on neonatal health in Malawi

BMC Research Notes ◽

10.1186/s13104-021-05679-5 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Mai-Lei Woo Kinshella ◽

Alinane Linda Nyondo-Mipando ◽

Queen Dube ◽

David M. Goldfarb ◽

Kondwani Kawaza

Keyword(s):

Low Income ◽

Service Providers ◽

Health Centre ◽

Newborn Health ◽

World Health ◽

Neonatal Health ◽

Facility Assessment ◽

Health Innovations ◽

Care Assessment ◽

Implementation Factors

Abstract Objectives The “Integrating a neonatal healthcare package for Malawi” (IMCHA#108030) project conducted mixed-methods to understand facility-based implementation factors for newborn health innovations in low-resourced health settings. The objective of the two datasets was to evaluate: (a) capacity of quality newborn care in three districts in southern Malawi, and (b) barriers and facilitators the scale up of bubble continuous positive airway pressure (CPAP), a newborn health innovation to support babies with respiratory distress. Data description The Integrated Maternal, Neonatal and Child Quality of Care Assessment and Improvement Tool (version April-2014) is a standardized facility assessment tool developed by the World Health Organization (WHO) that examines quality as well as quantity and availability. The facility survey is complemented by a qualitative dataset of illustrative quotes from health service providers and supervisors on bubble CPAP implementation factors. Research was conducted in one primary health centre (facility assessment only), three district-level hospitals (both) and a tertiary hospital (qualitative only) in southern Malawi. These datasets may be used by other researchers for insights into health systems of low-income countries and implementation factors for the roll-out of neonatal health innovations as well as to frame future research questions or preliminary exploratory research on similar topics.

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Mapping the inequality of the global distribution of seasonal influenza vaccine

Environment and Planning A Economy and Space ◽

10.1177/0308518x21998356 ◽

2021 ◽

pp. 0308518X2199835

Author(s):

Yen Ching Yau ◽

Michael T Gastner

Keyword(s):

Influenza Vaccine ◽

Respiratory Diseases ◽

Seasonal Influenza ◽

Developed Countries ◽

Essential Medicines ◽

World Health ◽

Equitable Access ◽

Seasonal Influenza Vaccine ◽

Choropleth Map ◽

Vaccine Distribution

With an estimated annual worldwide death toll of between 290 000 and 650 000, seasonal influenza remains one of the deadliest respiratory diseases. Influenza vaccines provide moderate to high protection and have been on the World Health Organization’s Model List of Essential Medicines since 1979. Approximately 490 million doses of influenza vaccine are produced per year, but an investigation of geographic allocation reveals enormous disparities. Here, we present two maps that visualise the inequality of the distribution across 195 countries: a conventional choropleth map and a cartogram. In combination, these two maps highlight the widespread lack of coverage in Africa and many parts of Asia. As COVID-19 vaccines are now being distributed in developed countries, data for seasonal influenza vaccine distribution emphasises the need for policymakers to ensure equitable access to COVID-19 vaccines.

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Intention to Be Vaccinated for COVID-19 among Italian Nurses during the Pandemic

Vaccines ◽

10.3390/vaccines9050500 ◽

2021 ◽

Vol 9 (5) ◽

pp. 500

Author(s):

Marco Trabucco Aurilio ◽

Francesco Saverio Mennini ◽

Simone Gazzillo ◽

Laura Massini ◽

Matteo Bolcato ◽

...

Keyword(s):

Vaccine Efficacy ◽

Online Survey ◽

Vaccine Development ◽

Vaccine Coverage ◽

World Health ◽

Vaccine Hesitancy ◽

Effective Vaccine ◽

Online Questionnaire ◽

Cross Sectional ◽

Female Sex

Background: While the COVID-19 pandemic has spread globally, health systems are overwhelmed by both direct and indirect mortality from other treatable conditions. COVID-19 vaccination was crucial to preventing and eliminating the disease, so vaccine development for COVID-19 was fast-tracked worldwide. Despite the fact that vaccination is commonly recognized as the most effective approach, according to the World Health Organization (WHO), vaccine hesitancy is a global health issue. Methods: We conducted a cross-sectional online survey of nurses in four different regions in Italy between 20 and 28 December 2020 to obtain data on the acceptance of the upcoming COVID-19 vaccination in order to plan specific interventions to increase the rate of vaccine coverage. Results: A total of 531 out of the 5000 nurses invited completed the online questionnaire. Most of the nurses enrolled in the study (73.4%) were female. Among the nurses, 91.5% intended to accept vaccination, whereas 2.3% were opposed and 6.2% were undecided. Female sex and confidence in vaccine efficacy represent the main predictors of vaccine intention among the study population using a logistic regression model, while other factors including vaccine safety concerns (side effects) were non-significant. Conclusions: Despite the availability of a safe and effective vaccine, intention to be vaccinated was suboptimal among nurses in our sample. We also found a significant number of people undecided as to whether to accept the vaccine. Contrary to expectations, concerns about the safety of the vaccine were not found to affect the acceptance rate; nurses’ perception of vaccine efficacy and female sex were the main influencing factors on attitudes toward vaccination in our sample. Since the success of the COVID-19 immunization plan depends on the uptake rate, these findings are of great interest for public health policies. Interventions aimed at increasing employee awareness of vaccination efficacy should be promoted among nurses in order to increase the number of vaccinated people.

