A cross-sectional survey on cold chain management of vaccines in Cebu, Philippines

Introduction: Vaccination is one of the most effective disease prevention strategies and potency of vaccines is dependent on effective management of cold chain at all levels of vaccine handling. The objective was to assess the status of cold chain at the primary health centers and to assess the knowledge and practices of medical officers at these centers regarding cold chain management.Materials and Methods: This cross sectional study was conducted at 70 primary health centers of Dakshina Kannada District of Coastal South India. Cold chain equipment and maintenance process was noted following direct observation on uninformed visits. Data regarding the knowledge and practices of cold chain management was obtained by interviewing the medical officers using structured pretested questionnaire.Results: Ice lined refrigerators and deep freezers were available in 69 (98.6%) and 67(95.8%) of centers. Dial thermometer was present in all the centers. Cold boxes, frozen packs and automated voltage stabilizers were available in 68(97.2%) centers. Improper vaccine storage was observed in 7 (10%) centers. Majority of medical officers had knowledge and correct practices in fields like ideal equipment, OPV administration, vaccine requiring diluents but only 47 (61.8%) medical officers had correct practice of defrosting the deep freezers.Conclusions: The availability of equipment is near universal. Improper vaccine storage practices and poor knowledge in some fields of cold chain management may adversely affect the quality of administered vaccine. Relevant training for those handling the cold chain is recommended.Key words: Cold Chain; India; Primary health center; Temperature monitoring DOI: http://dx.doi.org/10.3126/jnps.v32i1.5946 J. Nepal Paediatr. Soc. Vol.32(1) 2012 19-22

Download Full-text

Adherence to Cold-Chain Management Guidelines and Influence on Stability of Live Attenuated Vaccines: Results from an Observational Study in Kisumu County, Kenya.

International Journal of Health, Medicine and Nursing Practice ◽

10.47941/ijhmnp.375 ◽

2020 ◽

Vol 2 (1) ◽

pp. 1-13

Author(s):

Moses Olunga Okomo John ◽

Dickens S. Omondi Aduda ◽

Bernard Guyah

Keyword(s):

Cold Chain ◽

P Value ◽

Unique Contribution ◽

Adherence Level ◽

Cross Sectional ◽

Chain Management ◽

Live Attenuated Vaccines ◽

Ethical Frameworks ◽

Management Procedures ◽

Improved Stability

Purpose: Guidelines provide ethical frameworks to streamline processes for best outcomes. Live-attenuated vaccines in routine immunization programs in Kenya have challenges of instability despite the availability of guidelines. Diseases preventable by these vaccines are reported in Kisumu County more than others in the region. This observation is suspected to be associated with lapses in adherence to cold-chain management procedures. This study, hence purposed to assess whether there was any association between instability of vaccines and staff adherence level to the guidelines.Method: Using analytical cross-sectional design with repeated observations, data was collected from 120 out of 170 public and non-governmental health facilities in the Kisumu County at three intervals, between October 2018 and March 2019. In each health facility, immunization manager on duty was interviewed and observations made on compliance with cold-chain protocols using a checklist. Data was summarized descriptively and regression used to identify key points of adherence levels. Qualitative information was analyzed thematically to identify evolving themes.Result: In 40% of the facilities, staff did not transfer vaccines when the need arose; 8.3% did not defrost fridges; while 45.8% did not dispense vaccines at VVM stage 2. Transferred vaccines accounted for improved stability of both OPV (95%C.I; 3.1 – 16.8, OR 7.2, p value< 0.001) and measles-rubella vaccines (95% C.I, 2.1 – 10.4, OR, 4.7, p=value <0.001). Dispensing vaccines at VVM stage 2 ahead of FEFO had better stability of OPV (95%C.I, 6.0 - 49, OR17.2, p=value <0.001) and measles-rubella vaccines (95%C.I 3.3-17.4; OR7.6, p=value <0.001) respectively. Defrosted fridge enhanced stability of OPV (95% C.I, 1.1 – 15.5; OR 4.17, p=value 0.033), measles-rubella (95% C.I, 1.3 – 12.3, OR 4, p-value 0.0017) and ROTA vaccine (95% C.I 1.9 – 21.5; OR 6.3, p= value 0.003).Unique contribution to practice and policy: Lapses in transferring vaccines, defrosting of fridges and use of VVM to dispense vaccines significantly destabilized live attenuated vaccines worth linking to the outbreaks of Rota diarrhea and measles outbreaks in Kisumu. Due to inadequate staff adherence level to guidelines, new innovations meant to help improve stability of vaccines, inadequately improved the situation, so calls for strengthened capacity building to staff.

