Use of administrative data to estimate mass vaccination campaign coverage,Burkina Faso, 1999

Administrative coverage data are commonly used to assess coverage of mass vaccination campaigns. These estimates are obtained by dividing the number of doses administered by the number of children of eligible age, usually at the health district level. This study used data from a cluster survey conducted in each of the 53 Burkina Faso health districts immediately after 1999 the National Immunization Days to assess whether administrative estimates correlated with those obtained through survey and whether the former identified districts that achieved suboptimal coverage as measured by cluster survey. During the first round of the campaign there was no significant correlation between data obtained by either method. The correlation was only marginally better during the second round. Although useful to help plan the logistics of a campaign, administrative coverage data should be used with other evaluation techniques in order to determine the number of eligible children vaccinated during a mass campaign.     

Measles incidence before and after mass vaccination campaigns in Burkina Faso

Burkina Faso conducted mass measles vaccination campaigns among children aged 9 months to 4 years during December 1998 and December 1999. The 1998 campaign was limited to six cities and towns, while the 1999 campaign was nationwide. The last year of explosive measles activity in Burkina Faso was 1996. Measles surveillance data suggest that the 1998 urban campaigns did not significantly impact measles incidence. After the 1999 national campaign, the total case count decreased during 2000 and 2001. However, 68% of measles cases occurred among children aged 5 years or older who were not included in the mass vaccination strategy. During 2000 and 2001, areas with high measles incidence were characterized by low population density and presence of mobile and poor populations. Measles control strategies in Sahelian Africa must balance incomplete impact on virus circulation with cost of more aggressive strategies that include older age groups.     

Stabilization of HIV infection rates in urban Burkina Faso, 1995-1999

The objectives of this study were to monitor the trends of the HIV epidemic between 1995 and 1999 among pregnant women in Bobo-Dioulasso, the second largest town of Burkina Faso, and to discuss the possible effect of preventive interventions (condom availability) on sexual transmission of HIV in this context. Age-specific trends in HIV prevalence obtained from sentinel surveillance programme were analysed. Among antenatal clinic attendees, HIV prevalence was 7.5% (n=401) in 1995, 10% (n=200) in 1996, 7.6% (n=448) in 1997, 8.4% (n=642) in 1998 and 5.3% (n=716) in 1999 without demonstrated temporal trend (P=0.12). The average number of condoms available per person (aged 15-49 years) per year increased from 0.6 in 1992 to 5.7 in 1995 and 6.0 in 1999. Anonymous surveys are less subject to selection bias and suggest a stabilization of the HIV prevalence around 7.3% in Bobo-Dioulasso. Distribution of condoms could explain at least, partly, this stabilization of the HIV epidemic.     

Antiretroviral use in Ouagadougou, Burkina Faso

Burkina Faso has the second highest seroprevalence rate for HIV in West Africa, estimated at 6.5% of the population. Although it is one of the poorest countries in the world, antiretrovirals have been used on an extremely limited basis in Burkina Faso since at least the early 1990s. In this article we will review the evolution of antiretroviral availability in this country, describe the mechanisms by which drugs are being accessed, and review our experience with expanding antiretroviral access through drug donations in community-based settings. Finally, we will discuss some of the implications for future attempts to expand access to treatment for people living with HIV in Africa.     

Factors influencing participation in national immunization days in Kumasi, Ghana

A study of the factors influencing participation in national immunization days (NID) in Kumasi, Ghana was carried out between the April and June of 1999. Polio-immunization coverage during NID was assessed among children aged < 5 years; > 90% of these children had received polio vaccinations on both of the two previous NID. The mothers who participated most in the NID tended to be those who were better educated and Ghanaian. Mothers who were salaried workers participated fully in NID. Radio and television played a major role in public education about NID, whereas the attitude of health workers was a strong factor that prevented many mothers/caregivers from bringing their children to be immunized. The coverage of the Expanded Programme on Immunization (EPI) was assessed in children aged 12-23 months; nearly 70% of these children were fully immunized. BCG had the highest coverage (97.0%) and measles the lowest (79%). Again, full coverage of the children of mothers who had been educated beyond primary level was higher than that of the other children (75.9% v. 65.2%), and coverage of the children of Ghanaian women was higher than that of the others (70.8%. v. 50.0%). Although the mothers/caregivers raised concerns about the costs of the routine immunizations, these charges apparently did not prevent them from taking their children to be immunized. NID complement the routine EPI-associated work in Ghana, increasing overall polio-immunization coverage. The results of this study will be used to improve the overall performance of immunization programmes, especially in the Kumasi metropolis. Hopefully, sustained, increased polio-immunization coverage will contribute positively towards polio eradication in Ghana.     

