Journal of immunological sciences最新文献

Background: The risk for importation and reintroduction wild poliovirus in areas that have been cleared of the wild poliovirus in the Horn of Africa will remain if the surveillance systems are weak and porous.

Methods: Consequently, the Horn of Africa Polio Coordinating Office in Nairobi, together with partners conducted surveillance reviews for some of the countries in the Horn of Africa, especially Ethiopia, Kenya and Somalia to identify gaps in the polio surveillance and provided recommendations for improved surveillance. Structured questionnaires collected information about acute flaccid paralysis (AFP) surveillance resources, training, data monitoring, and supervision at provincial, district, and health facility levels. Other information collected included resource availability, management and monitoring of AFP surveillance.

Results: The result revealed that although AFP surveillance systems were well established in these countries, a number of gaps and constraints existed. Widespread deficiencies and inefficient resource flow systems were observed and reported at all levels. There were also deficiencies related to provider knowledge, funding, training, and supervision, and were particularly evident at the health facility level. These weaknesses were corroborated with the sustained transmission of polioviruses in the region, where the surveillance systems were not sensitive enough to pick the viruses.

Conclusion: The review teams made useful recommendations that led to strengthening of the surveillance systems in these countries, including the formation and use of village polio volunteers in the south and central zones of Somalia, where security was heavily compromised and surveillance officers lacked regular access to the communities.

The polio Eradication Initiative (PEI) is one of the most important public health interventions in Africa. Quality data is necessary to monitor activities and key performance indicators and access year by year progress made. This process has been possible with a solid polio health information system that has been consolidated over the years. This study describes the whole process to have data for decision making. The main components are the data flow, the role of the different levels, data capture and tools, standards and codes, the data cleaning process, the integration of data from various sources, the introduction of innovative technologies, feedback and information products and capacity building. The results show the improvement in the timeliness of reporting data to the next level, the availability of quality data for analysis to monitor key surveillance performance indicators, the output of the data cleaning exercise pointing out data quality gaps, the integration of data from various sources to produce meaningful outputs and feedback for information dissemination. From the review of the process, it is observed an improvement in the quality of polio data resulting from a well-defined information system with standardized tools and Standard Operating Procedures (SOPs) and the introduction of innovative technologies. However, there is room for improvement; for example, multiple data entries from the field to the surveillance unit and the laboratory. Innovative technologies are implemented for the time being in areas hard to reach due to the high cost of the investment. A strong information system has been put in place from the community level to the global level with a link between surveillance, laboratory and immunization coverage data. To maintain standards in Polio Information system, there is need for continuous training of the staff on areas of surveillance, information systems, data analysis and information sharing. The use of innovative technologies on web-based system and mobile devices with validation rules and information check will avoid multiple entries.

Background: The WPV1, first detected in Somalia in April 2013, quickly spread to Kenya and Ethiopia and triggered a multi-country coordinated effort. In February 2014, a formal HoA Polio Outbreak Coordination Office was established by WHO AFRO and WHO EMRO in Nairobi to provide technical and managerial leadership. An independent assessment was conducted to ascertain the usefulness of the HoA Coordination in response to the outbreaks.

Methods: The independent assessment team conducted desk review of the rules and guidelines forming the HoA Coordination office and committee. It also reviewed minutes of meetings and interviewed various stakeholders at the Regional levels.

Results: This independent review of the work of the office, in September 2016, showed that the office was fully functional and had benefited from financial and technical support from regional and global GPEI partners. The office is based in the WHO Kenya Country Office which also provides administrative, logistics and until August 2016, data management support. The close working relationship with technical partners ensured alignment and close coordination of outbreak response activities. The mechanism also allowed partners to identify areas of work based on their expertise and avoided duplication of efforts at the local level. Overall, the office was effective in close monitoring of implementation of the outbreak response, strengthening of cross-border activities, monitoring implementation of the TAG recommendations, improving SIA planning and quality, and expanding independent monitoring in Somalia and South Sudan. Key constraints included limited office space for day-to-day operations, and disruption of some activities due to interruption of contracts of technical staff. However, the closure of the HoA outbreak in August 2015 led to some complacency, resulting in a lost sense of urgency, negatively impacting the coordination.

Conclusions: The HoA Coordination Office should continue to function into the foreseeable future. To ensure sustainability of activities, the technical staff should be given contracts for a minimum of 12 months. The Office should reintroduce and schedule the Joint Polio Outbreak Response team meetings at least once every three months.

The use of online Integrated Supportive Supervision (ISS) is aimed to improve the quality of services provided by front line health workers. This work is aimed to document the effects of ISS on the performance of health workers in Zambia using selected key surveillance and immunization process indicators. ISS data on WHO ODK server of all Integrated Supportive Supervisory (ISS) visits that were conducted in Zambia between 1^st January 2018 to 30^th September 2018 were analysed to determine the Percentage point difference between the first and the most recent ISS visits in order to determine whether an observed gap during first ISS visit had persisted during the most recent ISS visit. Our study demonstrated that ISS has remarkable percentage point increase between the first and the most recent ISS visits on availability of an updated monitoring chart, health workers knowledge of AFP case definition and AFP case files. However, there exist variations in the frequency of ISS visits across the provinces of the country. Future research effort should consider assessing the quality of the ISS data through periodic data validation missions.