Journal Article > Short ReportFull Text
Public Health Action. 2023 June 21; Volume 13 (Issue 2); 31-33.; DOI:10.5588/pha.23.0011
Mangion JP, Mancini S, Bachy C, de Weggheleire A, Zamatto F
Public Health Action. 2023 June 21; Volume 13 (Issue 2); 31-33.; DOI:10.5588/pha.23.0011
English
Français
A rising number of diphtheria cases were recorded in Europe in 2022, including in Belgium, within the newly arriving young migrant population. In October 2022, Médecins Sans Frontières (MSF) opened a temporary roadside container-clinic offering free medical consultations. Over 3 months of activity, the temporary clinic detected 147 suspected cases of cutaneous diphtheria with 8 laboratory-confirmed cases growing toxigenic Corynebacterium diphtheriae. This was followed by a mobile vaccination campaign, during which 433 individuals living rough in squats and informal shelters were vaccinated. This intervention has shown how even in Europe’s capital, access to preventive and curative medical services remains difficult for those who need it the most. Appropriate access to health services, including routine vaccination, are crucial to improve the health status among migrants.
Conference Material > Slide Presentation
Finger F, Mimbu N, Ratnayake R, Meakin S, Bahati JB, et al.
MSF Scientific Days International 2024. 2024 May 16; DOI:10.57740/tC1av3293
Journal Article > ResearchFull Text
BMJ Open. 2022 July 26; Volume 12 (Issue 7); e059900.; DOI:10.1136/bmjopen-2021-059900
Borras-Bermejo B, Panunzi I, Bachy C, Gil-Cuesta J
BMJ Open. 2022 July 26; Volume 12 (Issue 7); e059900.; DOI:10.1136/bmjopen-2021-059900
OBJECTIVE
To describe missed opportunities for vaccination (MOV) among children visiting Médecins Sans Frontières (MSF)-supported facilities, their related factors, and to identify reasons for non-vaccination.
DESIGN
Cross-sectional surveys conducted between 2011 and 2015.
SETTING AND PARTICIPANTS
Children up to 59 months of age visiting 19 MSF-supported facilities (15 primary healthcare centres and four hospitals) in Afghanistan, Democratic Republic of the Congo, Mauritania, Niger, Pakistan and South Sudan. Only children whose caregivers presented their vaccination card were included.
OUTCOME MEASURES
We describe MOV prevalence and reasons for no vaccination. We also assess the association of MOV with age, type of facility and reason for visit.
RESULTS
Among 5055 children’s caregivers interviewed, 2738 presented a vaccination card of whom 62.8% were eligible for vaccination, and of those, 64.6% had an MOV. Presence of MOV was more likely in children visiting a hospital or a health facility for a reason other than vaccination. MOV occurrence was significantly higher among children aged 12–23 months (84.4%) and 24–59 months (88.3%) compared with children below 12 months (56.2%, p=0.001). Main reasons reported by caregivers for MOV were lack of vaccines (40.3%), reason unknown (31.2%) and not being informed (17.6%).
CONCLUSIONS
Avoiding MOV should remain a priority in low-resource settings, in line with the new ‘Immunization Agenda 2030’. Children beyond their second year of life are particularly vulnerable for MOV. We strongly recommend assessment of eligibility for vaccination as routine healthcare practice regardless of the reason for the visit by screening vaccination card. Strengthening implementation of ‘Second year of life’ visits and catch-up activities are proposed strategies to reduce MOV.
To describe missed opportunities for vaccination (MOV) among children visiting Médecins Sans Frontières (MSF)-supported facilities, their related factors, and to identify reasons for non-vaccination.
DESIGN
Cross-sectional surveys conducted between 2011 and 2015.
SETTING AND PARTICIPANTS
Children up to 59 months of age visiting 19 MSF-supported facilities (15 primary healthcare centres and four hospitals) in Afghanistan, Democratic Republic of the Congo, Mauritania, Niger, Pakistan and South Sudan. Only children whose caregivers presented their vaccination card were included.
