2009 Pandemic Influenza A Virus Subtype H1N1 Vaccination in Africa-Successes and Challenges
ABSTRACT To provide vaccination against infection due to 2009 pandemic influenza A virus subtype H1N1 (A[H1N1]pdm09) to resource-constrained countries with otherwise very little access to the A(H1N1)pdm09 vaccine, the World Health Organization (WHO) coordinated distribution of donated vaccine to selected countries worldwide, including those in Africa. From February through November 2010, 32.2 million doses were delivered to 34 countries in Africa. Of the 19.2 million doses delivered to countries that reported their vaccination activities to WHO, 12.2 million doses (64%) were administered. Population coverage in these countries varied from 0.4% to 11%, with a median coverage of 4%. All countries targeted pregnant women (median proportion of all vaccine doses administered [mpv], 21% [range, 4%-72%]) and healthcare workers (mpv, 9% [range, 1%-73%]). Fourteen of 19 countries targeted persons with chronic conditions (mpv, 26% [range, 5%-66%]) and 10 of 19 countries vaccinated children (mpv, 54% [range, 17%-75%]). Most vaccine was distributed after peak A(H1N1)pdm09 transmission in the region. The frequency and severity of adverse events were consistent with those recorded after other inactivated influenza vaccines. Pandemic preparedness plans will need to include strategies to ensure more-rapid procedures to identify vaccine supplies and distribute and import vaccines to countries that may bear the brunt of a future pandemic.
- The Journal of Infectious Diseases 12/2012; 206 Suppl 1:S1-4. DOI:10.1093/infdis/jis548 · 5.78 Impact Factor
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ABSTRACT: Background Although influenza surveillance has recently been improved in some sub-Saharan African countries, no information is yet available from Burkina Faso.Objectives Our study was the first to determine the prevalence of influenza viruses circulating in Burkina Faso through a sentinel surveillance system.Methods We conducted sentinel surveillance with oropharyngeal (OP) swabs collected from outpatients (1 month to 83 years) from six sites in Bobo-Dioulasso and Ouagadougou, among patients meeting the WHO/CDC case definition for influenza-like illness (ILI; fever ≥38°C, and cough and/or sore throat in the absence of other diagnosis) from July 2010 to May 2012. Influenza viruses were detected by real-time RT-PCR using CDC primers, probes, and protocols.ResultsThe first three ILI cases were enrolled each day; of 881 outpatients with ILI enrolled and sampled, 58 (6·6%) tested positive for influenza viruses (29 influenza A and 29 influenza B). Among the influenza A viruses, 55·2% (16/29) were influenza A (H1N1)pdm09 and 44·8% (13/29) were seasonal A (H3N2). No cases of seasonal A/H1N1 were detected. Patients within 0–5 years and 6–14 years were the most affected, comprising 41·4% and 22·4% laboratory-confirmed influenza cases, respectively. Influenza infections occurred during both the dry, dusty Harmattan months from November to March and the rainy season from June to October with peaks in January and August.Conclusions This surveillance was the first confirming the circulation of influenza A (H1N1)pdm09, A/H3N2, and influenza B viruses in humans in Burkina Faso.Influenza and Other Respiratory Viruses 06/2014; 8(5). DOI:10.1111/irv.12259 · 1.90 Impact Factor
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ABSTRACT: Influenza vaccine effectiveness (VE) and coverage data for sub-Saharan Africa are scarce. Using a test-negative case-control design, we estimated influenza VE annually amongst individuals with influenza-like illness presenting to an outpatient sentinel surveillance programme in South Africa from 2010-2013. A knowledge, attitudes and practices (KAP) influenza vaccine survey of programme clinicians was conducted in 2013. In total, 9420 patients were enrolled in surveillance of whom 5344 (56.7%) were included in the VE analysis: 2678 (50.1%) were classified as controls (influenza test-negative) and 2666 (49.9%) as cases (influenza test-positive). Mean annual influenza vaccine coverage among controls was 4.5% for the four years. Annual VE estimates adjusted for age, underlying medical conditions and seasonality for 2010-2013 were 54.2% (95% confidence interval (CI): 2.4% to 78.6%), 57.1% (95% CI: 15.5% to 78.2%), 38.4% (95% CI: -71.7% to 78.1%), and 87.2% (95% CI: 67.2% to 95.0%), respectively. The KAP survey showed that >90% of clinicians were familiar with the indications for and the benefits of influenza vaccination. Our study showed that the vaccine was significantly protective in 2010, 2011 and 2013, but not in 2012 when the circulating A(H3N2) strain showed genetic drift. Vaccine coverage was low despite good clinician knowledge of vaccination indications. Further studies are needed to investigate the reason for the low uptake of influenza vaccine.This article is protected by copyright. All rights reserved.Influenza and Other Respiratory Viruses 02/2015; 9(3). DOI:10.1111/irv.12305 · 1.90 Impact Factor