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Yellow Fever Outbreak in Eastern Senegal, 2020–2021

Viruses ◽

10.3390/v13081475 ◽

2021 ◽

Vol 13 (8) ◽

pp. 1475

Author(s):

Moussa Moïse Diagne ◽

Marie Henriette Dior Ndione ◽

Alioune Gaye ◽

Mamadou Aliou Barry ◽

Diawo Diallo ◽

...

Keyword(s):

Yellow Fever ◽

Yellow Fever Virus ◽

Mosquito Species ◽

Virus Transmission ◽

Genomic Analysis ◽

Hemorrhagic Fever ◽

Fever Virus ◽

World Health ◽

Effective Vaccine ◽

Ministry Of Health

Yellow fever virus remains a major threat in low resource countries in South America and Africa despite the existence of an effective vaccine. In Senegal and particularly in the eastern part of the country, periodic sylvatic circulation has been demonstrated with varying degrees of impact on populations in perpetual renewal. We report an outbreak that occurred from October 2020 to February 2021 in eastern Senegal, notified and managed through the synergistic effort yellow fever national surveillance implemented by the Senegalese Ministry of Health in collaboration with the World Health Organization, the countrywide 4S network set up by the Ministry of Health, the Institut Pasteur de Dakar, and the surveillance of arboviruses and hemorrhagic fever viruses in human and vector populations implemented since mid 2020 in eastern Senegal. Virological analyses highlighted the implication of sylvatic mosquito species in virus transmission. Genomic analysis showed a close relationship between the circulating strain in eastern Senegal, 2020, and another one from the West African lineage previously detected and sequenced two years ago from an unvaccinated Dutch traveler who visited the Gambia and Senegal before developing signs after returning to Europe. Moreover, genome analysis identified a 6-nucleotide deletion in the variable domain of the 3′UTR with potential impact on the biology of the viral strain that merits further investigations. Integrated surveillance of yellow fever virus but also of other arboviruses of public health interest is crucial in an ecosystem such as eastern Senegal.

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IoT and Deep Learning Based Approach for Rapid Screening and Face Mask Detection for Infection Spread Control of COVID-19

Applied Sciences ◽

10.3390/app11083495 ◽

2021 ◽

Vol 11 (8) ◽

pp. 3495

Author(s):

Shabir Hussain ◽

Yang Yu ◽

Muhammad Ayoub ◽

Akmal Khan ◽

Rukhshanda Rehman ◽

...

Keyword(s):

Deep Learning ◽

Low Cost ◽

Face Mask ◽

World Health ◽

Rapid Screening ◽

Screening System ◽

Source Of Infection ◽

The Face ◽

Health Organization ◽

Vaccine Distribution

The spread of COVID-19 has been taken on pandemic magnitudes and has already spread over 200 countries in a few months. In this time of emergency of COVID-19, especially when there is still a need to follow the precautions and developed vaccines are not available to all the developing countries in the first phase of vaccine distribution, the virus is spreading rapidly through direct and indirect contacts. The World Health Organization (WHO) provides the standard recommendations on preventing the spread of COVID-19 and the importance of face masks for protection from the virus. The excessive use of manual disinfection systems has also become a source of infection. That is why this research aims to design and develop a low-cost, rapid, scalable, and effective virus spread control and screening system to minimize the chances and risk of spread of COVID-19. We proposed an IoT-based Smart Screening and Disinfection Walkthrough Gate (SSDWG) for all public places entrance. The SSDWG is designed to do rapid screening, including temperature measuring using a contact-free sensor and storing the record of the suspected individual for further control and monitoring. Our proposed IoT-based screening system also implemented real-time deep learning models for face mask detection and classification. This module classified individuals who wear the face mask properly, improperly, and without a face mask using VGG-16, MobileNetV2, Inception v3, ResNet-50, and CNN using a transfer learning approach. We achieved the highest accuracy of 99.81% while using VGG-16 and the second highest accuracy of 99.6% using MobileNetV2 in the mask detection and classification module. We also implemented classification to classify the types of face masks worn by the individuals, either N-95 or surgical masks. We also compared the results of our proposed system with state-of-the-art methods, and we highly suggested that our system could be used to prevent the spread of local transmission and reduce the chances of human carriers of COVID-19.