OUTCOME MEASURES
We describe MOV prevalence and reasons for no vaccination. We also assess the association of MOV with age, type of facility and reason for visit.
RESULTS
Among 5055 children’s caregivers interviewed, 2738 presented a vaccination card of whom 62.8% were eligible for vaccination, and of those, 64.6% had an MOV. Presence of MOV was more likely in children visiting a hospital or a health facility for a reason other than vaccination. MOV occurrence was significantly higher among children aged 12–23 months (84.4%) and 24–59 months (88.3%) compared with children below 12 months (56.2%, p=0.001). Main reasons reported by caregivers for MOV were lack of vaccines (40.3%), reason unknown (31.2%) and not being informed (17.6%).
CONCLUSIONS
Avoiding MOV should remain a priority in low-resource settings, in line with the new ‘Immunization Agenda 2030’. Children beyond their second year of life are particularly vulnerable for MOV. We strongly recommend assessment of eligibility for vaccination as routine healthcare practice regardless of the reason for the visit by screening vaccination card. Strengthening implementation of ‘Second year of life’ visits and catch-up activities are proposed strategies to reduce MOV.
Conference Material > Slide Presentation
Shyaka A, Kabongo F, Tolno C, Barry I, Bachy C
MSF Paediatric Days 2024. 2024 May 3; DOI:10.57740/iNG4avXIn
Français
Journal Article > ResearchFull Text
Vaccine. 2020 February 25; Volume 38 (Issue 13); DOI:10.1016/j.vaccine.2020.02.029
Coulborn RM, Nackers F, Bachy C, Porten K, Vochten H, et al.
Vaccine. 2020 February 25; Volume 38 (Issue 13); DOI:10.1016/j.vaccine.2020.02.029
BACKGROUND:
During a measles epidemic, the Ministry of Public Health (MOH) of the Democratic Republic of the Congo conducted supplementary immunization activities (2016-SIA) from August 28-September 3, 2016 throughout Maniema Province. From October 29-November 4, 2016, Médecins Sans Frontières and the MOH conducted a reactive measles vaccination campaign (2016-RVC) targeting children six months to 14 years old in seven health areas with heavy ongoing transmission despite inclusion in the 2016-SIA, and a post-vaccination survey. We report the measles vaccine coverage (VC) and effectiveness (VE) of the 2016-SIA and VC of the 2016-RVC.
METHODS:
A cross-sectional VC cluster survey stratified by semi-urban/rural health area and age was conducted. A retrospective cohort analysis of measles reported by the parent/guardian allowed calculation of the cumulative measles incidence according to vaccination status after the 2016-SIA for an estimation of crude and adjusted VE.
RESULTS:
In November 2016, 1145 children (6-59 months old) in the semi-urban and 1158 in the rural areas were surveyed. Post-2016-SIA VC (documentation/declaration) was 81.6% (95%CI: 76.5-85.7) in the semi-urban and 91.0% (95%CI: 84.9-94.7) in the rural areas. The reported measles incidence in October among children less than 5 years old was 5.0% for 2016-SIA-vaccinated and 11.2% for 2016-SIA-non-vaccinated in the semi-urban area, and 0.7% for 2016-SIA-vaccinated and 4.0% for 2016-SIA-non-vaccinated in the rural area. Post-2016-SIA VE (adjusted for age, sex) was 53.9% (95%CI: 2.9-78.8) in the semi-urban and 78.7% (95%CI: 0-97.1) in the rural areas. Post 2016-RVC VC (documentation/declaration) was 99.1% (95%CI: 98.2-99.6) in the semi-urban and 98.8% (95%CI: 96.5-99.6) in the rural areas.
CONCLUSIONS:
Although our VE estimates could be underestimated due to misclassification of measles status, the VC and VE point estimates of the 2016-SIA in the semi-urban area appear suboptimal, and in combination, could not limit the epidemic. Further research is needed on vaccination strategies adapted to urban contexts.
