Nyirimanzi Joseph Désiré, Ngenzi Joseph, Kagisha Védaste, Bizimana Thomas, Kayitare Egide
East Africa Community Regional Center of Excellence for Vaccines, Immunization and Health Supply Chain Management (RCE-VIHSCM), College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Department of Pharmacy, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
J Pharm Policy Pract. 2023 Feb 28;16(1):31. doi: 10.1186/s40545-023-00534-3.
Despite the prominent evidence of cold chain monitoring in the health system to reduce wastage and maintain product potency, there are still inefficiencies in the storage and transportation of cold chain products. This study assessed medicine cold chain storage conformity in health facilities in the Eastern Province of Rwanda.
A cross-sectional and prospective with quantitative and qualitative approaches study was approved, and 44 health facilities (public, faith-based and private) were selected using both convenience, stratified, and purposive sampling techniques. Temperature data loggers were mounted in refrigerators to measure the Mean Kinetic Temperature (MKT).
The overall performance of cold chain storage conformity of refrigerators assessed was 54 (73.0%). The conformity found in refrigerators of pharmacy stock in public health facilities was 22 (56.0%), in vaccination program was 25 (100.0%), and in private retail pharmacies was 7 (70.0%). The MKT measured fit the required cold chain storage at this rate. Most refrigerators used in pharmacy stock (27.0%) were aged between 8 and 10 years, while those used in vaccination programs were less than 4 years. Regular calibration of refrigerator and temperature monitoring device (TMD) was 39.0% and 24.0%, respectively. Most respondents, 44 (80.0%), knew the proper cold chain storage. However, few identified the impact of storing cold chain products with vaccines at 16 (29.1%). The transportation of cold chain products from two central medical stores assessed showed inefficiencies as only one of them uses temperature data loggers during transportations of the products mentioned above.
The medicines cold chain storage conformity investigated in seven districts of the Eastern Province in Rwanda was better than reported previously in other LMICs. However, cold chain storage for pharmacy stock often did not meet the requirements. The observed drawback represented a serious risk to public health. Calibrating cold chain equipment, regular maintenance, and commissioning new cold chain equipment should be done to improve cold chain storage.
尽管卫生系统中有关于冷链监测以减少浪费和维持产品效力的显著证据，但冷链产品的储存和运输仍存在效率低下的问题。本研究评估了卢旺达东部省卫生机构中药品冷链储存的合规情况。
一项采用定量和定性方法的横断面前瞻性研究获得批准，使用便利抽样、分层抽样和目的抽样技术选取了44家卫生机构（公立、宗教性质和私立）。在冰箱中安装温度数据记录器以测量平均动力学温度（MKT）。
所评估冰箱的冷链储存合规总体表现为54（73.0%）。公立卫生机构药房库存冰箱的合规率为22（56.0%），疫苗接种项目冰箱的合规率为25（100.0%），私立零售药店冰箱的合规率为7（70.0%）。以此比率测量的MKT符合所需的冷链储存要求。药房库存中使用的大多数冰箱（27.0%）使用年限在8至10年之间，而疫苗接种项目中使用的冰箱使用年限不到4年。冰箱和温度监测设备（TMD）的定期校准率分别为39.0%和24.0%。大多数受访者，44（80.0%），了解正确的冷链储存知识。然而，很少有人认识到将冷链产品与疫苗一起储存在16℃时的影响（29.1%）。对从两家中央医疗商店评估的冷链产品运输情况显示效率低下，因为在上述产品运输过程中只有其中一家使用温度数据记录器。
在卢旺达东部省七个地区调查的药品冷链储存合规情况优于先前在其他低收入和中等收入国家报告的情况。然而，药房库存的冷链储存往往不符合要求。观察到的缺陷对公众健康构成严重风险。应校准冷链设备、进行定期维护并启用新的冷链设备以改善冷链储存。