Download Full-text

The Implementation of Immunization Cold Chain Management in Surabaya City

Jurnal Berkala Epidemiologi ◽

10.20473/jbe.v9i12021.62-69 ◽

2021 ◽

Vol 9 (1) ◽

pp. 62

Author(s):

Alfilia Lusita ◽

Fariani Syahrul ◽

Ponconugroho Ponconugroho

Keyword(s):

Health Care ◽

Primary Health Care ◽

Secondary Data ◽

Cold Chain ◽

Success Rates ◽

Cross Sectional ◽

Chain Management ◽

Primary Health ◽

The City

Background: Immunization success rates can be determined by several factors. The factors that can cause occurrences of immunization preventable disease (PD3I) cases include the quality of the cold chain and invalid doses of immunization medicines. Purpose: The aim of this research was to analyze the implementation of cold chain management in the city of Surabaya. Methods: This research was conducted as a descriptive study with a cross-sectional research design. The population consisted of all primary health care centers in the city of Surabaya, and the data used were secondary data, guided by interviews with informants. Results: The majority of cold chain management personnel were found to have a medical education background of 98.42%, and primary health care workers have received cold chain-related training (100%). All primary health care equipment has a 100% cold chain. The completeness of cold chain reporting was 93.51%, and the accuracy of the cold chain reporting was 71.52%. Regarding the quality of the equipment, some vaccine refrigerators were found 12% of vaccine refrigerators were found not to be in optimal condition, and 14% of temperature monitoring devices was not activated. Conclusion: The implementation of cold chain management in public health center and the availability of equipment in the Surabaya City are going well, although there are still some problems such as undisciplined reporting and inadequate quality of tools for cold chain implementation as well as the discovery of vaccine refrigerators easily leaks, and their temperature can rise easily.

Download Full-text

Evaluation of vaccine storage and cold chain management practices during intensified mission Indradhanush in community health centers of Tikamgarh district of Madhya Pradesh

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20190215 ◽

2019 ◽

Vol 6 (2) ◽

pp. 823

Author(s):

Ram K. Panika ◽

Pankaj Prasad ◽

Sunil Nandeshwar

Keyword(s):

Community Health Centers ◽

Management Practices ◽

Cross Sectional Study ◽

Cold Chain ◽

Voltage Stabilizer ◽

Cross Sectional ◽

Chain Management ◽

Record Keeping ◽

Shake Test ◽

Immunization Services

Background: Vaccination is one of the most effective disease prevention strategies and potency of vaccine is dependent on effective management of cold chain at all levels of vaccine handling. An effective cold chain maintenance system is the backbone of success of any immunization program. This study was done to assess the cold chain management and vaccine storage practices in Tikamgarh district of Madhya Pradesh.Methods: Cross-sectional study was carried out using a structured questionnaire.Results: Dedicated room/space for dry storage not available in any of 03 CHCs. Dedicated table for conditioning of icepacks, dedicated clean clothes for wiping of icepacks after conditioning and power back up was available, ILR and DF were connected to separate functional voltage stabilizer and thermometers were placed correctly only in 66.6% CHCs. ILRs and DFs were properly placed, cabinet temperature of ILR and DFs was maintained in normal range in all the three (100%) CHCs. Record of power failure, records of defrosting/cleaning was maintained in temperature log book and cold chain handlers had knowledge of shake test in only 33.3% CHC.Conclusions: Proper vaccine storage and management of cold chain system is essential for immunization. In order to improve quality of immunization services there is a need of space, temperature monitoring and regular defrosting with record keeping and regular training of cold chain handlers to keep their knowledge and skills updated. Monitoring and supervision of cold chain points by DIO should be on regular basis.

Download Full-text

COVID-19 Vaccine Acceptance among Cold-Chain Food Workers in China: A Cross-Sectional Survey (Preprint)

10.2196/preprints.29646 ◽

2021 ◽

Author(s):

Lizhen Liu ◽

Minyi Zhang ◽

Hongbiao Chen ◽

Juxian Xian ◽

He Cao ◽

...

