跳至主要内容

Successes, Challenges and Lessons Learned in Accelerating Introduction of Rotavirus Immunisation in Zambia

Read  full  paper  at:
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=53525#.VMdJASzQrzE'

ABSTRACT
Introduction: Under five mortality in Zambia is unacceptably high and diarrhoea is the third leading contributor. The Programme for Awareness and Elimination of Diarrhoea (PAED) sought to support the government to accelerate the introduction of new vaccines, including the pneumococcal, second dose measles and rotavirus vaccines in Zambia. Here we present our approach, progress and lessons learned in two years of the programme. Stakeholder Engagement: Definite commitment and buy-in and sign off by the MOH were fundamental prerequisites. National and international stakeholders including the Inter Agency Coordinating Committee (ICC), GAVI Alliance, WHO, University Teaching Hospital, Paediatrics Association of Zambia, and UNICEF were engaged for stakeholder buy-in and integration. Progress made: Following successful integration, PAED was officially launched in January 2012. Preparatory work done included: Introduction and acceptance of the PAED agenda in ICC, new vaccines proposal to GAVI, resource mobilisation, Effective Vaccine Management implementation, national cold chain scale-up strategy, vaccine orientation and adapted data collection tools, health worker training, step-wise vaccine introduction to Lusaka province districts and finally national roll-out of the rotavirus vaccine immunisation. Between January 2011 and November 2013, over 270,000 vaccine doses were distributed in Lusaka province. When 94,500 infants were fully immunised, adequate preparations had been made to facilitate national launch of rotavirus immunisations countrywide on 27th November 2013. Discussion: The PAED model was successful at resource mobilization; it has demonstrated how private sector can contribute to new vaccine introduction. Lessons learned from this model can be replicated in other countries with similar need and constraints.
 
Cite this paper
Chilengi, R. , Rudd, C. , Bolton, C. , Guffey, B. , Masumbu, P. and Stringer, J. (2015) Successes, Challenges and Lessons Learned in Accelerating Introduction of Rotavirus Immunisation in Zambia. World Journal of Vaccines, 5, 43-53. doi: 10.4236/wjv.2015.51006.
 
References
[1]World Health Organization (2007) Rotavirus Vaccines. Weekly Epidemiological Record, 82, 285-296.
 
[2]Parashar, U.D., Burton, A., Lanata, C., et al. (2009) Global Mortality Associated with Rotavirus Disease among Children in 2004. The Journal of Infectious Diseases, 200, S9-S15.
http://dx.doi.org/10.1086/605025
 
[3]Parashar, U.D., Gibson, C.J., Bresse, J.S. and Glass, R.I. (2006) Rotavirus and Severe Childhood Diarrhoea. Emerging Infectious Diseases, 12, 304-306.
http://dx.doi.org/10.3201/eid1202.050006
 
[4]ZMOH (2009) Zambia Ministry of Health 2008. Annual Health Statistical Bulletin, 2009.
 
[5]Steele, A.D., Kasolo, F.C., Bos, P., et al. (1998) Characterization of VP6 Subgroup, VP7 and VP4 Genotype of Rotavirus Strains in Lusaka, Zambia. Annals of Tropical Paediatrics, 18, 111-116.
 
[6]Mpabalwani, M., Oshitani, H., Kasolo, F., et al. (1995) Rotavirus Gastro-Enteritis in Hospitalized Children with Acute Diarrhoea in Zambia. Annals of Tropical Paediatrics, 15, 39-43.
 
[7](2014) Gavi. Value of Immunisation.
http://www.gavialliance.org/about/value/
 
[8]Chilengi, R. and Gitaka, J. (2010) Is Vaccine the Magic Bullet for Malaria Elimination? A Reality Check. Malaria Journal, 9(S3).
 
[9](2014) Global Health Research Policy Network. Making Markets for Vaccines—A Practical Plan.
http://www.who.int/intellectualproperty/news/en/SubmissionBarder1.pdf
 
[10]Taylor K., Nguyen A. and Stéphenne J. (2009) The Need for New Vaccines. Vaccine, 27, G3-G8.
http://dx.doi.org/10.1016/j.vaccine.2009.10.014
 
[11]Gavi (2014) Health Equity. www.gavialliance.org/about/value/health-equity/
 
[12]UNICEF/WHO (2009) Diarrhoea: Why Children Are Still Dying and What Can Be Done.
http://www.who.int/maternal_child_adolescent/documents/9789241598415/en/index.html
 
[13]WHO (2014) Introduction of rotavirus vaccines. Information for Policy Makers, Programme Managers and Health Workers.
 
