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Background There is growing interest and investment in electronic immunization registries (EIRs) in low- and middle-income countries. EIRs provide ready access to patient- and aggregate-level service delivery data that can be used to improve patient care, identify spatiotemporal trends in vaccination coverage and dropout, inform resource allocation and program operations, and target quality improvement measures. The Government of Tanzania introduced the Tanzania Immunization Registry (TImR) in 2017, and the system has since been rolled out in 3736 facilities in 15 regions. Objective The aims of this study are to conceptualize the additional ways in which EIRs can add value to immunization programs (beyond measuring vaccine coverage) and assess the potential value-add using EIR data from Tanzania as a case study. Methods This study comprised 2 sequential phases. First, a comprehensive list of ways EIRs can potentially add value to immunization programs was developed through stakeholder interviews. Second, the added value was evaluated using descriptive and regression analyses of TImR data for a prioritized subset of program needs. Results The analysis areas prioritized through stakeholder interviews were population movement, missed opportunities for vaccination (MOVs), continuum of care, and continuous quality improvement. The included TImR data comprised 958,870 visits for 559,542 patients from 2359 health facilities. Our analyses revealed that few patients sought care outside their assigned facility (44,733/810,568, 5.52% of applicable visits); however, this varied by region; facility urbanicity, type, ownership, patient volume, and duration of TImR system use; density of facilities in the immediate area; and patient age. Analyses further showed that MOVs were highest among children aged <12 months (215,576/831,018, 25.94% of visits included an MOV and were applicable visits); however, there were few significant differences based on other individual or facility characteristics. Nearly half (133,337/294,464, 45.28%) of the children aged 12 to 35 months were fully vaccinated or had received all doses except measles-containing vaccine–1 of the 14-dose under-12-month schedule (ie, through measles-containing vaccine–1), and facility and patient characteristics associated with dropout varied by vaccine. The continuous quality improvement analysis showed that most quality issues (eg, MOVs) were concentrated in <10% of facilities, indicating the potential for EIRs to target quality improvement efforts. Conclusions EIRs have the potential to add value to immunization stakeholders at all levels of the health system. Individual-level electronic data can enable new analyses to understand service delivery or care-seeking patterns, potential risk factors for underimmunization, and where challenges occur. However, to achieve this potential, country programs need to leverage and strengthen the capacity to collect, analyze, interpret, and act on the data. As EIRs are introduced and scaled in low- and middle-income countries, implementers and researchers should continue to share real-world examples and build an evidence base for how EIRs can add value to immunization programs, particularly for innovative uses.

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Studies estimate that a substantial proportion of SARS-CoV-2 transmission occurs through individuals who do not exhibit symptoms. Mitigation strategies test only those who are moderately to severely symptomatic, excluding the substantial portion of cases that are asymptomatic yet still infectious and likely responsible for a large proportion of the virus spread (1-8). While isolating asymptomatic cases will be necessary to effectively control viral spread, these cases are functionally invisible and there is no current method to identify them for isolation. To address this major omission in COVID-19 control, we develop a strategy, Sampling-Testing-Quarantine (STQ), for identifying and isolating individuals with asymptomatic SARS-CoV-2 in order to mitigate the epidemic. STQ uses probability sampling in the general population, regardless of symptoms, then isolates the individuals who test positive along with their household members who are high probability for asymptomatic infections. To test the potential efficacy of STQ, we use an agent-based model, designed to computationally simulate the epidemic in the Seattle with infection parameters, like R0 and asymptomatic fraction, derived from population data. Our results suggest that STQ can substantially slow and decrease the spread of COVID-19, even in the absence of school and work shutdowns. Results also recommend which sampling techniques, frequency of implementation, and population subject to isolation are most efficient in reducing spread with limited numbers of tests.

The objective of preformulation study is to develop the elegant, stable, effective and safe dosage form by establishing kinetic profile, compatibility with other formulation excipients and to establish physico-chemical parameter of new drug substance. This could provide important information for formulation design or support the need for molecular modification. So, in the present study preformulation studies were performed on Dolasetron (DS) to assess its suitability for nasal formulation. DS is a specific and selective serotonin subtypes 3 (5-HT) receptor antagonists, used to treat chemotherapy induced nausea and vomiting. The authenticity of DS was established by DSC and FITR spectra. An UV spectrophotometric method and HPLC method were employed for determination of DS in bulk and blood plasma respectively. Saturation solubility, micromeritical properties, melting point, pH, hygroscopicity and stability profile were studied. The UV method was linear in the range of 5-50 μg/ml. The low % CV values of intra-day and inter-day variations revealed that the proposed method is robust. The retention time of DS in HPLC method was found to be 2.8 min. The method was proven robust by obtaining very high regression coefficient value (0.999). The results of the physicochemical study of drug revealed suitability of DS for nasal route. Moreover, the drug was found stable in both solid as well as liquid state at different conditions.