Haddison Eposi C, Abdullahi Leila H, Muloiwa Rudzani, Hussey Gregory D, Kagina Benjamin M
Vaccines for Africa Initiative (VACFA), University of Cape Town, Cape Town, South Africa.
School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
F1000Res. 2017 Oct 13;6:1833. doi: 10.12688/f1000research.12804.1. eCollection 2017.
Some vaccine preventable diseases (VPDs) still remain a public health burden in many African countries. The occurrence of VPDs in all age groups has led to the realization of the need to extend routine immunisation services to school age children, adolescents and adults. Supplemental immunisation activities (SIAs) and school based vaccinations (SBVs) are common strategies used to complement the expanded programme on immunisation (EPI). This review aimed to assess the effectiveness of SIAs compared to SBVs in the administration of vaccines to 5-19 year olds in Africa.
Systematic review methods were used to address our study aim. Several electronic databases were searched up to March 30, 2017 for primary studies investigating the delivery of vaccines via SIAs or SBVs to 5-19 year olds. This search was complemented by browsing reference lists of potential studies obtained from search outputs. Outcomes considered for inclusion were: vaccination coverage, costs of the strategy or its effect on routine immunisation services.
Out of the 4938 studies identified, 31 studies met the review inclusion criteria. Both SIAs and SBVs showed high vaccination coverage. However, the SIAs reported higher coverage than SBVs: 91% (95% CI: 84%, 98%) versus 75% (95% CI: 67%, 83%). In most settings, SBVs were reported to be more expensive than SIAs. The SIAs were found to negatively affect routine immunisation services.
Both SIAs and SBVs are routinely used to complement the EPI in the delivery of vaccines in Africa. In settings where school enrolment is suboptimal, as is the case in many African countries, our results show SIAs may be more effective in reaching school age children and adolescents than SBVs. Our results re-iterate the importance of evaluating systematic evidence to best inform African authorities on the optimal vaccine delivery strategies targeting school age children and adolescents.
在许多非洲国家，一些疫苗可预防疾病（VPDs）仍然是公共卫生负担。所有年龄组中VPDs的出现促使人们认识到有必要将常规免疫服务扩展到学龄儿童、青少年和成年人。补充免疫活动（SIAs）和学校疫苗接种（SBVs）是用于补充扩大免疫规划（EPI）的常见策略。本综述旨在评估在非洲对5至19岁人群进行疫苗接种时，SIAs与SBVs相比的有效性。
采用系统综述方法来实现我们的研究目的。检索了多个电子数据库，截至2017年3月30日，查找关于通过SIAs或SBVs为5至19岁人群接种疫苗的原始研究。通过浏览从检索结果中获得的潜在研究的参考文献列表对此次检索进行补充。纳入考虑的结果包括：疫苗接种覆盖率、策略成本或其对常规免疫服务的影响。
在识别出的4938项研究中，31项研究符合综述纳入标准。SIAs和SBVs均显示出高疫苗接种覆盖率。然而，SIAs报告的覆盖率高于SBVs：91%（95%CI：84%，98%）对75%（95%CI：67%，83%）。在大多数情况下，据报告SBVs比SIAs更昂贵。发现SIAs对常规免疫服务有负面影响。
在非洲，SIAs和SBVs都经常用于补充EPI进行疫苗接种。在许多非洲国家那样入学率不理想的情况下，我们的结果表明，与SBVs相比，SIAs在覆盖学龄儿童和青少年方面可能更有效。我们的结果重申了评估系统证据以最佳地为非洲当局提供关于针对学龄儿童和青少年的最佳疫苗接种策略的信息的重要性。
