Impact of the Ebola outbreak on routine immunization in western area, Sierra Leone - a field survey from an Ebola epidemic area

• Published in: BMC public health Vol. 17; no. 1; p. 363
• Main Authors: Sun, Xiaojin, Samba, T T, Yao, Jianyi, Yin, Wenwu, Xiao, Lin, Liu, Fuqiang, Liu, Xiaoqiang, Zhou, Jikun, Kou, Zengqiang, Fan, Hongwei, Zhang, Hao, Williams, Aqnes, Lansana, Paul M, Yin, Zundong
• Format: Journal Article
• Language: English
• Published: England BioMed Central 26.04.2017; BMC
• Subjects: Age; Cards; Child, Preschool; Children; Children & youth; Childrens health; Confidence intervals; Disease Outbreaks - statistics & numerical data; Ebola virus; Ebola virus disease; Ebolavirus; Epidemics; Field survey; Hemorrhagic Fever, Ebola - epidemiology; Humans; Immunity; Immunization; Immunization Programs - statistics & numerical data; Infectious diseases; Maternal & child health; Measles; Outbreaks; Parents & parenting; Polls & surveys; Public health; Rubella; Rural areas; Sample size; Sierra Leone - epidemiology; Teams; Towns; Vaccination; Vaccination coverage; Vaccines; Viral diseases; Viral Vaccines - administration & dosage; Sierra Leone; China; Vaccination coverage; Field survey; Ebola virus disease
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-017-4242-7

Since March 2014, the Ebola Virus Disease (EVD) outbreak in West Africa disrupted health care systems - especially in Guinea, Liberia and Sierra Leone - with a consequential stress on the area's routine immunization programs. To address perceived decreased vaccination coverage, Sierra Leone conducted a catch-up vaccination campaign during 24-27 April 2015. We conducted a vaccination coverage survey and report coverage estimates surrounding the time of the EVD outbreak and the catch-up campaign. We selected 3 villages from each of 3 communities and obtained dates of birth and dates of vaccination with measles vaccine (MV) and the 3rd dose of Pentavalent vaccine (Pentavalent3) of all children under 4 years of age in the 9 selected villages. Vaccination data were obtained from parent-held health cards. We calculated the children's MV and Pentavalent3 coverage rates at 3 time points, 1 August 2014, 1 April 2015, and 1 May 2015, representing coverage rates before the EVD outbreak, during the EVD outbreak, and after the Maternal and Child Health Week (MCHW) catch-up campaign. The final sample size was 168 children. MV coverage among age-eligible children was 71.3% (95% confidence interval [CI]: 62.1% - 80.4%) and 45.7% (95% CI: 29.2% - 62.2%) before and during the outbreak of EVD, respectively, and was 56.8% (95% CI: 40.8% - 72.7%) after the campaign. Pentavalent3 coverage among age-eligible children was 79.8% (95% CI: 72.6% - 87.0%) and 40.0% (95% CI: 22.5% - 57.5%) before and during the outbreak of EVD, and was 56.4% (95% CI: 39.1% - 73.4%) after the campaign. Coverage levels of MV and Pentavalent3 were low before the EVD outbreak and decreased further during the outbreak. Although the MCHW catch-up campaign increased coverage levels, coverage remained below pre-outbreak levels. High-quality supplementary immunization activities should be conducted and routine immunization should be strengthened to address gaps in immunity among children in this EVD-affected area.