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Investigation of a cross-border measles outbreak in Moroto District, northeastern Uganda, March–September, 2024

Discover public health 2025年第1期22卷 1-15页

作者： Mfitundinda, Emmanuel Migisha, Richard Namusisi, Annet Mary Wenani, Daniel Kwesiga, Benon Ayeerwot, Ruth Korobe, Emmanuel Ssekandi, Druscillah Bulage, Lilian Ario, Alex Riolexus Uganda Public Health Fellowship Program Uganda National Institute of Public Health Kampala Uganda Karamoja Regional Emergency Operations Centre Moroto Uganda Moroto District Local Government Moroto Uganda Uganda National Expanded Program on Immunization Ministry of Health Kampala Uganda

Background: On June 26, 2024, Ministry of Health was notified of a measles outbreak in Moroto District, northeastern Uganda, which had already resulted in four deaths. We investigated to assess magnitude of the outbreak, identify its source and risk factors, and recommend evidence-based control and prevention measures. Methods: We defined a suspected case as onset of fever and maculopapular rash, and ≥ 1 of cough, coryza, or conjunctivitis in a resident of Moroto District from March 15 to September 22, 2024. A confirmed case was a suspected case with a positive measles-specific IgM test. We identified cases using health facility records and active case search within the health facilities. We conducted a hospital-based case–control study with a 1:2 ratio. Controls were children admitted to the pediatric ward with an alternative diagnosis but no history of fever, rash, or conjunctivitis. We used logistic regression to identify risk factors. We estimated the vaccine effectiveness (VE) from adjusted odds ratio (aOR) associated with vaccination (VE = 1-aOR) % and vaccination coverage (VC) from percentage of vaccinated controls. Results: We identified 290 case-patients (275 suspected and 15 confirmed), with 6 deaths (case fatality rate [CFR] = 2%). The index case-patient was a 10-month-old child who had returned from the Western Turkana Region of Kenya, where a measles outbreak was ongoing. The overall attack rate (AR) was 19/10,000. Lotisan Sub-county (AR = 50/10,000) and children < 1 year (AR = 194/10,000) were the most affected. Being vaccinated was protective (aOR = 0.11, 95% CI 0.03–0.4). Visiting a health facility 7–21 days before the onset of rash (aOR = 3.8, 95% CI 1.3–11) and having malnutrition (aOR = 6.1, 95% CI 1.3–27) increased the odds of contracting measles. Estimated VC was 67% and VE was 89% (95% CI 60–97%). Conclusion: The outbreak was likely imported from Kenya, and was propagated by low vaccination coverage, and healthcare visits within the exposure pe

关键词： Cross-border health surveillance Disease outbreak Measles Uganda Vaccine-coverage Vaccine-effectiveness

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Adverse events Following immunization with Fractional one-fifth and one-half doses of Yellow Fever Vaccine compared to full dose in children 9–23 months old in Uganda — Preliminary report

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International Journal of Infectious Diseases 2025年 152卷 107485-107485页

作者： Twinomuhwezi, Ms Ellon Casey, Dr. Rebecca M Tumwine, Dr. Conrad Namwanje, Ms Angela Nakato, Dr. Winfred Nansozi Sekiziyivu, Dr. Arthur Brian Najjengo, Mrs Marjorie Sserunga Lubega, Dr. Irene Ampeire, Dr. Immaculate Tuttle, Ms Alexandra Chub, Ms Susan Y. Chub Susan Y Doshi, Ms Reena H. H Kambugu, Dr. Andrew Gidudu, Dr. Jane F Infectious Diseases Institute Makerere College Of Health Sciences Global Immunization Division Centers for Disease Control and Prevention Expanded Program on Immunization Ministry of Health Kampala Uganda

