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乍得游牧民中脊髓灰质炎疫情:疫情应对及经验教训

Polio outbreak among nomads in Chad: outbreak response and lessons learned.

作者信息

Ndiaye Serigne M, Ahmed Mahamat Abdoulaye, Denson Melinda, Craig Allen S, Kretsinger Katrina, Cherif Baharadine, Kandolo Pierre, Moto Daugla Doumagoum, Richelot Ayangma, Tuma Jude

机构信息

Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia.

Centre de Support en Santé International.

出版信息

J Infect Dis. 2014 Nov 1;210 Suppl 1(Suppl 1):S74-84. doi: 10.1093/infdis/jit564. Epub 2013 Oct 23.

Abstract

BACKGROUND

In response to the 2011 and 2012 polio epidemic in Chad, Chad's Ministry of Public Health, with support from Global Polio Eradication Initiative partners, took steps to increase vaccination coverage of nomadic children with targeted polio campaigns. This article describes the strategies we used to vaccinate nomads in 3 districts of Chad.

METHODS

Our targeted interventions involved using mobile vaccination teams, recruiting local nomads to identify settlements, using social mobilization, and offering vaccinations to children, women, and animals.

RESULTS

Vaccination coverage of nomadic children 0-59 months of age increased, particularly among those never before vaccinated against polio. These increases occurred mostly in the intervention districts of Dourbali, from 2956 to 8164 vaccinated children, and Kyabe, from 7319 to 15 868. The number of first-time vaccinated nomadic children also increased the most in these districts, from 60 to 131 in Dourbali and from 1302 to 2973 in Kyabe. Coverage in the Massaguet district was only 37.7%.

CONCLUSIONS

Our success was probably due to (1) appointment of staff to oversee implementation, (2) engagement of the national government and its partners, (3) participation of nomadic community leaders, (4) intersectoral collaboration between human and animal health services, and (5) flexibility and capacity of vaccinators to vaccinate when and where nomads were available.

摘要

背景

为应对2011年和2012年乍得的脊髓灰质炎疫情,乍得公共卫生部在全球根除脊髓灰质炎行动伙伴的支持下,采取措施通过有针对性的脊髓灰质炎疫苗接种活动提高游牧儿童的疫苗接种覆盖率。本文描述了我们在乍得3个地区为游牧民接种疫苗所采用的策略。

方法

我们的针对性干预措施包括使用流动疫苗接种团队、招募当地游牧民确定定居点、开展社会动员以及为儿童、妇女和动物提供疫苗接种。

结果

0至59个月大的游牧儿童的疫苗接种覆盖率有所提高,尤其是在那些从未接种过脊髓灰质炎疫苗的儿童中。这些增长主要发生在杜尔巴利和基亚贝等干预地区,杜尔巴利接种疫苗的儿童从2956名增加到8164名,基亚贝从7319名增加到15868名。首次接种疫苗的游牧儿童数量在这些地区也增加最多,杜尔巴利从60名增加到131名,基亚贝从1302名增加到2973名。马萨盖特区的覆盖率仅为37.7%。

结论

我们的成功可能归因于以下几点:(1)任命工作人员监督实施情况;(2)国家政府及其合作伙伴的参与;(3)游牧社区领袖的参与;(4)人类和动物卫生服务部门之间的跨部门合作;(5)疫苗接种人员在游牧民出现时和地点进行接种的灵活性和能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e4a/10429808/66a65ea63a2c/nihms-1922756-f0001.jpg

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