During a measles epidemic, the Ministry of Public Health (MOH) of the Democratic Republic of the Congo conducted supplementary immunization activities (2016-SIA) from August 28-September 3, 2016 throughout Maniema Province. From October 29-November 4, 2016, Médecins Sans Frontières and the MOH conducted a reactive measles vaccination campaign (2016-RVC) targeting children six months to 14 years old in seven health areas with heavy ongoing transmission despite inclusion in the 2016-SIA, and a post-vaccination survey. We report the measles vaccine coverage (VC) and effectiveness (VE) of the 2016-SIA and VC of the 2016-RVC.
METHODS:
A cross-sectional VC cluster survey stratified by semi-urban/rural health area and age was conducted. A retrospective cohort analysis of measles reported by the parent/guardian allowed calculation of the cumulative measles incidence according to vaccination status after the 2016-SIA for an estimation of crude and adjusted VE.
RESULTS:
In November 2016, 1145 children (6-59 months old) in the semi-urban and 1158 in the rural areas were surveyed. Post-2016-SIA VC (documentation/declaration) was 81.6% (95%CI: 76.5-85.7) in the semi-urban and 91.0% (95%CI: 84.9-94.7) in the rural areas. The reported measles incidence in October among children less than 5 years old was 5.0% for 2016-SIA-vaccinated and 11.2% for 2016-SIA-non-vaccinated in the semi-urban area, and 0.7% for 2016-SIA-vaccinated and 4.0% for 2016-SIA-non-vaccinated in the rural area. Post-2016-SIA VE (adjusted for age, sex) was 53.9% (95%CI: 2.9-78.8) in the semi-urban and 78.7% (95%CI: 0-97.1) in the rural areas. Post 2016-RVC VC (documentation/declaration) was 99.1% (95%CI: 98.2-99.6) in the semi-urban and 98.8% (95%CI: 96.5-99.6) in the rural areas.
CONCLUSIONS:
Although our VE estimates could be underestimated due to misclassification of measles status, the VC and VE point estimates of the 2016-SIA in the semi-urban area appear suboptimal, and in combination, could not limit the epidemic. Further research is needed on vaccination strategies adapted to urban contexts.
Journal Article > ResearchFull Text
Emerg Infect Dis. 2007 June 1; Volume 13 (Issue 6); 920-923.; DOI:10.3201/eid1306.060940
Nathan N, Rose AMC, Legros D, Tiendrebeogo SRM, Bachy C, et al.
Emerg Infect Dis. 2007 June 1; Volume 13 (Issue 6); 920-923.; DOI:10.3201/eid1306.060940
In 2002, the largest epidemic of Neisseria meningitidis serogroup W135 occurred in Burkina Faso. The highest attack rate was in children <5 years of age. We describe cases from 1 district and evaluate the performance of the Pastorex test, which had good sensitivity (84%) and specificity (89%) compared with culture or PCR.
Journal Article > ResearchFull Text
Improved vaccination coverage after two rounds of multi-antigenic catch-up vaccination in Mauritania
PLOS Glob Public Health. 2024 February 14; Volume 4 (Issue 2); e0002939.; DOI:10.1371/journal.pgph.0002939
Pagola-Ugarte M, Rakesh A, Gil-Cuesta J, Kidinda D, Kelly TM, et al.
PLOS Glob Public Health. 2024 February 14; Volume 4 (Issue 2); e0002939.; DOI:10.1371/journal.pgph.0002939
Although Mauritania carried out its Expanded Programme on Immunization (EPI), in 2015 the goal of vaccination coverage (VC) remained unmet in Bassikounou district and Mbera camp, contexts with large migrant populations. In response, during 2018, the national authorities, together with Médecins Sans Frontières organised two rounds of multi-antigenic mass vaccination campaigns (2RMASVC). The campaigns included oral polio (OPV), pneumococcal (PCV13), pentavalent and rotavirus vaccines for all eligible children six weeks to 59 months old. This study describes the results of the 2RMASVC. Cross-sectional household VC surveys (VCS1 and VCS2) were conducted before and after the 2RMASVC. Data were collected on vaccination status according to self-reporting and vaccination cards, and on reasons for non-vaccination (RNV). In total, 4,569 children received at least one dose of vaccine in the first round and 5,602 children in the second. Baseline VC, as fully vaccinated, according to VCS1, was 59.9% of children 12 to 59 months in Bassikounou district and 65.8% in Mbera camp. After the 2RMASVC, the coverages increased to 84.7% and 75.9% respectively. Absence from home, lack of motivation, late initiation of vaccinations and lack of awareness about vaccination were the main RNV during the 2RMASVC. Although the 2RMASVC did not reach its goal of 90%-95% VC, the strategy significantly increased VC in the two settings for children aged 12 to 59 months. Therefore, this catch-up approach could be considered to improve VC of children who miss out of the EPI strategy in resource-limited settings.
