Evaluation of the adverse events following immunization surveillance system in Guruve District, Mashonaland Central 2017

Abstract

Introduction An adverse event following immunisation is any untoward medical occurrence which follows vaccination. Frequency of adverse events ranges from 13% to 34% and they should be reported regardless of severity. From the beginning of 2016 to mid-2017, Guruve district in Zimbabwe did not report any AEFIs. This suggests the surveillance system may be failing to detect adverse events. We therefore evaluated the AEFI surveillance system in Guruve district. Methods We conducted a surveillance system evaluation using the updated Centers for Disease Control guidelines for evaluating public health surveillance systems. We interviewed health workers and caregivers of babies under 2 years in Guruve district. We also reviewed all records on AEFI surveillance for the period of January 2016 to November 2017. Results We recruited 31 health workers and 33 caregivers into the study. Between January 2016 and mid-2017, 39% of the caregivers had children who had suffered AEFIs and 45% of the health workers had encountered AEFIs but none had been notified. The main reasons for failure to report AEFIs included health workers' fear of personal consequences and caregivers thinking that an adverse event was not serious enough to report. Knowledge of the surveillance system was good amongst the majority of health workers. All the resources needed by the surveillance system were available. Conclusion We concluded that health workers in Guruve district were afraid to report adverse events following immunization and caregivers were reluctant to report mild adverse events hence the surveillance system was performing poorly and was not useful. However, the stability of the system and the good knowledge gives a good foundation for improving the surveillance system.

An Evaluation of the Adverse Events Following Immunization Surveillance System: A Case of the Oral Cholera Vaccine Mass Campaign, Chimanimani and Chipinge Districts, Zimbabwe, 2019.

“…The low sensitivity might also be due to HCWs' lack of knowledge as well as inadequate community sensitization. Consistent with ndings by Constantine et al 2018, who showed that inadequate community sensitization and staff training led to a low sensitivity of the AEFISS [17]. Hence there is a need for staff training to promote a high sense of vigilance [6].…”

“…Our study showed that the sensitivity of AEFISS in both districts was low. This was attributed to the passive nature of the system which relies on voluntary reporting [11,[16][17][18]. The low sensitivity might also be due to HCWs' lack of knowledge as well as inadequate community sensitization.…”

Evaluation of the adverse events following immunization surveillance system, Ghana, 2019

“…This is because the system is heavily reliant on voluntary reporting by caregivers and most of these caregivers were not reporting to the facilities. This may be because caregivers were not educated enough to know that they have to report these events, as found in a study by Constantine et al [ 3 ]. However, Chimusoro et al, had contrary findings where though caregivers had good knowledge on the surveillance system, they still did not report [ 16 ].…”

“…The adverse event may be any unfavorable or unintended sign, abnormal laboratory finding, symptom or disease. AEFIs may range from mild reactions such as fever or rash to severe reactions such as convulsions, coma and even death [ 3 ]. Based on the outcome of the event, the World Health Organization (WHO) has classified AEFIs as Serious and Non-serious which is used for regulatory classification.…”

“…Meanwhile, only half (51%) of the countries in the WHO African Region, reported AEFI cases in 2015, and the region recorded one of the lowest case reporting rates of 74 AEFIs per 100,000 surviving infants [ 11 ]. Studies done in some African countries have also reported incidence of AEFI ranging from 13 to 34% [ 3 , 12 ].…”