A reactive campaign using two doses of Shanchol Oral Cholera Vaccine (OCV) was implemented in 2016 in the Lake Chilwa Region (Malawi) targeting fish dependent communities. Three strategies for the second vaccine dose delivery (including delivery by a community leader and self-administration) were used to facilitate vaccine access.This assessment collected vaccine perceptions and opinions about the OCV campaign of 313 study participants, including: fishermen, fish traders, farmers, community leaders, and one health and one NGO officer. Socio-demographic surveys were conducted, In Depth Interviews and Focus Group Discussions were conducted before and during the campaign.Some fishermen perceived the traditional delivery strategy as reliable but less practical. Delivery by traditional leaders was acceptable for some participants while others worried about traditional leaders not being trained to deliver vaccines or beneficiaries taking doses on their own. A slight majority of beneficiaries considered the self-administration strategy practical while some beneficiaries worried about storing vials outside of the cold chain or losing vials. During the campaign, a majority of participants preferred receiving oral vaccines instead of injections given ease of intake and lack of pain. OCV was perceived as efficacious and safe. However, a lack of information on how sero-protection may be delayed and the degree of sero-protection led to loss of trust in vaccine potency among some participants who witnessed cholera cases among vaccinated individuals.OCV campaign implementation requires accompanying communication on protective levels, less than 100% vaccine efficacy, delays in onset of sero-protection, and out of cold chain storage.

and Haselbeck A ( ) Madagascar's EPI vaccine programs: A systematic review uncovering the role of a child's sex and other barriers to vaccination.

BackgroundThe Rabies lyssavirus is one of 16 species of the Lyssavirus genus causing fatal encephalomyelitis in humans. Infection usually occurs after a bite by an infected mammal. More than 99% of human rabies deaths worldwide are caused by a canine rabies with children at highest risk of infection. Although rabies has been endemic in the region of Mahajanga in Madagascar for a long time, research evaluating the current situation is still scarce. Here, we conducted a cross-sectional study to describe the dog demography and a survey of dog owners to evaluate rabies vaccination coverage, disease knowledge and measures taken in the districts against rabies in order to inform future interventions in the urban district of Mahajanga in the North West of Madagascar.ResultsA total of 400 dogs were recorded, of which 338 (84.5%) were owned. The vaccine coverage against rabies was at 34.4% (116/338). The reported key barriers to vaccination were lack of financial resources and the lack of geographic access to veterinary services. The transmission route of rabies being dog bites was known to 85.4% of the surveyed dog owners (105/123). Out of 19 reported dog bites, 13 were caused by the owner`s or the neighbour’s dog. 6 out of 19 cases affected children between 7 and 15 years of age. ConclusionMost of the dogs in the urban district of Mahajanga are accessible for preventive vaccination through their owners, but less than one third of the canine population is vaccinated against rabies. Assuming that stray dogs are not vaccinated against rabies, Mahajanga is far from reaching the 70% coverage believed to minimise the spread of the disease. The prioritization of dog owner education, school campaigns that sensitize children on the interactions with dogs and vaccination campaigns for owned dogs in collaboration with local veterinary services has shown success in other settings in Africa and will be crucial for future rabies eradication in Madagascar.