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Hemanthi

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  • Joined 7 years ago
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  • Hemanthi added a new resource to the Knowledge Hub
     Chemoprophylaxis and vaccination in preventing subsequent cases of meningococcal disease in household contacts of a case of meningococcal disease: a systematic review.
    Household contacts of an index case of invasive meningococcal disease (IMD) are at increased risk of acquiring disease. In revising WHO guidance on IMD in sub-Saharan Africa, a systematic review was undertaken to assess the effect of chemoprophylaxis and of vaccination in preventing subsequent cases of IMD in household contacts following an index case. A literature search for systematic reviews identified a single suitable review on chemoprophylaxis in 2004 (three studies meta-analysed). A search for primary research papers published since 2004 on chemoprophylaxis and without a date limit on vaccination was therefore undertaken. There were 2381 studies identified of which two additional studies met the inclusion criteria. The summary risk ratio for chemoprophylaxis vs. no chemoprophylaxis (four studies) in the 30-day period after a case was 0·16 [95% confidence interval (CI) 0·04-0·64, P = 0·008]; the number needed to treat to prevent one subsequent case was 200 (95% CI 111-1000). A single quasi-randomized trial assessed the role of vaccination. The risk ratio for vaccination vs. no vaccination at 30 days was 0·11 (95% CI 0·01-2·07, P = 0·14). The results support the use of chemoprophylaxis to prevent subsequent cases of IMD in household contacts of a case. Conclusions about the use of vaccination could not be drawn.
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  •  Electronic Immunization Registries in Tanzania and Zambia: Shaping a Minimum Viable Product for Scaled Solutions
    As part of the work the Better Immunization Data (BID) Initiative undertook starting in 2013
    to improve countries’ collection, quality, and use of immunization data, PATH partnered
    with countries to identify the critical requirements for an electronic immunization registry
    (EIR). An EIR became the core intervention to address the data...
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  • A white paper is available on Technet-21. To access them in English or French – please see below links:

     Harmonizing vaccination coverage measures in household surveys: A primer

    https://www.technet-21.org/en/?option=com_sobipro&sid=5300&pid=57&Itemid=2586

     Guide pour l’harmonisation des indicateurs de couverture vaccinale dans le cadre des enquêtes auprès des ménages

    https://www.technet-21.org/en/?coption=com_sobipro&sid=5301&pid=57&Itemid=2586

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  • Article above by Minal K Patel and Walter A Oreinstein - available here: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30492-3/fulltext

    Summary

    Background Despite improvements in reported coverage of measles-containing vaccine (MCV) and progress towards elimination of measles, 172 939 measles cases were reported worldwide in 2017. Questions have been raised about whether measles cases are due to failure of immunisation programmes or vaccine policy failure, which might require changes to vaccination schedules or number of doses.

    Methods This retrospective review of global surveillance data analysed case-based data for cases of measles occurring during 2013–17 submitted to WHO by its member states. Cases were classified as programmatically preventable(ie, did not receive the age-appropriate number of doses for that country) or programmatically non-preventable(ie, appropriately vaccinated as per national programme) on the basis of age at onset, year of birth,...

    Article above by Minal K Patel and Walter A Oreinstein - available here: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30492-3/fulltext

    Summary

    Background Despite improvements in reported coverage of measles-containing vaccine (MCV) and progress towards elimination of measles, 172 939 measles cases were reported worldwide in 2017. Questions have been raised about whether measles cases are due to failure of immunisation programmes or vaccine policy failure, which might require changes to vaccination schedules or number of doses.

    Methods This retrospective review of global surveillance data analysed case-based data for cases of measles occurring during 2013–17 submitted to WHO by its member states. Cases were classified as programmatically preventable(ie, did not receive the age-appropriate number of doses for that country) or programmatically non-preventable(ie, appropriately vaccinated as per national programme) on the basis of age at onset, year of birth, vaccination status,and eligibility for MCV doses in the country reporting the case. We grouped reasons why cases were non-preventableinto four categories as follows: (1) received at least two doses of MCV; (2) too young for first dose; (3) received one dose but was too young to receive the second; or (4) was only eligible for one dose according to the national schedule. We analysed numbers and proportions of preventable and non-preventable cases of measles by region and year, reasons for non-preventable cases by year, preventable cases by age group, and preventable and non-preventable cases,including reasons for non-preventable cases, by measles elimination status of countries.