BackgroundIn 2016, the World Health Organization recommended that a fractional dose of yellow fever vaccine could be used in persons 2 years of age or older in response to an emergency situation that resulted in a global shortage of available yellow fever vaccine. However, this recommendation did not extend to the youngest age group licensed for yellow fever vaccine as no published data were available on the use or safety of fractional dose yellow fever vaccination among children aged 9–23 months. We conducted a single-blind randomized controlled trial comparing the immunogenicity and safety of fractional one-fifth and one-half doses of Bio-Manguinhos 17DD yellow fever vaccine with full dose in children 9-23 months old in Uganda. In this paper, we present the interim analysis on safety. MethodsChildren aged 9–23 months presenting for routine well-child services were recruited for inclusion at one of three study sites. We collected data on all adverse event(s) following immunization (AEFI) during active AEFI surveillance for 28 days post-vaccination using multiple data collection tools including a home diary card with an objective measurement of fever. An independent team from the Uganda national AEFI Committee investigated and classified serious AEFI (SAE) according to Brighton Collaboration Criteria. ResultsAmong 1053 enrolled children, 672 (64%) were reported to have a non-serious AEFI (NSAE) and 18 (2%) were reported to have a SAE. The most commonly reported AEFI were diarrhoea, fever and rash, each reported by 355 (34%), 338 (33%) and 188 (18%) participants, respectively. Among 18 participants with SAE, eight were reported to have seizures and five were hospitalised for seizures or other causes (respiratory symptoms, gastrointestinal illness, malaria). Four SAEs (deaths) occurred >28 days after vaccination. There were no reported cases of pre-specified or vaccine-related SAEs. We observed no significant difference in frequency or severity of adverse event among

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A PERSPECTIVE ON CONTROLLING VACCINE-PREVENTABLE DISEASES AMONG CHILDREN IN LIBERIA

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INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY 1984年第11期5卷 538-541页

作者： WEEKS, RM Expanded Program on Immunization Ministry of Health and Social Welfare Republic of Liberia

In 1978 the Ministry of Health and Social Welfare in Liberia embarked on a major initiative to expand immunization activity countrywide. During its early development, the expanded program on immunization (EPI) experienced the realities of establishing an immunization program in a developing country, including the high costs of maintaining mobile operations and a network of kerosene refrigerators. To improve vaccination coverage with diminishing resources, the program recently began to place greater emphasis on integrating immunization activities into the existing infrastructure of hospitals, clinics, and health posts. Although the EPI goal and objectives, which in retrospect were highly ambitious, have not yet been achieved, it is possible to immunize effectively the children and women of Liberia. Effective vaccination coverage can be achieved by developing local strategies, coordinating resources, and most importantly, involving the community. International organizations must support such efforts by continuing to supplement essential supplies and by promoting research to develop vaccines that are more heat-stable and immunogenic.

关键词： Africa Africa South Of The Sahara Bacterial And Fungal Diseases--prevention and control Child Mortality Communicable Disease Control Communicable Diseases--prevention and control Delivery Of Health Care Developing Countries Diseases English Speaking Africa Equipment And Supplies Five-year Plans Government Sponsored programs Health Health Facilities Health Services immunization Infections International Agencies Liberia Medicine Mobile Health Units Mortality Organization And Administration Preventive Medicine Primary Health Care program Evaluation programs Tetanus--prevention and control Tuberculosis--prevention and control Un Unicef Usaid Usphs Vaccination Viral Diseases--prevention and control Voluntary Health Agencies Western Africa Who

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Willingness of the General Public to Receive the COVID-19 Vaccine During a Second-Level Alert——Beijing Municipality,China,May 2020

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China CDC weekly 2021年第25期3卷 531-537页

作者： Rui Ma Luodan Suo Li Lu Xinghuo Pang Division of Expanded Program of Immunization(EPI) Beijing Center for Disease Control and Prevention/Beijing Center for Preventive Medicine ResearchBeijingChina

Summary What is already known on this topic?Preclinical trials showed the effectiveness of domestic inactivated vaccine candidates for coronavirus disease 2019(COVID-19).However,it is necessary to evaluate the willingness of the public to receive future domestic vaccines and to understand factors associated with willingness at the early stages of vaccine development.