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Training physicians in India to interpret pediatric chest radiographs according to World Health Organization research methodology

Pediatric Radiology ◽

10.1007/s00247-021-04992-2 ◽

2021 ◽

Author(s):

Eric D. McCollum ◽

Melissa M. Higdon ◽

Nicholas S. S. Fancourt ◽

Jack Sternal ◽

William Checkley ◽

...

Keyword(s):

World Health Organization ◽

Primary Endpoint ◽

Low Income ◽

Chest Radiography ◽

Epidemiological Studies ◽

Chest Radiographs ◽

World Health ◽

Average Score ◽

Pediatric Chest ◽

Health Organization

Abstract Background Chest radiography is the standard for diagnosing pediatric lower respiratory infections in low-income and middle-income countries. A method for interpreting pediatric chest radiographs for research endpoints was recently updated by the World Health Organization (WHO) Chest Radiography in Epidemiological Studies project. Research in India required training local physicians to interpret chest radiographs following the WHO method. Objective To describe the methodology for training Indian physicians and evaluate the training’s effectiveness. Materials and methods Twenty-nine physicians (15 radiologists and 14 pediatricians) from India were trained by two WHO Chest Radiography in Epidemiological Studies members over 3 days in May 2019. Training materials were adapted from WHO Chest Radiography in Epidemiological Studies resources. Participants followed WHO methodology to interpret 60 unique chest radiographs before and after the training. Participants needed to correctly classify ≥80% of radiographs for primary endpoint pneumonia on the post-training test to be certified to interpret research images. We analyzed participant performance on both examinations. Results Twenty-six of 29 participants (89.7%) completed both examinations. The average score increased by 9.6% (95% confidence interval [CI] 5.0–14.1%) between examinations (P<0.001). Participants correctly classifying ≥80% of images for primary endpoint pneumonia increased from 69.2% (18/26) on the pretraining to 92.3% (24/26) on the post-training examination (P=0.003). The mean scores of radiologists and pediatricians on the post-training examination were not statistically different (P=0.43). Conclusion Our results demonstrate this training approach using revised WHO definitions and tools was successful, and that non-radiologists can learn to apply these methods as effectively as radiologists. Such capacity strengthening is important for enabling research to support national policy decision-making in these settings. We recommend future research incorporating WHO chest radiograph methodology to consider modelling trainings after this approach.

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Evaluation of Prescribing Indicators in a Paediatric Population Seen in an Outpatient Consultation at the Gaspard Kamara Health Centre in 2019 (Senegal)

Pharmacy ◽

10.3390/pharmacy9020113 ◽

2021 ◽

Vol 9 (2) ◽

pp. 113

Author(s):

Oumar Bassoum ◽

Mouhamadou Faly Ba ◽

Ndèye Marème Sougou ◽

Djibril Fall ◽

Adama Faye

Keyword(s):

Descriptive Analysis ◽

Health Centre ◽

Paediatric Population ◽

Essential Medicines ◽

World Health ◽

Bivariate Analysis ◽

Prescribing Indicators ◽

Outpatient Consultation ◽

International Nonproprietary Name ◽

Health Organization

Introduction: Data on drug use in paediatrics are scarce in Senegal. The objective of this study was to assess the prescribing indicators in a paediatric population seen in an outpatient consultation at a Health Centre in Dakar, Senegal. Methods: A retrospective and analytical study was conducted. The study population consisted of prescriptions for children aged 0 to 14 years who were seen in ambulatory consultation between 1 June and 30 November 2019. The sample size was 600 prescriptions. The systematic survey was then conducted. Five prescription indicators recommended by the World Health Organization were calculated. The R software was used for descriptive analysis, bivariate analysis and binomial logistic regression. Results: The average number of drugs per prescription was 2.56. The proportion of drugs prescribed under the International Nonproprietary Name (INN) was 18.9%, while the proportion of drugs on the National Essential Medicines List (NEML) was 41.3%. The proportions of prescriptions with at least one antibiotic and one injectable product were 41.5% and 1.3%, respectively. Conclusions: This study showed that prescribing habits were inadequate. Thus, it would be necessary to move towards continuing training of prescribers in the wise use of medicines.

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