    Findings Between Jan 1, 2013, and Dec 31, 2017, 634 139 measles cases were reported; 7850 (1%) cases were excluded because they did not provide age at onset, so 626 289 were included in our analysis. 191 333 (31%) of these cases had unknown vaccination status. 275 754 (63%) of the 434 956 cases with available vaccination data were categorised as programmatically preventable, 213 461 (77%) of whom were aged 1 year to less than 15 years. 156 384 (36%) cases were categorised as non-preventable, of whom 38 677 (25%) were two-dose vaccine recipients, 74 438 (48%) were too young to receive their first MCV dose, 11 914 (8%) received their first dose and were too young to receive their second dose,and 31 355 (20%), mostly in the Africa region, were non-preventable because they were only eligible for one dose onthe basis of the national immunisation programme.

    Interpretation Most measles cases during 2013–17 were programmatically preventable, highlighting the need for improving the effectiveness of immunisation programmes that already exist. Individual countries should do similar analyses to establish the changes needed in their country to decrease numbers of measles cases.

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  •   Alain Blaise Tatsinkou reacted to this post about 5 years ago
    Hemanthi started a new discussion, EPI Core Reference Materials
    EPI Core Reference Materials
    •   Data
    •   Monday, February 11 2019, 01:15 PM

    Sharing a summary table with important core EPI material with links and sorted by topic. Please note that this is for information only, and not an official WHO document.

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  • New materials are available on the "Coverage Surveys" page of TechNet-21 (https://www.technet-21.org/en/topics/vaccination-coverage-surveys) on the "17 Steps to do a Coverage Survey".

    This collection contains a series of documents & presentations outlining the basic steps of a vaccination coverage survey, as well as some presentations on commonly asked questions and variations on a coverage survey. This also contains links to resources (templates, models, examples, etc).

    This link takes you to the drop box folder with all the materials.

    https://www.dropbox.com/sh/96ho3ta1l2qo65s/AAAAcmmNryuBksMk7o5mcLEza?dl=0
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  • A new article Expenditures on vaccine-preventable disease surveillance: Analysis and evaluation of comprehensive multi-year plans (cMYPs) for immunization, recently published,  is available here: https://www.ncbi.nlm.nih.gov/pubmed/30236633

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  • The article Considerations for the development and implementation of electronic immunization registries in Africa, published this year, can be found here: https://www.ncbi.nlm.nih.gov/pubmed/30344865

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  • PAHO has released a new Article: Improving immunization data quality in Peru and Mexico: Two case studies highlighting challenges and lessons learned. Available here: https://www.sciencedirect.com/science/article/pii/S0264410X18314701?via%3Dihub

    Abstract

    Introduction

    The Global Vaccine Action Plan and the Regional Immunization Action Plan of the Americas call for countries to improve immunization data quality. Immunization information systems, particularly electronic immunization registries (EIRs), can help to facilitate program management and increase coverage. However, little is known about efforts to develop and implement such systems in low- and middle-income countries. We present the experiences of Mexico and Peru in implementing EIRs.

    Methods

    We conducted case studies of an EIR in Mexico and of a population registry in Peru. Information was gathered from technical documents, stakeholder focus groups, site visits, and semi-structured interviews of national stakeholders....

    PAHO has released a new Article: Improving immunization data quality in Peru and Mexico: Two case studies highlighting challenges and lessons learned. Available here: https://www.sciencedirect.com/science/article/pii/S0264410X18314701?via%3Dihub

    Abstract

    Introduction

    The Global Vaccine Action Plan and the Regional Immunization Action Plan of the Americas call for countries to improve immunization data quality. Immunization information systems, particularly electronic immunization registries (EIRs), can help to facilitate program management and increase coverage. However, little is known about efforts to develop and implement such systems in low- and middle-income countries. We present the experiences of Mexico and Peru in implementing EIRs.

