A locally initiated and executed measles outbreak response immunization campaign in the nylon health district, Douala Cameroon 2011

Abstract

The Cameroon health system is divided into central, intermediate and peripheral levels. Of the 43 health districts with a measles outbreak in Cameroon in 2011, only the Nylon Health District organized a documented outbreak response immunization. We present the methods and results of the response campaign solely shouldered by the district and intermediate level. The risk group, targets and neighborhoods to be vaccinated were identified after a detailed analysis of initial cases. The intermediate level defined strategies, provided logistics, capacity building and 41% of the operational budget while 59% was completed by the peripheral level. Microsoft Office Excel 2007 was used to estimate coverage rates and to draw an epidemic curve. The response immunization campaign was organized on the 14th epidemiological week, 10 weeks after the onset of the outbreak which ended 11 weeks thereafter. A total of 15867(108.5%) children aged 9-59 months were vaccinated in five health areas at a direct cost (vaccines excluded) of 71.34FCFA ($0.143) per vaccinated child. An additional 824 children aged 9-59 months were vaccinated around the residence of notified cases in neighborhoods which were not involved in the response campaign. The number of cases after the response campaign was lower than before. Once vaccines are available, prompt outbreak response campaigns can be organized at operational level to obtain commendable results instead of depending solely on international organizations or central levels. Decision makers at the intermediate and operational levels should redeploy available funds during emergencies to prevent the development of extreme public health conditions.

A Systematic Review of the Incremental Costs of Implementing a New Vaccine in the Expanded Program of Immunization in Sub-Saharan Africa

“…The results regarding the proportion of the total cost per dose accounted for by each cost category are based on the studies for which these data were available. Sixteen of the 58 articles do not report any data on cost categories, 9,22,23,25,28,35,37,38,40,41,44–49 and one study only provides details on transportation, representing 17% of the total cost per dose. 50 Table 4 presents the number of data points for each cost category and its average proportion of the cost per dose based on the available data (Note: the average proportions are not supposed to sum to 100 across the cost categories due to the gaps in the reporting of categories).…”

Systematic Review of Health Economic Analyses of Measles and Rubella Immunization Interventions

“…After review of papers, we further excluded 39 studies that focused on cost minimization for strategies related to: screening of health‐care workers, women of child‐bearing age (for rubella), military recruits, college students, children prior to revaccination, or students before school entry; communications and other measures to encourage vaccination; alternative delivery or vaccine presentations (including hypothetical options); treatment; and different screening tests . We also excluded 13 papers that reported costs only for outbreaks (including any outbreak response efforts that occurred) without analysis of a comparator . In addition, we excluded 14 studies that presented theoretical economic analyses, including early efforts to explore the dynamics of rubella, the first analysis to demonstrate the importance of using a dynamic model in CEA, several analyses that explored game‐theoretic aspects, and a study providing a generic tool for measles CEAs …”

Burden of vaccine-preventable diseases, trends in vaccine coverage and current challenges in the implementation of the expanded program on immunization: A situation analysis of Cameroon

“… 20 , 21 , 24 In 2010, 10 health districts in the northern part of the country reported measles outbreaks with over 800 cases and a case fatality of 2%. 25 In 2012, about 43 (25%) of the 173 health districts in the country had a measles outbreak, with over 14000 cases reported. 25 In 2015, a locality in the Northwest region recorded 223 measles cases with a case fatality of 9%.…”

“… 25 In 2012, about 43 (25%) of the 173 health districts in the country had a measles outbreak, with over 14000 cases reported. 25 In 2015, a locality in the Northwest region recorded 223 measles cases with a case fatality of 9%. 26 Furthermore, a model of the incidence pattern of measles across the country revealed that the three northernmost regions experience major epidemics every year, while the southern regions show evidence of experiencing major epidemics every third year.…”