Italy s new vaccination schedule reduced coverage of poliomyelitis vaccine in Naples

Italy s health ministry introduced changes to the immunisation schedules for children on 7 April 1999, including immunisation against poliomyelitis. The changes included the replacement of the first two childhood doses of oral poliomyelitis vaccine (OPV)     

Evaluation of the cold chain during the national antipoliomyelitis vaccination days. Mexico, 1987-1988

An evaluation of the cold chain used during the "National Vaccination Days Against Poliomyelitis" in January and March of 1987 and 1988 was performed in 32 states of Mexico, both the potency of the trivalent Sabin vaccine and completion of requirements for the maintenance of the cold chain were evaluated at each level in the Ministry of Health's structure. Only 56 percent of the refrigeration units exclusively stored vaccines, more than 10 percent of refrigerators were broken, and 44 percent of the persons responsible for the cold chain system considered the storage capacity inadequate. A correlation was found between non-fulfillment of maintenance requirements for cold chain and a decreased in vaccine potency.     

Birthweight distribution in rural North-West Burkina Faso

Summary Two thousand and twenty-six delivery records from 1987 to 1989 in 5 rural health units in North Western Burkina Faso were analysed. The mean birthweight was 2899 g, with an overall incidence of low birthweight of 9.3%. Increasing birth order from 1 to 3 was associated with increasing birthweight; for birth orders >3, birthweight was relatively constant. There is a marked seasonal variation in birthweight, with a decrease in the rainy season and an increase during the dry season. These findings are compared with other African populations. The anthropometric measurements of these newborns were slightly lower than standards from industrialized North America.     

Measles incidence, vaccine efficacy, and mortality in two urban African areas with high vaccination coverage

Measles incidence, vaccine efficacy, and mortality were examined prospectively in two districts in Bissau where vaccine coverage for children aged 12-23 months was 81% (Bandim 1) and 61% (Bandim 2). There was little difference in cumulative measles incidence before 9 months of age (6.1% and 7.6%, respectively). Between 9 months and 2 years of age, however, 6.1% contracted measles in Bandim 1 and 13.7% in Bandim 2. Even adjusting for vaccination status, incidence was significantly higher in Bandim 2 (relative risk 1.6, P = .04). Even though 95% of the children had measles antibodies after vaccination, vaccine efficacy was not more than 68% (95% confidence interval [CI] 39%-84%) and was unrelated to age at vaccination. Unvaccinated children had a mortality hazard ratio of 3.0 compared with vaccinated children (P = .002), indicating a protective efficacy against death of 66% (CI 32%-83%) of measles vaccination. These data suggest that it will be necessary to vaccinate before age 9 months to control measles in hyperendemic urban African areas.     

Malnutrition in young children of rural Burkina Faso: comparison of survey data from 1999 with 2009

Objective For measurement of progress towards the Millennium Development Goal (MDG) 1, reliable data on nutrition indicators of specific countries are essential. Malnutrition is also the main determinant for childhood mortality, which is addressed in MDG 4. Methods In the health and demographic surveillance area of Kossi Province in north‐western Burkina Faso, nutritional parameters were compared in two cohorts of young children of the same age range from eight villages. Surveys took place in June and December of the year 1999 and 2009. A multivariate model was used to control for confounding variables. Results For the 1999 study, data were analysed for 179 and 197 children who took part in the June and December survey respectively. In 2009, corresponding data were analysed for 460 and 409 children. Prevalence of underweight was highest in December 1999 (42.6%) and lowest in December 2009 (34.1%). After adjustment for age, sex and village, there was a slight but not always significant improvement in the z‐scores of weight‐for‐age, weight‐for‐length, length‐for‐age, and mid‐arm circumference over time. Conclusions The findings from this study confirm the still unacceptable high prevalence of malnutrition in young children of rural sub‐Saharan Africa (SSA). Progress in the reduction of malnutrition remains slow on this continent making it rather unlikely that the corresponding MDGs will be achieved. Large‐scale multi‐sectoral community‐based interventions are urgently needed for a sustainable improvement of child health in SSA.     

Measles immunization in Iran

Mass immunization with live measles vaccine has been carried out in rural Iran since 1968. Two strains have been used: primary baby calf kidney cell-adapted Sugiyama strain and human diploid cell-adapted AIK strain. More than 94% of the susceptible children experimentally vaccinated with either of the two vaccines have shown seroconversion. Mass immunization in rural regions has covered about 80% of susceptible children. It is now recommended that the live vaccine be administered twice: the first dose at six to nine months and the second at 12-15 months of age. In all of 100 cases of subacute sclerosing panencephalitis (SSPE) observed in the Tehran region between 1977 and 1982, the patient had a history of measles infection in childhood; there was no indication that SSPE developed after vaccination. Most of the patients with SSPE have had a high titer of antibody to measles virus in serum and cerebrospinal fluid, and antibody has commonly been demonstrated in saliva as well.     