Journal Article > ResearchFull Text
Trans R Soc Trop Med Hyg. 2006 May 1; Volume 100 (Issue 5); DOI:10.1016/j.trstmh.2005.07.017
Grandesso F, Bachy C, Donam I, Ntambi J, Habimana J, et al.
Trans R Soc Trop Med Hyg. 2006 May 1; Volume 100 (Issue 5); DOI:10.1016/j.trstmh.2005.07.017
We report two 28-day in-vivo antimalarial efficacy studies carried out in the urban centres of Bongor and Koumra, southern Chad. We assess chloroquine (CQ), sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ) to treat Plasmodium falciparum uncomplicated malaria. Methods and outcome classification complied with latest WHO guidelines. Out of the 301 and 318 children aged 6-59 months included in Bongor and Koumra, respectively, 246 (81.7%) and 257 (80.8%) were eligible for analysis. In Bongor and Koumra, the 28-day PCR-adjusted failure rates for CQ were 23.7% (95% CI 14.7-34.8%) and 32.9% (95% CI 22.1-45.1%), respectively, and those for SP were 16.3% (95% CI 9.4-25.5%) and 4.3% (95% CI 1.2-10.5%). AQ failure rates were 6.4% (95% CI 2.1-14.3%) and 2.2% (95% CI 0.3-7.6%). The current use of CQ in Bongor and Koumra is questionable, and a more efficacious treatment is needed. Considering the reduced efficacy of SP in Bongor, AQ seems to be the best option for the time being. Following WHO recommendations that prioritize the use of artemisinin-based combinations, artesunate plus amodiaquine could be a potential first-line treatment. Nevertheless, the efficacy of this combination should be evaluated and the change carefully prepared, implemented and monitored.
Journal Article > ResearchFull Text
Bull Soc Pathol Exot. 2002 December 1; Volume 95 (Issue 5); 351-354.
Brown V, Jacquier G, Bachy C, Bitar D, Legros D
Bull Soc Pathol Exot. 2002 December 1; Volume 95 (Issue 5); 351-354.
Cholera epidemics in refugee camps represent a major public health emergency. In camps, precarious living conditions contribute to the transmission of the vibrio. Among the major epidemics reported in camps, we note as well those which have affected Africa in the last two decades. These epidemics are characterized by high attack rates and high case fatality ratios. Attack rates in refugee camps can exceed 5%. Appropriate control measures are adopted at international level. Actions carried out urgently must allow the proper supply of water, the control of excreta, and the improvement of general sanitary conditions and individual hygiene. Efficient management of cases in specialized cholera treatment centres (CTC) should decrease the case fatality ratio to less than 1%. Treatment is mainly based on the prompt rehydration of patients. For wide camps, rapid access to oral rehydration units is essential. Availability of all necessary equipment in kit form is required.
Conference Material > Abstract
Shyaka A, Kabongo F, Tolno C, Barry I, Bachy C
MSF Paediatric Days 2024. 2024 May 3; DOI:10.57740/KTMPcj
Français
BACKGROUND AND OBJECTIVES
The proportion of hypothermic neonates was significant, and several contributing factors were identified. Recommendations include the installation of a door into the delivery room and appropriate heating systems in both the delivery room and PNC ward. Training of MCH staff is required to build knowledge and skills regarding the maintenance of the warm chain, and highlighting the importance of immediate skin-to-skin at birth and KMC, which have an important role in preventing hypothermia and must be encouraged.
