In Rwanda, HPV vaccine introduction through a new school-based delivery program provided the opportunity to offer additional health services to all school-children (girls and boys), including health promotion sessions, de-worming and opportunities for voluntary, free circumcision.
Africa
A strong national immunization program can be leveraged during health emergencies
The Government of Nigeria used the Incident Management System (IMS) to establish a national Emergency Operations Center (EOC) as part of a new national emergency plan for the global polio eradication initiative. The use of IMS through the EOC changed the operational tempo, accountability measures, and programmatic success of the polio program. This existing infrastructure was in place and leveraged to contain the outbreak of Ebola.
Diarrhea is associated with pneumonia in undernourished children
In a recent review of data from developing countries, researchers found that episodes of diarrhea may predispose undernourished children to pneumonia.
Undernourished children have a higher likelihood for diarrhea and pneumonia but immunization can improve infant growth
Multiple studies show that
- Diarrhea and pneumonia impair children’s growth and that underlying malnutrition is a major risk factor for these conditions.
- “Episodes of diarrhea may predispose to pneumonia in undernourished children” and
- Immunization against influenza (in mothers) and Streptococcus pneumoniae may improve infant growth. In addition, new studies from Bangladesh, Colombia, Ghana, and Israel further support the paradigm that malnutrition is a key risk factor for diarrhea and pneumonia.
Vaccines are most cost-effective in low income countries
An analysis of the impact of rotavirus vaccine in 25 countries found that the rates of vaccination in all countries were highest and risk mortality lowest in the top two wealth quintile’s coverage. Countries differed in the relative inequities in these two underlying variables. Cost per DALYs averted in substantially greater in the higher quintiles. In all countries, the greatest potential vaccine benefit was in the poorest quintiles; however, reduced vaccination coverage lowered the projected vaccine benefit.
Pediatric pneumococcal or Hib meningitis surviviors had a higher likelihood for neuropsychological deficits
In a systematic literature review of studies in Africa, it was found that 25% of children who survived pneumococcal or Hib meningitis had neuropsychological deficits.
Bacterial meningitis is associated with long-term neurophysiological impacts
A systematic literature review analyzing data from 21 African countries revealed that bacterial meningitis is associated with high case fatality and frequent neurophysiological sequelae. Pneumococcal and Hib meningitis contribute to one third of disease related mortality. They also cause clinically evident sequalae in 25% of survivors prior to hospital discharge. The three main causes of bacterial meningitis- Haemophilus influenzae type B; Streptococcus pneumoniae (pneumococcus) and Neisseria meningitidis (meningococcus) are vaccine preventable, routine use of conjugate vaccines have potential for significant health and economic benefits.
Neuropsychological sequelae includes hearing loss, vision loss, cognitive delay, speech/language disorder, behavioural problems, motor delays/impairment, and seizures.
Children with sickle cell disease stand to benefit enormously from PCV and Hib immunization
Nearly a quarter of a million children are born with sickle cell disease in Africa each year. Sickle cell disease was found to increase the risk of Hib infections by 13-fold and pneumococcal infections by 36 fold. This means that children with sickle cell disease stand to benefit enormously from PCV and Hib immunization.
Introduction of rotavirus vaccine also benefited the health of older children who were ineligible for vaccination
In Rwanda, the number of hospital admissions for diarrhea and rotavirus fell substantially after rotavirus vaccine (RVV) introduction, including among older children age-ineligible for vaccination. This suggests indirect protection through reduced transmission of rotavirus. Two years after RVV introduction, the country had nearly 400 fewer hospital admissions for diarrhea among young children.
Rotavirus introduction reduced hospital admissions for young children
Two years after rotavirus vaccine introduction in Rwanda, the country saw nearly 400 fewer hospital admissions for diarrhea among young children at 24 district hospitals.