关键词： COV Public Summary

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Post-Marketing Surveillance of Adverse Events Following Meningococcal Vaccination-China,2013-2021

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China CDC weekly 2024年第50期6卷 1325-1330页

作者： Yuyang Xu Keli Li Yan Li Yuan Li Lina Zhang Chunxiang Fan Minrui Ren Zundong Yin Department of Expanded Program on Immunization Hangzhou Center for Disease Control and PreventionHangzhou CityZhejiang ProvinceChina National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases(NITFID) National Immunization ProgramChinese Center for Disease Control and PreventionBeijingChina

What is already known about this topic?From 2010 to 2012,the incidence of adverse vaccine reactions from meningococcal vaccine(MenV)in China ranged from 8.46 to 56.30 per 100,000 *** is added by this report?From 2013 to 2021,the overall reported rate of adverse events following immunization(AEFI)of five types of market-authorized MenV-containing vaccines in China was 37.87 per 100,000 doses administered,with a reported incidence of adverse vaccine reactions of 37.39 per 100,000 *** reported incidence of adverse vaccine reactions was comparable to that from 2010 to 2012 and perceived to be within an acceptable *** rare vaccine reactions were allergic rashes,and most of these cases were transient and *** are the implications for public health practice?In China,the incidence of AEFI was very low,and serious abnormal reactions were extremely *** should continue to carry out technical training for vaccinators and on-site treatment capabilities to improve emergency treatment for anaphylactic shock and other serious events and ensure the continued safety of vaccination.

关键词： doses vaccine treatment

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Effect of target age of supplemental immunization campaigns on poliomyelitis occurrence in China

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JOURNAL OF INFECTIOUS DISEASES 1997年第Sup1期175卷 S210-S214页

作者： Zhang, J Yu, JJ Linkins, RW Zhang, RZ Wang, KA Cochi, SL CTR DIS CONTROL & PREVENT NATL IMMUNIZATION PROGRAMATLANTAGA 30333 MINIST PUBL HLTH CHINESE ACAD PREVENT MEDBEIJINGPEOPLES R CHINA MINIST PUBL HLTH DIS CONTROL DEPTEXPANDED PROGRAMME IMMUNIZAT DIVBEIJINGPEOPLES R CHINA

The World Health Organization recommends conducting supplemental immunization activities to eradicate poliomyelitis by the year 2000. Although effective in eliminating poliomyelitis from the Americas, supplemental campaigns require substantial resources. To assess differential campaign effectiveness in eliminating this disease, poliomyelitis occurrence was compared in counties in China that targeted children <3 versus <4 years of age. Counties that targeted children <3 years of age reported poliomyelitis more frequently after the campaigns. This association was observed even after accounting for the effects of previous poliomyelitis occurrence, urban versus rural setting, and population density. While several limitations emphasize the preliminary nature of these findings, these data support targeting the widest possible age group of susceptible children to ensure maximum effectiveness in eliminating poliomyelitis. Thus, while reducing the target age of these activities may result in considerable resource savings, such campaigns may not be as effective in eliminating poliomyelitis.

关键词： Polio Poliomyelitis Oral poliovirus vaccines Age groups Poliovirus Age distribution Preventive medicine Population density

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Risk factors for pertussis among children hospitalized for pertussis during 2016-2017, in Guizhou Province of China: a case-control study

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Global Health Journal 2021年第2期5卷 97-101页

作者： Feng Jiang Keli Li Guangpeng Tang Yan Huang Guizhou Center for Disease Control and Prevention Institute of Expanded Programme on ImmunizationGuiyang 550004China Chinese Center for Disease Control and Prevention Center for National Immunization ProgramBeijing 102206China Guizhou Centre for Disease Control and Prevention Institute of Communicable Disease Control and PreventionGuiyang 550004China