METHODS
Il s’agissait d’une étude transversale par entretien de sortie dans quatre établissements de santé (ES) de Matoto (Bernay Fotoba, Saint Gabriel, Tombolia, Dabompa) du 11-19 avril 2023. A été considéré comme OMV, tout enfant qui n'avait pas reçu les vaccins indiqués à l’issue de sa visite même s'il avait dépassé l'âge recommandé pour les recevoir selon la politique du pays.
Un échantillon de convenance par défaut a été utilisé avec au minimum, 100 enfants sélectionnés (50 âgés de 0-23 mois et 50 âgés de 24-59 mois) dans chaque ES. Les données ont été recueillies à l'aide d’un questionnaire anonyme standardisé MSF puis saisies dans une base de données Excel développé par MSF où les indicateurs ont été calculés automatiquement. Cette évaluation a reçu les approbations du comité national d’éthique et du comité d’éthique de MSF
RESULTS
Sur 357 enfants (0-23 mois=182 ; 24-59 mois=175) éligibles pour une vaccination, 300 ont présenté une OMV soit une prévalence des OMV de 84% (300/357). Parmi les enfants avec OMV, 53% (159/300) avait 24-59 mois. Ceux de 0-23 mois, cible du PEV, représentaient 47% (141/300). Le vaccin antirougeoleux (56%) et le vaccin antipoliomyélitique oral (50%) ont été les plus manqués. Nous notons que 41% (124/300) des enfants avec OMV étaient présents dans ces ES pour une vaccination. Le manque d’information (47%) et les ruptures de vaccins (38%) étaient les principales raisons invoquées par les participants pour justifier les OMV.
CONCLUSIONS
Nos résultats montrent la nécessité d’intégrer l’évaluation des OMV dans le système de santé en tant que processus de routine et d’assurer un approvisionnement constant et suffisant en vaccins et matériel de vaccination.
The proportion of hypothermic neonates was significant, and several contributing factors were identified. Recommendations include the installation of a door into the delivery room and appropriate heating systems in both the delivery room and PNC ward. Training of MCH staff is required to build knowledge and skills regarding the maintenance of the warm chain, and highlighting the importance of immediate skin-to-skin at birth and KMC, which have an important role in preventing hypothermia and must be encouraged.
METHODS
Il s’agissait d’une étude transversale par entretien de sortie dans quatre établissements de santé (ES) de Matoto (Bernay Fotoba, Saint Gabriel, Tombolia, Dabompa) du 11-19 avril 2023. A été considéré comme OMV, tout enfant qui n'avait pas reçu les vaccins indiqués à l’issue de sa visite même s'il avait dépassé l'âge recommandé pour les recevoir selon la politique du pays.
Un échantillon de convenance par défaut a été utilisé avec au minimum, 100 enfants sélectionnés (50 âgés de 0-23 mois et 50 âgés de 24-59 mois) dans chaque ES. Les données ont été recueillies à l'aide d’un questionnaire anonyme standardisé MSF puis saisies dans une base de données Excel développé par MSF où les indicateurs ont été calculés automatiquement. Cette évaluation a reçu les approbations du comité national d’éthique et du comité d’éthique de MSF
RESULTS
Sur 357 enfants (0-23 mois=182 ; 24-59 mois=175) éligibles pour une vaccination, 300 ont présenté une OMV soit une prévalence des OMV de 84% (300/357). Parmi les enfants avec OMV, 53% (159/300) avait 24-59 mois. Ceux de 0-23 mois, cible du PEV, représentaient 47% (141/300). Le vaccin antirougeoleux (56%) et le vaccin antipoliomyélitique oral (50%) ont été les plus manqués. Nous notons que 41% (124/300) des enfants avec OMV étaient présents dans ces ES pour une vaccination. Le manque d’information (47%) et les ruptures de vaccins (38%) étaient les principales raisons invoquées par les participants pour justifier les OMV.
CONCLUSIONS
Nos résultats montrent la nécessité d’intégrer l’évaluation des OMV dans le système de santé en tant que processus de routine et d’assurer un approvisionnement constant et suffisant en vaccins et matériel de vaccination.