[14]GlaxoSmithKline. Rotarix-Electronic Medicines Compendium.
http://www.medicines.org.uk/emc/document.aspx?documentId=17840#PRODUCTINFO
 
[15]Ruiz-Palacios, G.M., Perez-Schael, I. and Velazquez, F.R. (2006) Safety and Efficacy of an Attenuated Vaccine against Severe Rotavirus Gastroenteritis. New England Journal of Medicine, 354, 11-22.
http://dx.doi.org/10.1056/NEJMoa052434
 
[16]Drug Lib. Com. Rotateq (Rotavirus Vaccine)—Summary.
http://www.druglib.com/druginfo/rotateq/
 
[17]Vesikari, T., Matson, D.O., Dennehy, P., Van Damme, P., Santosham, M., Rodriguez, Z., et al. (2006) Safety and Efficacy of a Pentavalent Human-Bovine (WC3) Reassortant Rotavirus Vaccine. New England Journal of Medicine, 354, 23-33.
http://dx.doi.org/10.1056/NEJMoa052664
 
[18]Mwenda, J.M., Ntoto, K.M., Abebe, A., Enweronu-Laryea, C., Amina, I., Mchomvu, J., et al. (2010) Burden and Epidemiology of Rotavirus Diarrhoea in Selected African Countries: Preliminary Results from the African Rotavirus Surveillance Network. Journal of Infectious Diseases, 202, S5-S11.
http://dx.doi.org/10.1086/653557
 
[19]Levy, K., Hubbard, A.E. and Eisenberg, J.N.S. (2009) Seasonality of Rotavirus Disease in the Tropics: A Systematic Review and Meta-Analysis. International Journal of Epidemiology, 38, 1487-1496.
http://dx.doi.org/10.1093/ije/dyn260
 
[20]Madhi, S.A., Cunliffe, N.A., Steele, D., Witte, D., Kirsten, M., Louw, C., et al. (2010) Effect of Human Rotavirus Vaccine on Severe Diarrhoea in African Infants. New England Journal of Medicine, 362, 289-298.
http://dx.doi.org/10.1056/NEJMoa0904797
 
[21]Armah, G.E., Sow, S.O., Breiman, R.F., Dallas, M.J., Tapia, M.D., Feikin, D.R., et al. (2010) Efficacy of Pentavalent Rotavirus Vaccine against Severe Rotavirus Gastroenteritis in Infants in Developing Countries in Sub-Saharan Africa: A Randomised, Double-Blind, Placebo-Controlled Trial. The Lancet, 376, 606-614.
http://dx.doi.org/10.1016/S0140-6736(10)60889-6
 
[22]Clemens, J. and Jodar, L. (2005) Introducing New Vaccines into Developing Countries: Obstacles, Opportunities and Complexities. Nature Medicine, 11, S12-S15.
http://dx.doi.org/10.1038/nm1225
 
[23]PATH, Vaccine Resource Library (2011) HPV Vaccination in Africa: Lessons Learned From a Pilot Program in Uganda. www.path.org/vaccineresources/details.php?i=1350
 
[24]Ladner, J., Besson, M.H. and Rodrigues, M. (2014) Performance of 21 HPV Vaccination Programs Implemented in Low and Middle-Income Countries, 2009-2013. BMC Public Health, 14, 670.
http://dx.doi.org/10.1186/1471-2458-14-670
 
[25]Clemens, J. and Jodar, L. (2005) Introducing New Vaccines into Developing Countries: Obstacles, Opportunities and complexities. Nature Medicine, 11, S12-S15.
http://dx.doi.org/10.1038/nm1225
 
[26]WHO (2006) Sixth Global Vaccine Research Forum: Many New Life-Saving Vaccines in Pipeline, but Challenges Persist.
www.who.int/mediacentre/news/releases/2005/pr27/en/                                                  eww150127lx

评论

此博客中的热门博文

Does Immigration Promote the Investment of the Monopolistic Firm?

In the present paper, we examine the effect of increasing uncertainty of immigrants’ growth on the optimal timing of investment of a firm that has a monopolistic power over the labor market. It is revealed that when the uncertainty of immigrants’ growth is more than a threshold level, increasing uncertainty of immigrants’ growth accelerates the optimal timing of firms’ investment and enhances the economic growth, even if the uncertainty of immigrants’ growth is formulated by the geometric Brownian motion, which is in sharp contrast to the standard result that an increase in the uncertainty postpones the optimal timing. With an increase in the immigrants over the past ten years, workforces in the host countries have been growing significantly to the extent that the immigrants represent 70% of the increase in the workforce in Europe, and 47% in the United States as OECD indicates. In the present paper, we attempted to investigate the effect of increased uncertainty caused by the growi...

Education Policy Implementation: A Mechanism for Enhancing Primary Education Development in Zanzibar

Education is one of the fundamental rights of individuals; therefore, the government of a country needs to develop and strengthen educational policy and quality as well as to ensure that everyone has equal access to basic education. The improvement of access and quality of education in the world is becoming as an essential factor in development, whereas the basic education (primary school), is acknowledged as a foundation of the higher educational development for every country. To fulfill this goal, governments introduce several policies and procedures; however, it requires some reforms and participation from the politician, policymakers, and other stakeholders to re-examine educational policy so that it can lead to multiplication and betterment of the reforms. Educational reforms actually focus on accountability. A positive educational development and reform is very challenging and needs more effort and strategy on how to use and utilize the resources effectively as such it can achie...