Aim:Pertussis is a respiratory tract infection,the vaccine for which was introduced in the expanded programme on immunization(EPI)in Guizhou Province of China(hereafter referred as Guizhou)in the *** vaccine rapidly decreased incidence rates of pertussis in the province,however,despite the wide high coverage of the diphtheria,tetanus and acellular pertussis(DTaP)combined vaccine,there has been a resurgence of pertussis since *** with this recent increase in disease transmission,risk factors for pertussis infection have not been evaluated in *** aimed to provide information on pertussis risk factors and insight on designing targeted pertussis control policies and measures through this ***:A 1:2 matched retrospective case-control study was conducted between 2016 and 2017,involving infants and children younger than 6 years old and parents of the *** enrolled cases included clinical and laboratory confirmed pertussis cases according to the WHO-recommended pertussis *** were selected from children in the same neighborhood who were not diagnosed with pertussis prior to our investigation and did not exhibit any clinical manifestations of ***:The household size[Matched odds ratio(OR_(m)=1.4,95%confidence interval(Cl):1.1-1.7]and household members with antecedent cough(OR_(m)=3.6,95%CI:1.8-7.2)were significantly associated with their child’s pertussis *** parents’occupations were significantly associated with their child’s pertussis onset(ORm=9.4,95%CI:1.6-54.8,for mother side;ORm=4.5,95%CI:1.2-16.5,for father side),when they worked in the business and/or service *** family members with a history of cough was an independent risk factor for pertussis[Adjusted odds ratio(AOR)=43.6,95%CI:2.7-694.0].Besides,the parents’demographic characteristics and DTaP doses were not found to be independent ***:Household exposure is an important risk factor for pertussis infection in infa

关键词： Pertussis risk factors Household exposure Guizhou province China Pertussis resurgence Diphtheria Tetanus and acellular pertussis combined vaccine

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Sequential and combined use of inactivated and oral poliovirus vaccines: Dolj district, Romania, 1992-1994

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JOURNAL OF INFECTIOUS DISEASES 1997年第0期175卷 S241-S246页

作者： IonNedelcu, N Strebel, PM Toma, F BiberiMoroeanu, S Combiescu, M Persu, A AubertCombiescu, A Plotkin, SA Sutter, RW CTR DIS CONTROL & PREVENT NATL IMMUNIZATION PROGRAM ATLANTA GA 30333 USA MINIST HLTH EXPANDED PROGRAMME IMMUNIZAT NATL LAB CONTROL SERA & VACCINES BUCHAREST ROMANIA CANTACUZINO INST BUCHAREST ROMANIA PREVENT MED CTR CRAIOVA ROMANIA PASTEUR MERIEUX SERUMS & VACCINS LYON FRANCE

To determine the feasibility of a vaccination strategy that would reduce the risk of vaccine-associated paralysis while retaining a barrier against the spread of wild poliovirus, a 2-year project was undertaken using enhanced-potency inactivated poliovirus vaccine (IPV) administered at 2 and 3 months of age followed by doses of both IPV and oral poliovirus Vaccine (OPV) administered at 4 and 9 months of age, Vaccination coverage by 12 months of age with three or more doses of IPV and two doses of OPV among 16,566 infants eligible for vaccination was >95% and >80%, respectively. Among 51 children from whom blood samples were obtained 45 days after their third dose of IPV and first dose of OPV, 100% had serum neutralizing antibodies (reciprocal titer greater than or equal to 10) to all three poliovirus types. No cases of paralytic poliomyelitis due to either wild or vaccine-related strains were reported. The project demonstrated the feasibility, safety, and high immunogenicity of sequential use of IPV followed by OPV in Romania.

关键词： Oral poliovirus vaccines Hepatitis B vaccines Poliovirus Poliomyelitis Inactivated poliovirus vaccines Diptheria pertussis tetanus vaccines Measles vaccines Health care administration Toxoid vaccines

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The Contribution of Periodic Intensification of Routine immunization to Vaccination Coverage and Disease Surveillance in the South West Region of Cameroon amid Sociopolitical Crisis and Covid-19 Outbreak in 2020

Research Square

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Research Square 2021年

作者： Njoh, Andreas Ateke Saidu, Yauba Bachir, Hassan Ben Ndoula, Shalom Tchokfe Mboke, Eric Nembot, Raoul Tambasho, Azu Chrakoh Abizou, Messang Blandine Seungue, Judith Mbanga, Clarence Mbome, Victor Njie Expanded Program on Immunization Cameroon Clinton Health Access Initiative Cameroon MoPH: Ministry of Public Health Cameroon Expanded Program on Immunization Cameroon Faculty of Medicine and Biomedical Sciences Cameroon University of Buea Faculty of Health Sciences Cameroon

