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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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Overcoming challenges and achieving high HPV vaccination uptake in Cameroon: lessons learned from a gender-neutral and single-dose program and community engagement

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BMC Public Health 2025年第1期25卷 1-11页

作者： Njoh, Andreas Ateke Waheed, Dur-E-Nayab Kedakse, Tchokfe Shalom Ndoula Josue Ebongue, Lionel Junior Kongnyuy, Eugene Justine Amani, Adidja Tambasho, Afizu Chrakoh Saidu, Yauba Kaba, Mohamed II Sangwe, Clovis Nchinjoh Kenfack, Herman Seungue, Judith Nebongo, Daniel Nnang, Nadege Edwige Vorsters, Alex Cleenewerck de Kiev, Laurent Expanded Program on Immunization Ministry of Public Health Yaoundé Cameroon School of Global Health and Bioethics Euclid University Bangui Central African Republic Centre for Evaluation of Vaccination Vaccine and Infectious Disease Institute University of Antwerp Antwerp Belgium Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Clinton Health Access Initiative Inc Yaoundé Cameroon World Health Organization Cameroon Country Office Yaoundé Cameroon Division of Public Health Faculty of Health Sciences University of the Free State Bloemfontein South Africa Gavi The Vaccine Alliance Geneva Switzerland

Introduction: Human papillomavirus (HPV) is sexually transmissible and affects almost all sexually active people. The virus infects females and males, causing genital warts, cervical cancer, and oropharyngeal cancers in some. The disease burden is highest in resource-constrained countries, and it is a leading cause of cancer-related mortality in Cameroon. HPV infection is preventable by vaccination. Despite the merits of HPV vaccination, improving coverage has remained difficult in Cameroon. This paper highlights the challenges, lessons learned, and progress in HPV vaccination as part of Cameroon’s gender-neutral-single-dose approach and the periodic intensification of routine immunization (PIRI). Methods: This ecological cross-sectional study, conducted from July to December 2023, examines the introduction of the HPV vaccine in Cameroon, along with associated challenges, strategies, and progress. Vaccination data from 2020 to 2023 were retrieved from Cameroon’s District Health Information Software (DHIS2), while information on the vaccine introduction process and challenges was sourced from expanded programme on Immunisation (EPI) reports. Data analysis was performed using Python. The Shapiro–Wilk test assessed normality, and segmented regression analysis within an interrupted time series framework was applied to evaluate the contribution of each intervention to HPV vaccination uptake among girls. Statistical significance was set at a 95% confidence interval (CI) with a p-value < 0.05. Microsoft Excel 365 was used for calculating vaccination coverage proportions and visualizing results through figures and tables. Results: Cameroon introduced the HPV vaccine to nine-year-old girls in October 2020 amidst negative rumours. The first dose coverage stayed around 20% for three years. Following the National immunization Technical Advisory Group recommendation, the Ministry of Health intensified communication and community engagement, switched to a single-dose vaccination

关键词： Cameroon Cervical cancer Gender-neutral vaccination HPV Intensified communication PIRI Single-dose Vaccination

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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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Global and China burden of hormone-related cancers and risk factors, 1990–2021: results from the Global Burden of Disease Study 2021

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BMC Public Health 2025年第1期25卷 1-17页

作者： Hu, Xiaoyu Lv, Jingjing Qin, Chang Liu, Xiaoxuan Zhu, Jianbiao Cui, Yongchun Shandong First Medical University and Shandong Academy of Medical Sciences Shandong Cancer Hospital and Institute 440 Jiyan Road Huaiyin District Jinan 250117 China Expanded Program Immunization Division of Shandong Provincial Center for Disease Control and Prevention Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention 16992 Jingshi Road Lixia District Jinan 250014 China School of Public Health Cheeloo College of Medicine Shandong University 44 Wenhuaxi Road Lixia District Jinan 250012 China School of Public Health Shandong Second Medical University Shandong Weifang 261053 China School of Public Health Shandong First Medical University and Shandong Academy of Medical Sciences Shandong Jinan 250118 China

Background: Updated data on hormone-related cancers (HRCs) are crucial for their prevention, management, and treatment, aligning with the UN's Sustainable Development Goals. This study focuses on HRCs: breast, thyroid, uterine, ovarian, prostate, and testicular cancers. Despite their significance, comparative studies on these cancers are limited. Methods: Data for incidence, prevalence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) related to HRCs were obtained from the Global Burden of Disease Study 2021. Statistical analyses were performed using R and Joinpoint Software. Age-standardized rates (ASR), percentage changes (1990–2021), annual percent change (APC) and average annual percent change (AAPC) are used to examine trends and risk factors associated with HRCs across various years, genders, and age groups, both in China and globally. Findings: In 2021, China reported 659450 incidence cases of six HRCs, including 527009 cases (95% UI: 398030, 684814) in females and 132442 cases (89701, 181113) in males, reflecting a 29.97% increase since 1990. Deaths attributed to HRCs totaled 176526, with 130281 cases (99207, 166654) among females and 46245 cases (33049, 62510) among males, marking an 11.07% increase during the same period. The age-standardized incidence rates (ASIR) for HRCs in China were 10.70 (38.19, 65.86) per 100,000 for females and 13.87(9.50, 18.71) for males, in contrast to global rates of 17.07(62.11, 72.57) for females and 39.21(35.75, 41.69) for males. Age-standardized death rates (ASDR) were 3.54(9.22, 15.50) for females and 5.86(4.16, 7.83) for males, compared to higher global ASDRs of 6.17(19.49, 22.98) and 13.73(12.06, 14.78),respectively. From 1990 to 2021, China and the global population saw significant increases in ASIR for most cancers, except global ovarian cancer (AAPC = -0.229). Female HRCs mortality, YLLs, and DALYs declined significantly, particularly for uterine canc

关键词： China Global burden of disease Hormone-related cancer Neoplasms

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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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