Epidemiology of HIV infection in urban Burkina Faso

We conducted a cross-sectional study of sexually transmitted disease and HIV infections among a random sample of the 2364 adult population in 2000 in Bobo-Dioulasso, the second largest town in Burkina Faso. The prevalence of HIV infection was 5.2%. Risk factor analysis was conducted among sexually active men 20 to 34 years old and women 15 to 24 years old. Factors independently associated with HIV infection among men were having been married (adjusted odds ratio (aOR)=8.19 [1.70-39]), reporting more than two non-marital partners in the last 12 months (aOR=6.07 [1.14-32.4]), reporting a past urban residence other than Bobo-Dioulasso (aOR =6.37 [1.96-20.7] and having a positive serology for HSV-2 infection (aOR=12.0 [3.49-40.9]). Among women the factors were being Christian (aOR=3.73 [1.20-11.6]), having had a first sexual partner more than 24 years old (aOR =4.30 [1.35-13.6]) and having a positive serology for HSV-2 infection (aOR =4.40 [1.32-14.6]). HIV infection in Bobo-Dioulasso therefore depends on both exposure factors (sexual behaviours) and transmissibility cofactors (HSV-2).     

Mobility and HIV-Related Sexual Behavior in Burkina Faso

This study compared HIV-related sexual behavior among mobile and non-mobile populations in Burkina Faso and identified venues where HIV/AIDS interventions targeting mobile individuals should be implemented. Men (N = 940) and women (N = 430) responded to a sexual behavior survey while socializing at venues where people meet sexual partners in eight Burkina Faso villages. Mobile women were more likely than non-mobile women to report new sexual partnerships (adjusted prevalence odds ratio (POR): 2.07, 95% confidence interval (CI): 1.19-3.59) and transactional sex (adjusted POR: 2.30, 95% CI: 1.55-3.42) in the past month. Mobility was most common and associations between mobility and sexual partnership levels were particularly strong among women interviewed in urban commercial towns situated near international borders. Mobile women were most likely to be interviewed at venues such as bars and clubs, making these appropriate locations for HIV/AIDS interventions. Mobility was not associated with HIV-related sexual behaviors among men.     

Genomic Epidemiology of SARS-CoV-2 in Western Burkina Faso,West Africa

Background: After its initial detection in Wuhan, China, in December 2019, SARS-CoV-2 has spread rapidly, causing successive epidemic waves worldwide. This study aims to provide a genomic epidemiology of SARS-CoV-2 in Burkina Faso. Methods: Three hundred and seventy-seven SARS-CoV-2 genomes obtained from PCR-positive nasopharyngeal samples (PCR cycle threshold score < 35) collected between 5 May 2020, and 31 January 2022 were analyzed. Genomic sequences were assigned to phylogenetic clades using NextClade and to Pango lineages using pangolin. Phylogenetic and phylogeographic analyses were performed to determine the geographical sources and time of virus introduction in Burkina Faso. Results: The analyzed SARS-CoV-2 genomes can be assigned to 10 phylogenetic clades and 27 Pango lineages already described worldwide. Our analyses revealed the important role of cross-border human mobility in the successive SARS-CoV-2 introductions in Burkina Faso from neighboring countries. Conclusions: This study provides additional insights into the genomic epidemiology of SARS-CoV-2 in West Africa. It highlights the importance of land travel in the spread of the virus and the need to rapidly implement preventive policies. Regional cross-border collaborations and the adherence of the general population to government policies are key to prevent new epidemic waves.     

Causes of low attendance at national immunization days for polio eradication in Bushenyi district, Uganda

The purpose of this study was to investigate the factors influencing attendance for polio National Immunization Days (NIDs) using the Attitudes-Social-influence-self-Efficacy (ASE) model as a guiding theoretical framework. The data was collected in Bushenyi district of south-western Uganda in 6 focus group discussions about outcomes of attendance at NIDs, about who decides on attendance, and about attendance barriers and supports. The purpose of NIDs - eradicating polio - was not known to the informants. The main reason mentioned for attending NIDs and other immunization was to weaken childhood diseases or to strengthen the children's capability in fighting diseases, whether they are immunizable or not. However, it was strongly believed that the previous NIDs had caused a severe malaria epidemic with a very high mortality, and this led to most parents not attending the next. Sources of social influence were mostly opinion and local leaders in communities, health workers, friends and relatives. Opinion leaders who did not immunize their children were said to hinder attendance at NIDs by other lay people. NIDs cards, on the other hand, were regarded as valuable means of support for attendance. Thus to improve immunization coverage, there is need for issuing NIDs cards, for using health education to change the belief that NIDs cause malaria, and to encourage local leaders to attend NIDs.     

Living with HIV: women's experience in Burkina Faso, West Africa

Our study aimed at studying HIV-infected women's experience with sharing serostatus with their partner and their group support. A survey was carried out among 79 seropositive women involved in a therapeutic trial in Bobo-Dioulasso, following freely consented prenatal HIV testing. The study revealed that women are reluctant to inform their partners and fear being stigmatized by relatives and friends. The major concern reported was health consequences and most women wished to receive care. The non-governmental organizations supporting people living with HIV were not known by these women, but providing this information raised a high interest and many women considered joining them soon and getting themselves involved. These community-based organizations, lead by qualified and highly motivated volunteers, could facilitate a better social integration of HIV infected women in Burkina Faso.