Introduction: The Southwest Region of Cameroon has been hit by an armed conflict for over half a decade now, which has negatively affected routine immunization and disease surveillance activities in the region. This negative effect was further acerbated by the Covid-19 pandemic, which alongside the conflict caused thousands of children to miss out on life saving vaccinations. Herein, we present the contribution of periodic intensification of routine immunization, in improving immunization and surveillance activities amid crises. Method Periodic intensification of routine immunization (PIRI) and surveillance was carried out in three rounds per health district. Prior to the intervention, the security profile of each district involved was reviewed. Data for this study was extracted on vaccination and surveillance activities from the District Health Information Software and from monthly regional reports for 2019 and 2020. Results In total 54,242 persons were vaccinated in the SW region following these interventions. An increase in performance was observed in all 18 health districts of the region in 2020, with both DPT-3 and OPV-3 coverage rising by 28% points. Similarly, the proportion of health districts that investigated at least a case of acute flaccid paralysis increased by 83%, rising from just 3 districts in 2019 to 18 in 2020. Conclusion PIRI was a very useful approach to improve both vaccination coverage and surveillance indicators in this region amidst the ongoing conflict and Covid-19 pandemic. © 2021, CC BY.

关键词： immunization

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Malaria vaccine acceptance and associated factors in cameroon: A nationwide cross-sectional survey

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Vaccine 2025年 60卷 127323页

作者： Andreas Ateke Njoh Jerome Nyhalah Dinga Eugene Justine Kongnyuy Tchokfe Shalom Ndoula Adidja Amani Ibrahima Madaina Muluh Ngwe Sonnet Ticha Messang Blandine Abizou Yauba Saidu Hassan Ben Bachir Laurent Cleenewerck de Kiev Expanded Program on Immunization Ministry of Public Health Yaounde Cameroon School of Global Health and Bioethics Euclid University Bangui Central African Republic Michael Gahnyam Gbeugvat Foundation Buea Cameroon Biotechnology Unit University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Cameroon Clinton Health Access Initiative Cameroon Department of Health Promotion Ministry of Public Health Yaounde Cameroon

Introduction Malaria is a life-threatening mosquito-borne disease. This significant public health problem disproportionately affects people in Africa. Despite investments in existing vector control and curative treatments, malaria remains the first infant-child morbidity and mortality cause, with 11,000 annual deaths in Cameroon. However, there are effective vaccines against the disease. So, this study sought to evaluate vaccine acceptance and related factors to guide the vaccine rollout. Method This nationwide cross-sectional survey collected data from December 2023 to January 2024 using an online and in-person questionnaire. The chi-square test identified the malaria vaccine acceptance elements, and multiple logistic regression depicted factors linked to vaccine acceptance. SPSS enabled analysis, and a p -value <0.05 was considered significant. Microsoft Excel 365 eased the elaboration of charts and tables. Result Data from 2025 participants indicated a 91 % malaria vaccine acceptance. This rate varied from 78 % in the Littoral to 94 % in the Far North and South West regions. Factors that favor vaccine acceptance include a history of severe malaria (OR = 1.4, 95 %CI: 1.0–1.8, p = 0.03), awareness of the availability of the malaria vaccine for infants (OR = 1.4, 95 %CI: 1.0–2.0, p = 0.03), and working in the vaccination service (OR = 3.8, 95 %CI: 2.7–5.3, p < 0.01). Elements reported for vaccine hesitancy include fear of unsafe and negative rumors about the vaccine. Conclusion People in Cameroon are willing to get their children vaccinated against malaria. However, following regional acceptance disparities and identified hesitancy points, it is crucial to reinforce communication to address population groups, doubts, and rumors about vaccines to ensure optimal uptake in the country's regions during the malaria vaccine rollout.

关键词： Associated factors Cameroon Malaria vaccine Vaccine acceptance Vaccine hesitancy

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