The effects of switching from 10 to 5-dose vials of MR vaccine on vaccination coverage and wastage: A mixed-method study in Zambia

IntroductionVaccines procured for low-income countries are often packaged in multi-dose vials to reduce program costs. To avoid wastage, health workers may refrain from opening a vial if few children attend an immunization session, possibly leading to lower coverage. Lowering the number of doses in a vial may increase coverage and reduce wastage.MethodsWe used a mixed methods approach to measure the effects of switching from conventional 10-dose measles containing vaccine (MCV) vials to 5-dose MCV vials on coverage and open vial wastage in 14 districts purposely selected from two provinces in Zambia. The districts were paired based on the number of health facilities and the average size of the health facility catchment population. One district from each pair was randomly allocated to receive 5-dose vials while the other continued with the conventional vials. We applied propensity score matched difference-in-difference analysis to estimate intervention effects on coverage using pre-intervention household survey and post-intervention household survey after 11 months of the intervention. The intervention effects on wastage rates were estimated from multivariate analysis of the administrative data. Key informant interviews were conducted to better understand health workers’ behavior and preferences at baseline, midline and endline, and analyzed using thematic analysis techniques.ResultsMCV coverage rates increased across both arms for both doses. A five percentage-point intervention effect was detected for MCV1 and 3.5 percentage-point effect for MCV2. The MCV wastage rate was 47% lower in facilities using 5-dose vials (16.2%) versus 10-dose vials (30.5%). Healthcare workers reported being more willing to open a 5-dose vial than a 10-dose vial for one child, as they were less concerned about wastage.DiscussionSwitching 10-dose MCV vials to 5-dose vials improved coverage, decreased wastage, and improved willingness to open a vial. These findings can contribute to strategies for reducing missed opportunities for vaccination.     

广州市部分医疗机构锐器盒使用情况调查

目的了解广州市各级各类医疗机构锐器盒使用情况及其影响因素。方法采用抽样的方法,对广州市23家医疗机构的锐器盒及其431名护理人员进行调查。结果广州市各级各类医疗机构锐器盒总体情况一般,医院等级之间无显著差异,中医院锐器盒状况较西医院好。锐器盒的制作亟需改良完善,使其真正发挥防护效能。医疗机构及政府应重视加强对锐器盒的管理。     

口岸集装箱熏蒸效果评价研究

目的对集装箱熏蒸进行效果评价。方法采用模拟法,将受试鼠、蝇和蟑螂放入集装箱不同部位,按照规程要求对试验集装箱进行熏蒸,24 h后开箱散毒,记录受试媒介死亡情况,计算媒介杀灭率。结果应用硫酰氟对集装箱熏蒸24 h后,鼠、蝇和蟑螂的杀灭率均为100%,依据行标判定标准,熏蒸效果良好。结论现有的集装箱熏蒸方法满足口岸卫生处理要求。     

豆腐制硫黄过程中所产生的黑色物质成因初探

探讨了硫黄炮制过程中豆腐显黑绿色的原因,还对炮制过程中产生的使豆腐显黑绿色的物质进行了X衍射物相分析和化学定性分析,在此基础上对硫黄的炮制工艺、炮制容器等问题进行了讨论。     

入境集装箱携带媒介生物调查和处理

本文报道了经湛江口岸入境集装箱内携带媒介生物情况和处理方法。从检查来自19个国家和地区的1394个集装箱中,发现携带媒介生物的有258个,阳性率达18.51％。同时反映了不同国家和地区集装箱携带媒介生物率的差异有高度显著性(P<0.005);不同货物携带的媒介生物也有显著性差异(P<0.005)。重点探讨了入境的携带有媒介生物集装箱卫生处理方法。     

椭圆形封头的展开方法

用测地线与法截线相结合的方法,提出椭圆型封头曲面的展开模式,并建立了数学模型,为用计算机展开椭圆型封头曲面提供了途径。可以提高展开效率和精度,并使这种方法与[JB1154-73]标准相匹配。     

溴化甲烷熏蒸集装箱消杀灭效果实验研究

本课题以空集装箱为实验场所，研究了溴化甲烷熏蒸消毒、杀虫、灭鼠实验效果，其杀灭能力按杀灭小白鼠、德国小蠊成虫、德国小蠊卵荚、细菌繁殖体、细菌芽胞的顺序由大到小排列，所需剂量时间乘积相差200倍以上(10～2400g／h／m^3)；同时还分析了剂量为20g／m^3时溴化甲烷浓度时间乘积(CT值)与消毒效果之间的相关关系，并进行曲线拟合。建议采用低剂量、短时间熏蒸(20g／m^3。4h)进行杀虫、灭鼠也可取得较满意效果。     

SX－9207血小板袋保存血小板体外效果观察

用新型复合增塑剂制备血小板袋取代ＤＥＨＰ增塑剂，复合增塑剂能使ＰＣ贮存在透气性和酸碱性都较适宜的环境内。ＳＸ－９２０７血小板袋保存血小板５ｄ后，ｐＨ为７．１９±０．１８，血小板计数为（７８．７±９．６）％，低渗休克（ＨＳＲ）为（６３．３±８．７）％，聚集为（４５．５±２４．８）％，ＰＯ２为（１９．６±０．３）ｋＰａ，ＰＣＯ２为（１．４８±０．２４）ｋＰａ，亚显微结构显示形态好，与国际上具有代表性的ＰＬ－１２４０血小板专用袋处于同一水平。     

蒸制对酒萸肉微生物的影响

目的制订山茱萸蒸制容器,使酒萸肉微生物限度检查细菌数量低于1000个/g、霉菌数量低于100个/g。方法选择不同容器装载山茱萸,以微生物限度检查为指标,考察容器装载高度、蒸制温度、蒸制时间对酒萸肉微生物的影响,以选择合适的容器,制订合理的装载高度及蒸制温度、蒸制时间。结果与结论山茱萸拌酒后闷60 min,用不锈钢盘装山茱萸,高度2 cm,在蒸汽压力为0.001 Pa、温度为100℃时蒸制15 min、80℃烘干至水分低于4%,酒萸肉微生物限度检查细菌数量低于100个/g,霉菌数量低于10个/g,且生产周期合理,完全适用于大生产。     

垃圾容器蝇类孳生及其化学防治的研究

目的了解垃圾容器底垃圾残渣的蝇类孳生情况,探讨控制蝇蛆的有效措施。方法采用目测法,观察活蛆存在情况,进行分类鉴定;采用化学防治方法,观察控制效果。结果垃圾桶底的垃圾残渣中普遍有蝇幼虫孳生,平均孳生率为79.19%;其中残渣厚度在3 cm以上的,孳生率高达86.53%;优势蝇种为家蝇,占74.80%。结论垃圾日产日清后,垃圾容器底的垃圾残渣成为蝇类主要孳生场所,应列为防治的重点。