Keyword(s):

Population Based ◽

Cold Chain ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Vaccine Acceptance ◽

Effective Measure ◽

Frozen Food ◽

Attitudes And Practices ◽

High Level ◽

Food Workers

BACKGROUND As cold-chain transportation in frozen food may lead to localized outbreaks of COVID-19 in destinations. Given the high level of exposure to SARS-CoV-2, the cold-chain food workers are considered priority vaccination groups. To date, a number of studies have reported the willingness to be vaccinated against COVID-19 within distinct populations, whereas it has not been reported among cold-chain food workers worldwide. OBJECTIVE We aim to investigate the willingness for COVID-19 vaccination and its influencing factors within cold-chain food workers during the COVID-19 pandemic. METHODS An online cross-sectional, population-based survey was employed to gather information regarding the willingness of COVID-19 vaccination and the knowledge, attitudes, and practices (KAP) associated with COVID-19 and vaccination among cold-chain food workers in Shenzhen City of China. Binomial logistic analyses were conducted to qualify the associations between COVID-19-related KAP factors and the willingness of COVID-19 vaccination using adjusted odds ratios (aORs) and 95% confidence interval (CI). RESULTS A total of 244 cold-chain food workers were recruited. Overall, 76.2% of the subjects indicated that they were willing to be vaccinated. After adjustment for general characteristics, knowledge on COVID-19 conception (aOR 2.313, 95%CI 1.098-4.872), comprehending the most effective measure (aOR 2.399, 95%CI 1.233-4.666), understanding the transmission routes (aOR 8.760, 95%CI 2.406-31.890), and recognizing the priority vaccination groups (aOR 2.587, 95%CI 1.331-5.029) were positively associated with the dependent variable. Regarding attitude factors, perceiving the social harmfulness (aOR 2.643, 95%CI 1.178-5.927) and severity of COVID-19 (aOR 3.109, 95%CI 1.116-8.660) were related to a higher willingness to get vaccinated. In terms of practice factors, participants who have attained more knowledge (aOR 2.608, 95%CI 1.115-6.099) were more likely to be vaccinated, and higher self-reported compliance with maintaining indoor ventilation (aOR 2.371, 95%CI 1.049-5.363) was also positively associated with the dependent variable. Agreement on the importance of vaccination to prevent COVID-19 was the most frequent reason for accepting the COVID-19 vaccine; additionally, concerns about side effects and poor understanding of efficacy were the main factors contributing to the vaccination refusal. CONCLUSIONS Enhancing KAP levels related to COVID-19 might be the key to promote vaccine acceptance. Health authorities ought to promptly implement educational activities following the updated vaccine situations.

Download Full-text

Assessment of factors affecting vaccine cold chain management practice in public health institutions in east Gojam zone of Amhara region

BMC Public Health ◽

10.1186/s12889-019-7786-x ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Hewan Adam Bogale ◽

Abebe Feyissa Amhare ◽

Alemtsehay Adam Bogale

Keyword(s):

Logistic Regression ◽

Storage Temperature ◽

Health Workers ◽

Management Practice ◽

Cold Chain ◽

Knowledge Gap ◽

Amhara Region ◽

Cross Sectional ◽

Chain Management ◽

Health Institutions

Abstract Background Maintaining quality of vaccines is one of the main challenges of immunization programs in Ethiopia. The objective of this study is to assess the factor affecting vaccine cold chain management practice in immunization health institutions in East Gojam zone of Amhara region, Ethiopia. Method An institutional based cross-sectional study was conducted from March to April 2017 in ten districts of East Gojam zone of Amhara Region. Descriptive statistics and Logistic regression analysis were carried out to identify factors related to the practice of cold chain management. Result Among 60 health institutions, only 46(76.7%) had functional refrigerators. Twenty-one (35%) had a functional generator for backup service and 28(46.6%) had a car/motorbike for transportation of vaccines in case of refrigerator/power failure. Twenty-nine (48.3%) had known the correct vaccine storage temperature (2 °C – 8 °C) in the refrigerator and the results of this study revealed that only 23(38.3%) of respondents had sufficient knowledge about vaccine cold chain management. The finding of this study also revealed that 35(58.3%) had appropriate vaccine cold chain management practice and the rest 25(41.7%) had inappropriate practice. Logistic regression showed us the knowledge gap and profession were significantly associated with vaccine cold chain management practice at P < 0.05. Conclusion This study indicates that there was a knowledge gap of health workers who are working on cold chain management. There is an urgent need to improve knowledge and practice on cold chain management through improved supervision and training at a different level of health care system.

