Expanded Program on Immunization

Bogotá, Colombia

Expanded Program on Immunization

Bogotá, Colombia
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Demanou M.,Center Pasteur of Cameroon | Ratsitoharana R.,Center Pasteur of Cameroon | Yonga M.,Center Pasteur of Cameroon | Dosseh A.,WHO IST West Africa | And 3 more authors.
Virology Journal | Year: 2013

Background: Measles virus (MeV) is monotypic, but genetic variation in the hemagglutinin H and nucleoprotein N genes can be analyzed by molecular epidemiologic techniques and used to study virus transmission patterns. The World Health Organization currently recognizes 8 clades (A-H) within which are 24 genotypes of MeV and one provisional genotype, d11. Genotype B3 is clearly the endemic genotype in most of African continent where it is widely distributed. We provide an update on the molecular characterization of wild-type MeVs that circulated in Cameroon between 2010 and 2011. Findings. Viral RNA was extracted directly from samples obtained from clinically diagnosed measles patients using QIAamp viral RNA Mini Kit. Reverse transcription and PCR amplification of 634 nucleotides of the N gene was performed using the SuperScript™ III One-Step. Sequence analysis of 450 of the 634 nucleotides using Clustal X 2.0 program for multiple alignments and Mega version 5 for phylogenic analysis indicated that all the viruses belonged to genotype B3 with two distinct clusters. Twenty three (77%) belonged to subgroup B3.1 and the other 7 (23%) belonged to B3.3 a recently described subtype. Circulation of cluster 3 was detected in the Far-North Region (5/7) particularly along the Chad-Cameroon border in 2010 and later in Yaounde (2/7 in Biyem-assi Health District) the capital city of Cameroon in 2011. Conclusion: This study highlights the endemic circulation in Cameroon of MeV B3 subtype 1, which probably has its source in the neighboring Nigeria, and the presence of the new subtype B3.3, suggesting a possible importation from Northern Africa where it was first described between 2008 and 2009. © 2013 Demanou et al; licensee BioMed Central Ltd.


Castaneda-Orjuela C.,National University of Colombia | Romero M.,Salutia Foundation | Arce P.,Expanded Program on Immunization | Resch S.,Center for Health Decision Science | And 3 more authors.
Vaccine | Year: 2013

Introduction: The cost of Expanded Programs on Immunization (EPI) is an important aspect of the economic and financial analysis needed for planning purposes. Costs also are needed for cost-effectiveness analysis of introducing new vaccines. We describe a costing tool that improves the speed, accuracy, and availability of EPI costs and that was piloted in Colombia. Methods: The ProVac CostVac Tool is a spreadsheet-based tool that estimates overall EPI costs considering program inputs (personnel, cold chain, vaccines, supplies, etc.) at three administrative levels (central, departmental, and municipal) and one service delivery level (health facilities). It uses various costing methods. The tool was evaluated through a pilot exercise in Colombia. In addition to the costs obtained from the central and intermediate administrative levels, a survey of 112 local health facilities was conducted to collect vaccination costs. Total cost of the EPI, cost per dose of vaccine delivered, and cost per fully vaccinated child with the recommended immunization schedule in Colombia in 2009 were estimated. Results: The ProVac CostVac Tool is a novel, user-friendly tool, which allows users to conduct an EPI costing study following guidelines for cost studies. The total costs of the Colombian EPI were estimated at US$ 107.8 million in 2009. The cost for a fully immunized child with the recommended schedule was estimated at US$ 153.62. Vaccines and vaccination supplies accounted for 58% of total costs, personnel for 21%, cold chain for 18%, and transportation for 2%. Most EPI costs are incurred at the central level (62%). The major cost driver at the department and municipal levels is personnel costs. Conclusion: The ProVac CostVac Tool proved to be a comprehensive and useful tool that will allow researchers and health officials to estimate the actual cost for national immunization programs. The present analysis shows that personnel, cold chain, and transportation are important components of EPI and should be carefully estimated in the cost analysis, particularly when evaluating new vaccine introduction. © 2013 Elsevier Ltd.


Gumede N.,World Health Organization | Coulibaly S.O.,World Health Organization | Yahaya A.A.,World Health Organization | Ndihokubwayo J.-B.,World Health Organization | And 7 more authors.
Vaccine | Year: 2016

