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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.
Tsitsi Juru
University of Zimbabwe College of Health Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3570-2331
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This work is licensed under a CC BY 4.0 License. Read Full License
Background: Three cases of adverse events following immunization (AEFI), in Chimanimani and Chipinge districts, were notified during their oral cholera vaccine (OCV) mass campaigns post-Cyclone Idai. However, the coverage survey uncovered 93 AEFI cases. We determined the reasons for the AEFI surveillance system under-reporting and assessed performance of the system
Methods: We conducted a surveillance system evaluation using the updated CDC guidelines for surveillance system evaluation. Fifty-seven health workers and 50 community members were randomly selected from 39 health facilities. We reviewed completed AEFI reporting forms to check for data quality, simplicity, completeness, and timeliness of the system. We used questionnaires to determine HCWs and community’s knowledge on the operations of the surveillance system. We used a health facility checklist to assess the system’s stability. Data were analysed to generate means and frequencies. Three-point Likert scales were used to rate health worker knowledge on the AEFI system.
Results: Reasons for under-reporting were community’s poor knowledge, perceiving adverse events as minor issues and fear of being blamed for causing adverse events by health workers. The community had poor knowledge with 27/50 (54%) answering at least one out of three questions correctly. The system had a low sensitivity of 3% and was unstable, 24/39 (62%) of the facilities relied on public transport.
Conclusion: Community’s poor knowledge on AEFI, occurrence of mild adverse events and fear of being blamed led to under-reporting. The system was neither stable nor sensitive. Community sensitization on AEFI were thus improved.
Keywords
Immunisation surveillance, cholera vaccine, Zimbabwe
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CURRENT STATUS: Under Review
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Posted 22 Sep, 2020
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Received 07 Dec, 2020
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On 05 Nov, 2020
Reviewers invited
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This preprint is under consideration at BMC Health Services Research. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
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.
Tsitsi Juru
University of Zimbabwe College of Health Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3570-2331
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 22 Sep, 2020
No community comments so far
Review #1 received
Received 07 Dec, 2020
Reviewer #1 agreed
On 05 Nov, 2020
Reviewers invited
Invitations sent on 30 Sep, 2020
Editor invited
On 17 Sep, 2020
Editor assigned
On 17 Sep, 2020
Submission checks complete
On 16 Sep, 2020
Version (no preprint)
Posted 24 Aug, 2020
This version was not preprinted
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Three cases of adverse events following immunization (AEFI), in Chimanimani and Chipinge districts, were notified during their oral cholera vaccine (OCV) mass campaigns post-Cyclone Idai. However, the coverage survey uncovered 93 AEFI cases. We determined the reasons for the AEFI surveillance system under-reporting and assessed performance of the system
Methods: We conducted a surveillance system evaluation using the updated CDC guidelines for surveillance system evaluation. Fifty-seven health workers and 50 community members were randomly selected from 39 health facilities. We reviewed completed AEFI reporting forms to check for data quality, simplicity, completeness, and timeliness of the system. We used questionnaires to determine HCWs and community’s knowledge on the operations of the surveillance system. We used a health facility checklist to assess the system’s stability. Data were analysed to generate means and frequencies. Three-point Likert scales were used to rate health worker knowledge on the AEFI system.
Results: Reasons for under-reporting were community’s poor knowledge, perceiving adverse events as minor issues and fear of being blamed for causing adverse events by health workers. The community had poor knowledge with 27/50 (54%) answering at least one out of three questions correctly. The system had a low sensitivity of 3% and was unstable, 24/39 (62%) of the facilities relied on public transport.
Conclusion: Community’s poor knowledge on AEFI, occurrence of mild adverse events and fear of being blamed led to under-reporting. The system was neither stable nor sensitive. Community sensitization on AEFI were thus improved.
Figure 1
Figure 2