Wesseh C S, Najjemba R, Edwards J K, Owiti P, Tweya H, Bhat P
Ministry of Health, Republic of Liberia, Monrovia, Liberia.
Makerere University College of Health Sciences, Kampala, Uganda.
Public Health Action. 2017 Jun 21;7(Suppl 1):S82-S87. doi: 10.5588/pha.16.0104.
All health facilities providing routine immunisation services in Liberia. To compare the number of routine facility-based and outreach immunisations and measles cases before, during and after the Ebola outbreak. A descriptive cross-sectional study. Immunisation coverage for fully immunised children before the Ebola outbreak was 73%. Immunisation coverage for all antigens declined by half compared to baseline during the outbreak. These findings were similar in facility-based and outreach immunisations. During the outbreak, the proportion of fully immunised children dropped by respectively 58%, 33% and 39% in the most, moderately and least Ebola-affected counties. Immunisation rate of recovery in the post-Ebola period was respectively 82%, 21% and 9% in the most, moderately and least affected counties compared to the Ebola-outbreak period. Outreach immunisation recovered slowly compared to facility-based immunisation. The mean number of measles cases reported per month was 12 pre-Ebola, 16 Ebola and 60 post-Ebola. This study provides insights into the possible impact of an Ebola outbreak on countrywide immunisation. The outbreak weakened a struggling national immunisation programme, and post-outbreak recovery took significant time, which likely contributed to the measles epidemic. Recommendations for the improvement of immunisation services that could limit further preventable epidemics in Liberia and similar contexts at risk for Ebola are provided.
利比里亚所有提供常规免疫服务的卫生机构。比较埃博拉疫情爆发前、爆发期间和爆发后基于机构的常规免疫接种和外展免疫接种数量以及麻疹病例数。一项描述性横断面研究。埃博拉疫情爆发前，完全免疫儿童的免疫接种覆盖率为73%。疫情期间，所有抗原的免疫接种覆盖率与基线相比下降了一半。基于机构的免疫接种和外展免疫接种的这些结果相似。疫情期间，在受埃博拉影响最严重、中等和最轻的县，完全免疫儿童的比例分别下降了58%、33%和39%。与埃博拉疫情期间相比，在受影响最严重、中等和最轻的县，埃博拉疫情后免疫接种恢复率分别为82%、21%和9%。与基于机构的免疫接种相比，外展免疫接种恢复缓慢。埃博拉疫情前每月报告的麻疹病例平均数为12例，疫情期间为16例，疫情后为60例。本研究深入探讨了埃博拉疫情对全国免疫接种可能产生的影响。疫情削弱了本就举步维艰的国家免疫规划，疫情后恢复耗时良久，这可能助长了麻疹疫情。文中还提供了关于改善免疫服务的建议，这些建议可能会限制利比里亚及面临埃博拉风险的类似环境中进一步的可预防疫情。
