Constantine Mutata, Cremance Tshuma, Juru Tsitsi Patience, Gerald Shambira, Notion Gombe Tafara, Peter Nsubuga, Mufuta Tshimanga
University of Zimbabwe, Department of Community Medicine, Zimbabwe.
Provincial Medical Director, Mashonaland Central Province, Zimbabwe.
Pan Afr Med J. 2018 Nov 22;31:202. doi: 10.11604/pamj.2018.31.202.16573. eCollection 2018.
An adverse event following immunisation is any untoward medical occurrence which follows vaccination. Frequency of adverse events ranges from 13% to 34% and they should be reported regardless of severity. From the beginning of 2016 to mid-2017, Guruve district in Zimbabwe did not report any AEFIs. This suggests the surveillance system may be failing to detect adverse events. We therefore evaluated the AEFI surveillance system in Guruve district.
We conducted a surveillance system evaluation using the updated Centers for Disease Control guidelines for evaluating public health surveillance systems. We interviewed health workers and caregivers of babies under 2 years in Guruve district. We also reviewed all records on AEFI surveillance for the period of January 2016 to November 2017.
We recruited 31 health workers and 33 caregivers into the study. Between January 2016 and mid-2017, 39% of the caregivers had children who had suffered AEFIs and 45% of the health workers had encountered AEFIs but none had been notified. The main reasons for failure to report AEFIs included health workers' fear of personal consequences and caregivers thinking that an adverse event was not serious enough to report. Knowledge of the surveillance system was good amongst the majority of health workers. All the resources needed by the surveillance system were available.
We concluded that health workers in Guruve district were afraid to report adverse events following immunization and caregivers were reluctant to report mild adverse events hence the surveillance system was performing poorly and was not useful. However, the stability of the system and the good knowledge gives a good foundation for improving the surveillance system.
免疫接种后的不良事件是指接种疫苗后发生的任何不良医疗事件。不良事件的发生率在13%至34%之间，无论严重程度如何均应报告。从2016年初到2017年年中，津巴布韦的古鲁韦区未报告任何疑似预防接种异常反应。这表明监测系统可能未能检测到不良事件。因此，我们对古鲁韦区的疑似预防接种异常反应监测系统进行了评估。
我们使用美国疾病控制与预防中心更新的公共卫生监测系统评估指南对监测系统进行了评估。我们采访了古鲁韦区的卫生工作者和2岁以下婴儿的看护人。我们还查阅了2016年1月至2017年11月期间所有疑似预防接种异常反应监测记录。
我们招募了31名卫生工作者和33名看护人参与研究。2016年1月至2017年年中，39%的看护人的孩子发生过疑似预防接种异常反应，45%的卫生工作者遇到过疑似预防接种异常反应，但均未报告。未报告疑似预防接种异常反应的主要原因包括卫生工作者担心个人后果，以及看护人认为不良事件不够严重无需报告。大多数卫生工作者对监测系统的了解良好。监测系统所需的所有资源均已具备。
我们得出结论，古鲁韦区的卫生工作者害怕报告免疫接种后的不良事件，看护人不愿报告轻微不良事件，因此监测系统表现不佳且无用。然而，该系统的稳定性和良好的认知为改进监测系统奠定了良好基础。
