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Open Access Influence of the 2014–2015 Ebola outbreak on the vaccination of children in a rural district of Guinea

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Setting: All health centres in Macenta District, rural Guinea.

Objective: To compare stock-outs of vaccines, vaccine stock cards and the administration of various childhood vaccines across the pre-Ebola, Ebola and post-Ebola virus disease periods.

Design: This was an ecological study.

Results: Similar levels of stock-outs were observed for all vaccines (bacille Calmette–Guérin [BCG], pentavalent, polio, measles, yellow fever) in the pre-Ebola and Ebola periods (respectively 2760 and 2706 facility days of stock-outs), with some variation by vaccine. Post-Ebola, there was a 65-fold reduction in stock-outs compared to pre-Ebola. Overall, 24 facility-months of vaccine stock card stock-outs were observed during the pre-Ebola period, which increased to 65 facility-months of stock-outs during the Ebola outbreak period; no such stock-out occurred in the post-Ebola period. Apart from yellow fever and measles, vaccine administration declined universally during the peak outbreak period (August–November 2014). Complete cessation of vaccine administration for BCG and a prominent low for polio (86% decrease) were observed in April 2014, corresponding to vaccine stock-outs. Post-Ebola, overall vaccine administration did not recover to pre-Ebola levels, with the highest gaps seen in polio and pentavalent vaccines, which had shortages of respectively 40% and 38%.

Conclusion: These findings highlight the need to sustain vaccination activities in Guinea so that they remain resilient and responsive, irrespective of disease outbreaks.
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Keywords: SORT IT; health service utilisation; health systems strengthening; operational research; prevention

Document Type: Research Article

Affiliations: 1: Department of Public Health, Gamal University of Conakry, Conakry, Guinea 2: Department of Public Health, Gamal University of Conakry, Conakry, Guinea, Woman and Child Health Research Centre, Institute of Tropical Medicine, Antwerp, Belgium 3: University of Gondar, Gondar, Ethiopia 4: Bixby Center for Global Reproductive Health, University of California, San Francisco, California, USA 5: Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forecariah, Guinea 6: International Union Against Tuberculosis and Lung Disease, Paris, France 7: Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan 8: Department of Gynecology-Obstetrics, Gamal University of Conakry, Conakry, Guinea 9: Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium 10: Médecins Sans Frontières, Brussels Operational Centre (LuxOR), Luxembourg

Publication date: June 21, 2017

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  • Public Health Action (PHA), The Union's quarterly open access on-line journal, provides a platform for its mission 'Health solutions for the poor'. PHA addresses the need for show-casing operational research that addresses issues in health systems and services. It publishes high-quality scientific research that provides new knowledge to improve access, equity, quality and efficiency of health systems and services.

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