    Methods

    We conducted case studies of an EIR in Mexico and of a population registry in Peru. Information was gathered from technical documents, stakeholder focus groups, site visits, and semi-structured interviews of national stakeholders. We organized findings into narratives that emphasized challenges and lessons learned.

    Results

    Mexico built one of the world’s first EIRs, incorporating novel features such as local-level tracking of patients; however, insufficient resources and poor data registration practices led to the system’s discontinuation. Peru created an information system to improve affiliation to social programs, including the immunization program and quality of demographic data. Mexico’s experience highlights lessons in failed sustainability of an EIR and a laudable effort to reform a country’s information system. Peru’s demonstrates that attempts to improve health and other data may strengthen health systems, including immunization data. Major challenges in information system implementation and sustainability in Peru and Mexico related to funding, clear governance structures, and resistance among health workers.

    Discussion

    These case studies reinforce the need for countries to ensure adequate funding, plans for sustainability, and health worker capacity-building activities before implementing EIRs. They also suggest new approaches to implementation, including economic incentives for sub-national administrative levels and opportunities to link efforts to improve immunization data with other health and political priorities. More information on best practices is needed to ensure the successful adoption and sustainability of immunization registries in low- and middle-income countries.

    Keywords

    • Electronic immunization registries
    • Immunization information systems
    • Immunization data
    • National immunization programs
    • Global vaccine action plan
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  • Hemanthi added a new resource to the Knowledge Hub
     A Review of Data Quality Assessment Methods for Public Health Information Systems
    High quality data and effective data quality assessment are required for accurately evaluating the impact of public health interventions and measuring public health outcomes. Data, data use, and data collection process, as the three dimensions of data quality, all need to be assessed for overall data quality assessment. We reviewed current data quality assessment methods. The relevant study was identified in major databases and well-known institutional websites. We found the dimension of data was most frequently assessed. Completeness, accuracy, and timeliness were the three most-used attributes among a total of 49 attributes of data quality. The major quantitative assessment methods were descriptive surveys and data audits, whereas the common qualitative assessment methods were interview and documentation review. The limitations of the reviewed studies included inattentiveness to data use and data collection process, inconsistency in the definition of attributes of data quality, failure to address data users’ concerns and a lack of systematic procedures in data quality assessment. This review study is limited by the coverage of the databases and the breadth of public health information systems. Further research could develop consistent data quality definitions and attributes. More research efforts should be given to assess the quality of data use and the quality of data collection process.
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  • Hemanthi added a new resource to the Knowledge Hub
     Cluster Lot Quality Assurance Sampling: Effect of Increasing the Number of Clusters on Classification Precision and Operational Feasibility
    ACKGROUND:
    To assess the quality of supplementary immunization activities (SIAs), the Global Polio Eradication Initiative (GPEI) has used cluster lot quality assurance sampling (C-LQAS) methods since 2009. However, since the inception of C-LQAS, questions have been raised about the optimal balance between operational feasibility and precision of classification of lots to identify areas with low SIA quality that require corrective programmatic action.
    METHODS:
    To determine if an increased precision in classification would result in differential programmatic decision making, we conducted a pilot evaluation in 4 local government areas (LGAs) in Nigeria with an expanded LQAS sample size of 16 clusters (instead of the standard 6 clusters) of 10 subjects each.
    RESULTS:
    The results showed greater heterogeneity between clusters than the assumed standard deviation of 10%, ranging from 12% to 23%. Comparing the distribution of 4-outcome classifications obtained from all possible combinations of 6-cluster subsamples to the observed classification of the 16-cluster sample, we obtained an exact match in classification in 56% to 85% of instances.
    CONCLUSIONS:
    We concluded that the 6-cluster C-LQAS provides acceptable classification precision for programmatic action. Considering the greater resources required to implement an expanded C-LQAS, the improvement in precision was deemed insufficient to warrant the effort.
    Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.
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