Tohme Rania A, Francois Jeannot, Cavallaro Kathleen F, Paluku Gilson, Yalcouye Idrissa, Jackson Ernsley, Wright Tracie, Adrien Paul, Katz Mark A, Hyde Terri B, Faye Pape, Kimanuka Francine, Dietz Vance, Vertefeuille John, Lowrance David, Dahl Benjamin, Patel Roopal
Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
Direction du Program Elargi de Vaccination (DPEV), Ministry of Public Health and Population, Port-au-Prince, Haiti.
Am J Trop Med Hyg. 2017 Oct;97(4_Suppl):28-36. doi: 10.4269/ajtmh.16-0802.
Following the 2010 earthquake, Haiti was at heightened risk for vaccine-preventable diseases (VPDs) outbreaks due to the exacerbation of long-standing gaps in the vaccination program and subsequent risk of VPD importation from other countries. Therefore, partners supported the Haitian Ministry of Health and Population to improve vaccination services and VPD surveillance. During 2010-2016, three polio, measles, and rubella vaccination campaigns were implemented, achieving a coverage > 90% among children and maintaining Haiti free of those VPDs. Furthermore, Haiti is on course to eliminate maternal and neonatal tetanus, with 70% of communes achieving tetanus vaccine two-dose coverage > 80% among women of childbearing age. In addition, the vaccine cold chain storage capacity increased by 91% at the central level and 285% at the department level, enabling the introduction of three new vaccines (pentavalent, rotavirus, and pneumococcal conjugate vaccines) that could prevent an estimated 5,227 deaths annually. Haiti moved from the fourth worst performing country in the Americas in 2012 to the sixth best performing country in 2015 for adequate investigation of suspected measles/rubella cases. Sentinel surveillance sites for rotavirus diarrhea and meningococcal meningitis were established to estimate baseline rates of those diseases prior to vaccine introduction and to evaluate the impact of vaccination in the future. In conclusion, Haiti significantly improved vaccination services and VPD surveillance. However, high dependence on external funding and competing vaccination program priorities are potential threats to sustaining the improvements achieved thus far. Political commitment and favorable economic and legal environments are needed to maintain these gains.
2010年地震后，由于疫苗接种计划中长期存在的差距加剧以及随后从其他国家输入疫苗可预防疾病（VPD）的风险，海地爆发VPD的风险增加。因此，合作伙伴支持海地卫生和人口部改善疫苗接种服务和VPD监测。在2010 - 2016年期间，开展了三次脊髓灰质炎、麻疹和风疹疫苗接种运动，儿童接种率达到90%以上，使海地保持无这些VPD状态。此外，海地正在朝着消除孕产妇和新生儿破伤风的目标前进，70%的社区育龄妇女破伤风疫苗两剂接种率达到80%以上。此外，中央一级的疫苗冷链储存能力提高了91%，部门一级提高了285%，从而能够引入三种新疫苗（五价疫苗、轮状病毒疫苗和肺炎球菌结合疫苗），估计每年可预防5227例死亡。海地在2012年是美洲表现最差的国家之一，到2015年在对疑似麻疹/风疹病例进行充分调查方面跃升至表现最佳的国家第六位。建立了轮状病毒腹泻和脑膜炎球菌性脑膜炎的哨点监测点，以估计在引入疫苗之前这些疾病的基线发病率，并评估未来疫苗接种的影响。总之，海地显著改善了疫苗接种服务和VPD监测。然而，高度依赖外部资金以及疫苗接种计划优先事项相互竞争是维持迄今所取得进展的潜在威胁。需要政治承诺以及有利的经济和法律环境来保持这些成果。
