Implementation of an outbreak response vaccination campaign with typhoid conjugate vaccine – Harare, Zimbabwe, 2019

Poncin, Marc; Marembo, Joan; Chitando, Phillomina; Sreenivasan, Nandini; Makwara, I.; Machekanyanga, Zorodzai; Nyabyenda, William; Mukeredzi, Innocent; Munyanyi, M.; Hidle, A.; Chingwena, Florence; Chigwena, Chriswell T; Atuhebwe, Phionah; Matzger, Helen; Chigerwe, R.; Shaum, Anna; Date, Kashmira; Garone, Daniela; Chonzi, Prosper; Barak, J.; Phiri, Issac; Rupfutse, Maxwell; Masunda, Kudzai; Gasasira, Alex; Manangazira, Portia

doi:10.1016/j.jvacx.2022.100201

Cited by 10 publications

(3 citation statements)

References 32 publications

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“…Around seven out of every ten people were living below the international poverty line and health status indicators were among the poorest in Sub-Saharan Africa [ 16 ]. Furthermore, in the years immediately preceding the COVID-19 pandemic, the health system experienced intermittent industrial action by nurses and doctors, a series of natural disasters, and outbreaks of cholera, typhoid and measles [ 78 ]. Although the government increased its budgets for healthcare and unfroze healthcare worker posts to help cope with the pandemic [ 40 ], the fragility of the health system also made it likely that lockdown measures would only further reduce both the supply and demand for healthcare [ 79 ].…”

Section: Discussionmentioning

confidence: 99%

Understanding the impact of the COVID-19 pandemic and its control measures on women and children: A Zimbabwe case study

Taruvinga,

Chingono,

Olaru

et al. 2024

Preprint

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COVID-19 presented countries with unprecedented health policy challenges. For low-income countries in particular, policymakers had to contend with both the direct threats posed by COVID-19 as well as the social, educational, and economic harms associated with lockdown and other infection prevention and control measures. We present a holistic and contextualised case study of the direct and indirect impacts of COVID-19 on women and children, with some assessment of their uneven distribution across socio-economic, age and gender groups. We used different types of primary and secondary data from multiple sources to produce a holistic descriptive analysis. Primary data included: qualitative data obtained from 28 in-depth interviews of key informants, six focus group discussions; and 40 household interviews. We also extracted data from government reports and announcements, the District Health Information Software version 2 (DHIS2), newspaper articles and social media, as well as from published research articles. Our findings show that the direct and indirect adverse impacts of COVID-19 were compounded by many years of severe political economic challenges, and consequent deterioration of the healthcare system. The indirect effects of the pandemic had the most severe impacts on the poorest segment of society and widened age and gender inequalities. The pandemic and its accompanying infection prevention and control measures negatively affected health service delivery and uptake. The management of COVID-19 presented enormous challenges to policymakers and public health specialists. These included managing the greatest tension between direct and indirect harms; short-term and long-term effects; and the unequal distribution of harms across different segments of society.

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Section: Discussionmentioning

confidence: 99%

Understanding the impact of the COVID-19 pandemic and its control measures on women and children: A Zimbabwe case study

Taruvinga,

Chingono,

Olaru

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Therefore, mandating vaccination needs to be carefully balanced with other interventions. It might be noted that historically, Zimbabwe achieved high vaccine uptake across different vaccination programs including Expanded Program on Immunization for children, typhoid conjugate vaccine (84.5% for children and adults and human papilloma virus vaccine (88–94%) for young adults [ 47 , 48 ]. Mandatory vaccine policies were not in place for these other vaccine-preventable diseases.…”

Section: Discussionmentioning

confidence: 99%

Exploring COVID-19 vaccine uptake among healthcare workers in Zimbabwe: A mixed methods study