Download Full-text

Evaluation of Cold Chain Management Performance for Temperature-Sensitive Pharmaceuticals at Public Health Facilities Supplied by the Jimma Pharmaceuticals Supply Agency Hub, Southwest Ethiopia: Pharmaceuticals Logistic Management Perspective Using a Multicentered, Mixed-Method Approach

Advances in Pharmacological and Pharmaceutical Sciences ◽

10.1155/2021/5167858 ◽

2021 ◽

Vol 2021 ◽

pp. 1-13

Author(s):

Diriba Feyisa ◽

Awol Jemal ◽

Temesgen Aferu ◽

Fikadu Ejeta ◽

Alem Endeshaw

Keyword(s):

Public Health ◽

Assessment Tool ◽

Health Facilities ◽

Cold Chain ◽

Temperature Sensitive ◽

Management Performance ◽

Cross Sectional ◽

Southwest Ethiopia ◽

Chain Management ◽

Public Health Facilities

Background. Effective and efficient cold chain management maximizes utilization of healthcare resources, reduces cold chain products wastage, and improves the quality of health services. It eventually guarantees that clients receive cold chain products they need at service delivery points. The objective of this study was to evaluate cold chain management performance for temperature-sensitive medicines at public health facilities in Southwest Ethiopia supplied by the Jimma Pharmaceuticals Fund and Supply Agency hub. Method and Materials. The study used an institution-based cross-sectional study design. Forty-seven (47) public health facilities in Southwest Ethiopia were evaluated using checklists adopted from the Logistic Indicators Assessment Tool, Vaccine Management Assessment Tool, and Logistic System Assessment Tool. Results. The study revealed that the mean availability of essential cold chain products was 72.1 ± 14.8% while the average stock-out rate was 26.2 ± 8.6%. The median stock-out duration was 23 ± 21 days for all visited public health facilities. Two hundred and sixty-three (43.06 ± 15.3%) of the public health facilities’ stock records were found accurate, and the wastage rate due to expiration was 9.2 ± 7.8% for all visited health facilities. Thirty public health facilities (63.8 ± 36.2%) had acceptable storage conditions. Conclusions and Recommendations. Supply chain performance at the study facilities was not adequate overall, and focused efforts need to be directed at managing the availability of critical cold chain medicines. Some cold chain management challenges demand the attention of the top management, while the rest can be addressed by operational management at the facilities through provision of appropriate training and supervision of the cold chain pharmaceutical handlers.

Download Full-text

Knowledge of Health Professionals on Cold Chain Management and Associated Factors in Ezha District, Gurage Zone, Ethiopia

Scientifica ◽

10.1155/2019/6937291 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Zeyneba Jemal Yassin ◽

Habtamu Yimer Nega ◽

Behailu Tariku Derseh ◽

Yetnayet Sisay Yehuala ◽

Abel Fekadu Dad

Keyword(s):

Health Professionals ◽

Work Experience ◽

Data Entry ◽

Cross Sectional Study ◽

Cold Chain ◽

Multivariable Logistic Regression Model ◽

Cross Sectional ◽

Chain Management ◽

Health Officer ◽

Service Training

Background. Maintaining quality of vaccines has been one of the main challenges of immunization programs in Africa including Ethiopia, and this could mainly be explained by health professional’s knowledge about cold chain management. There are limited studies done in Ethiopia linking the knowledge of health professionals on cold chain management, and that is why we needed to conduct this study. Methodology. Institution-based cross-sectional study was conducted among all available health professionals in selected health facilities (232 health professionals). Face-to-face interview using a semistructured questionnaire was conducted to collect required information from September to October 2016. Observational checklist was used to spot availability and functionality of refrigerators. Data entry and cleaning was done using Epi Info and exported to SPSS for analysis. A multivariable logistic regression model was fitted to identify factors associated with health professional’s knowledge about cold chain management. Result. The response rate was 92.43%, and 119 (51.3%; 95% CI; 44.9%, 57.6%) health professionals had a satisfactory knowledge about cold chain management. Being trained on immunization program (AOR = 5.1; 95% CI: 2.68, 10.13), having a work experience above six years (AOR = 2.1; 95% CI: 1.8, 4.15), using EPI guidelines (AOR = 2.58; 95% CI: 1.47, 5.57), and being a BSc nurse/health officer (AOR = 2.4; 95% CI: 1.47, 14.4) had got better knowledge on cold chain management. Conclusion. Health professionals working in the health centers and health posts had low knowledge on cold chain management. Longer work experience, in-service training, and using EPI guideline at work were factors that improved health professionals’ knowledge about a cold chain management, which needs to be maintained.

Download Full-text