Background The laboratory has always played a very critical role in diagnosis of the diseases. The success of any disease programme is based on a functional laboratory network. Health laboratory services are an integral component of the health system. Efficiency and effectiveness of both clinical and public health functions including surveillance, diagnosis, prevention, treatment, research and health promotion are influenced by reliable laboratory services. The establishment of the African Regional polio laboratory for the Polio Eradication Initiative (PEI) has contributed in supporting countries in their efforts to strengthen laboratory capacity. On the eve of the closing of the program, we have shown through this article, examples of this contribution in two countries of the African region: Côte d'Ivoire and the Democratic Republic of Congo. Methods Descriptive studies were carried out in Côte d'Ivoire (RCI) and Democratic Republic of Congo (DRC) from October to December 2014. Questionnaires and self-administered and in-depth interviews and group discussions as well as records and observation were used to collect information during laboratory visits and assessments. Results The PEI financial support allows to maintain the majority of the 14 (DRC) and 12 (RCI) staff involved in the polio laboratory as full or in part time members. Through laboratory technical staff training supported by the PEI, skills and knowledge were gained to reinforce laboratories capacity and performance in quality laboratory functioning, processes and techniques such as cell culture. In the same way, infrastructure was improved and equipment provided. General laboratory quality standards, including the entire laboratory key elements was improved through the PEI accreditation process. Conclusion The Polio Eradication Initiative (PEI) is a good example of contribution in strengthening public health laboratories systems in the African region. It has established strong Polio Laboratory network that contributed to the strengthening of capacities and its expansion to surveillance of other viral priority diseases such as measles, yellow fever, Influenza, MERS-CoV and Ebola. This could serve as lesson and good example of laboratory based surveillance to improving diseases prevention, detection and control in our middle and low income countries as WHO and partners are heading to polio eradication in the world. © 2016


PubMed | Expanded Program on Immunization, World Health Organization and Global Public Health Solutions
Type: Journal Article | Journal: Vaccine | Year: 2016

The laboratory has always played a very critical role in diagnosis of the diseases. The success of any disease programme is based on a functional laboratory network. Health laboratory services are an integral component of the health system. Efficiency and effectiveness of both clinical and public health functions including surveillance, diagnosis, prevention, treatment, research and health promotion are influenced by reliable laboratory services. The establishment of the African Regional polio laboratory for the Polio Eradication Initiative (PEI) has contributed in supporting countries in their efforts to strengthen laboratory capacity. On the eve of the closing of the program, we have shown through this article, examples of this contribution in two countries of the African region: Cte dIvoire and the Democratic Republic of Congo.Descriptive studies were carried out in Cte dIvoire (RCI) and Democratic Republic of Congo (DRC) from October to December 2014. Questionnaires and self-administered and in-depth interviews and group discussions as well as records and observation were used to collect information during laboratory visits and assessments.The PEI financial support allows to maintain the majority of the 14 (DRC) and 12 (RCI) staff involved in the polio laboratory as full or in part time members. Through laboratory technical staff training supported by the PEI, skills and knowledge were gained to reinforce laboratories capacity and performance in quality laboratory functioning, processes and techniques such as cell culture. In the same way, infrastructure was improved and equipment provided. General laboratory quality standards, including the entire laboratory key elements was improved through the PEI accreditation process.The Polio Eradication Initiative (PEI) is a good example of contribution in strengthening public health laboratories systems in the African region. It has established strong Polio Laboratory network that contributed to the strengthening of capacities and its expansion to surveillance of other viral priority diseases such as measles, yellow fever, Influenza, MERS-CoV and Ebola. This could serve as lesson and good example of laboratory based surveillance to improving diseases prevention, detection and control in our middle and low income countries as WHO and partners are heading to polio eradication in the world.


Garcia L D.A.,Expanded Program on Immunization | Velandia-Gonzalez M.,Comprehensive Family Immunization Unit | Trumbo S.P.,Comprehensive Family Immunization Unit | Pedreira M.C.,Comprehensive Family Immunization Unit | And 2 more authors.
BMC Public Health | Year: 2014

Background: The Expanded Program on Immunization (EPI) in Colombia has made great advances since its inception in 1979; however, by 2010 vaccination coverage rates had been declining. In 2010, the EPI commissioned a nationwide study on practices on immunization, attitudes and knowledge, perceived service quality, and barriers to childhood immunization in order to tailor EPI communication strategies. Methods. Colombia's 32 geographical departments were divided into 10 regions. Interviewers from an independent polling company administered a survey to 4802 parents and guardians of children aged <5 years in these regions. To better assess barriers to vaccination, the study was designed to have 70% of participants who had children with incomplete vaccination schedules. Explanatory factorial, principal component, and cluster analyses were performed to place participants into a group (segment) representing the primary category of reasons respondents offered for not vaccinating their children. Types of barriers were then compared to other variables, such as service quality, communication preferences, and parental attitudes on vaccination. Results: Although all respondents indicated that vaccines have health benefits, and 4738 (98.7%) possessed vaccination cards for their children, attitudes and knowledge were not always favorable to immunization. Six groups of immunization barriers were identified: 1) factors related to caregivers (24.4%), 2) vaccinators (19.7%), 3) health centers (18.0%), 4) the health system (13.4%), 5) concerns about adverse events (13.1%), and 6) cultural and religious beliefs (11.4%); groups 1, 5 and 6 together represented almost half (48.9%) of users, indicating problems related to the demand for vaccines as the primary barriers to immunization. Differences in demographics, communication preferences, and reported service quality were found among participants in the six groups and among participants in the 10 regions. Additionally, differences between how participants reported receiving information on vaccination and how they believed such information should be communicated were observed. Conclusions: Better understanding immunization barriers and the users of the EPI can help tailor communication strategies to increase demand for immunization services. Results of the study have been used by Colombia's EPI to inform the design of new communication strategies. © 2014 García L et al.; licensee BioMed Central Ltd.

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