Berhane Y, Demissie M
Department of Community Health, Faculty of Medicine, Addis Ababa University, P.O. Box 2077, Addis Ababa, Ethiopia.
East Afr Med J. 2000 Sep;77(9):476-9. doi: 10.4314/eamj.v77i9.46692.
Child immunisation is among the most cost-effective ways of preventing premature child deaths, and the potency of vaccines, crucial for vaccine efficacy, is dependent on effective management of the cold chain at all levels of vaccine handling.
To assess the status of the cold chain at peripheral vaccine stores in Ethiopia.
Institution based cross-sectional survey in two rural and one urban administrative areas were included in the study. Sixty seven health institutions providing static vaccination services were included in the study but cold chain system was assessed fully in only sixty four. Data were collected by interviewing health workers and by directly observing the cold chain equipment and records using structured forms.
Conditions of the cold chain system were described based on 64 of the 67 centres visited, three were excluded because of non-functioning cold chain. Complete temperature record was observed in 37 (57.8%) of the centres. Thermometer was not available in four (6.3%) and thermometer reading was found to be outside the optimal range in another seven (10.9%) centres. Vaccine storage in the refrigerator was not proper in 47 (73.4%) centres. Majority of the centres had neither trained personnel nor budget for maintenance of the cold chain.
There is a real danger of vaccines losing their potency at these centres even if they were potent on arrival. Relevant training for those handling the cold chain, improving the maintenance conditions of refrigerators and introduction of cold chain monitoring devises are recommended.
儿童免疫接种是预防儿童过早死亡最具成本效益的方法之一，而疫苗效力对于疫苗效果至关重要，它取决于疫苗处理各环节冷链的有效管理。
评估埃塞俄比亚基层疫苗储存点的冷链状况。
本研究采用基于机构的横断面调查，纳入了两个农村和一个城市行政区。研究包括67个提供常规疫苗接种服务的卫生机构，但仅对其中64个机构的冷链系统进行了全面评估。通过与卫生工作者访谈以及使用结构化表格直接观察冷链设备和记录来收集数据。
根据所走访的67个中心中的64个中心描述了冷链系统状况，3个中心因冷链无法正常运行而被排除。37个（57.8%）中心有完整的温度记录。4个（6.3%）中心没有温度计，另外7个（10.9%）中心的温度计读数超出最佳范围。47个（73.4%）中心的疫苗在冰箱中的储存不当。大多数中心既没有经过培训的人员，也没有用于冷链维护的预算。
即使疫苗到达时有效，在这些中心也存在疫苗失去效力的实际风险。建议对冷链处理人员进行相关培训，改善冰箱的维护条件，并引入冷链监测设备。