Taruvinga,

Chingono,

Marambire

et al. 2023

PLOS Glob Public Health

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With COVID-19 no longer categorized as a public health emergency of international concern, vaccination strategies and priority groups for vaccination have evolved. Africa Centres for Diseases Prevention and Control proposed the ‘100-100-70%’ strategy which aims to vaccinate all healthcare workers, all vulnerable groups, and 70% of the general population. Understanding whether healthcare workers were reached during previous vaccination campaigns and what can be done to address concerns, anxieties, and other influences on vaccine uptake, will be important to optimally plan how to achieve these ambitious targets. In this mixed-methods study, between June 2021 and July 2022 a quantitative survey was conducted with healthcare workers accessing a comprehensive health check in Zimbabwe to determine whether and, if so, when they had received a COVID-19 vaccine. Healthcare workers were categorized as those who had received the vaccine ‘early’ (before 30.06.2021) and those who had received it ‘late’ (after 30.06.2021). In addition, 17 in-depth interviews were conducted to understand perceptions and beliefs about COVID-19 vaccines. Of the 3,086 healthcare workers employed at 43 facilities who participated in the study, 2,986 (97%, 95% CI [92%-100%]) reported that they had received at least one vaccine dose. Geographical location, older age, higher educational attainment and having a chronic condition was associated with receiving the vaccine early. Qualitatively, (mis)information, infection risk perception, quasi-mandatory vaccination requirements, and legitimate concerns such as safety and efficacy influenced vaccine uptake. Meeting the proposed 100-100-70 target entails continued emphasis on strong communication while engaging meaningfully with healthcare workers’ concerns. Mandatory vaccination may undermine trust and should not be a substitute for sustained engagement.

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“…In Pakistan and Zimbabwe, TCV immunisation campaigns have been deployed to help control XDR and ciprofloxacin-resistant S . Typhi outbreaks, respectively 16, 17 . These successful campaigns were followed by introduction of national typhoid immunisation programmes 18, 19 , which are now being considered by several other countries.…”

Section: Introductionmentioning

confidence: 99%

Genomic epidemiology and antimicrobial resistance transmission ofSalmonellaTyphi and Paratyphi A at three urban sites in Africa and Asia

Dyson

Ashton

Khanam

et al. 2023

Preprint

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Background: Enteric fever is a serious public health concern. The causative agents, Salmonella enterica serovars Typhi and Paratyphi A, are frequently antimicrobial resistant (AMR), leading to limited treatment options and poorer clinical outcomes. We investigated the genomic epidemiology, resistance mechanisms and transmission dynamics of these pathogens at three urban sites in Africa and Asia. Methods: Bacteria isolated from febrile children and adults at study sites in Dhaka, Kathmandu, and Blantyre were sequenced and AMR determinants identified. Phylogenomic analyses incorporating globally-representative genome data, and ancestral state reconstruction, were used to differentiate locally-circulating from imported pathogen variants. Findings: S. Paratyphi A was present in Dhaka and Kathmandu but not Blantyre. S. Typhi genotype 4.3.1 (H58) was common in all sites, but with different dominant variants (4.3.1.1.EA1 in Blantyre; 4.3.1.1 in Dhaka; 4.3.1.2 in Kathmandu). Resistance to first-line antimicrobials was common in Blantyre (98%) and Dhaka (32%) but not Kathmandu (1.4%). Quinolone-resistance mutations were common in Dhaka (99.8%) and Kathmandu (89%) but not Blantyre (2.1%). AcrB azithromycin-resistance mutations were rare (Dhaka only; n=5, 1.1%). Phylogenetic analyses showed that (a) most cases derived from pre-existing, locally-established pathogen variants; (b) nearly all (98%) drug-resistant infections resulted from local circulation of AMR variants, not imported variants or recent de novo emergence; (c) pathogen variants circulated across age groups. Most cases (67%) clustered with others that were indistinguishable by point mutations; individual clusters included multiple age groups and persisted for up to 2.3 years, and AMR determinants were invariant within clusters. Interpretation: Enteric fever was associated with locally-established pathogen variants that circulate across age groups. AMR infections resulted from local transmission of resistant strains. These results form a baseline against which to monitor the impacts of control measures.

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Implementation of an outbreak response vaccination campaign with typhoid conjugate vaccine – Harare, Zimbabwe, 2019

Cited by 10 publications

References 32 publications

Understanding the impact of the COVID-19 pandemic and its control measures on women and children: A Zimbabwe case study

Understanding the impact of the COVID-19 pandemic and its control measures on women and children: A Zimbabwe case study

Exploring COVID-19 vaccine uptake among healthcare workers in Zimbabwe: A mixed methods study

Genomic epidemiology and antimicrobial resistance transmission ofSalmonellaTyphi and Paratyphi A at three urban sites in Africa and Asia

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