Assessing the impact of COVID-19 on routine immunization in Sierra Leone.

BCG vaccine Bacillus calmette–guérin COVID-19 Health Information system Measles-Rubella Pandemic Pentavalent vaccine Public health emergencies Routine immunization Sierra leone Vaccination coverage rate

Journal

BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562

Informations de publication

Date de publication:
05 Jul 2024
Historique:
received: 25 05 2023
accepted: 21 06 2024
medline: 6 7 2024
pubmed: 6 7 2024
entrez: 5 7 2024
Statut: epublish

Résumé

The COVID-19 pandemic had a profound impact on healthcare systems and services, including routine immunization (RI). To date, there is limited information on the effects of the COVID-19 pandemic on RI in West African countries such as Sierra Leone, which had already experienced public health emergencies that disrupted its healthcare system. Here, we describe the impact of the COVID-19 pandemic on the RI of key antigens in Sierra Leone. We used vaccination data from the District Health Information System for BCG, measles-rubella 1 and 2, and pentavalent 1 and 3 antigens. We compared 2019, 2020, 2021, and 2022 annual coverage rates for the selected antigens at the national and district levels. We used the Pearson chi-square test to assess the difference between annual coverage rates between 2019 and 2020, 2020-2021, and 2021-2022. National coverage rates for all antigens declined in 2019-2020, notably measles-rubella 1 and pentavalent 3 (-5.4% and - 4.9%). Between 2020 and 2021, there was an overall increase in coverage (+ 0.2% to + 2.5%), except for measles-rubella 2 (-1.8%). Measles-rubella antigens rebounded in 2021-2022, while others decreased between - 0.5 and - 1.9% in coverage. Overall, all district-level coverage rates in 2022 were lower than those in 2019. Most districts decreased between 2019 and 2022, though a few had a continuous increase; some had an increase/recovery between 2020 and 2021; some districts had recovered 2019 levels by 2022. The COVID-19 pandemic impacted Sierra Leone's national BCG, measles-rubella, and pentavalent antigen immunization, which were not fully restored in 2022. Most districts experienced notable coverage declines during the pandemic, though a few reached or surpassed 2019 rates in 2022. Examining pandemic impact can benefit from a focus beyond the national level to identify vulnerable regions. Sierra Leone's post-pandemic RI reestablishment needs targeted strategies and continual investments for equitable access and coverage, as well as to prevent vaccine-preventable diseases.

Sections du résumé

BACKGROUND BACKGROUND
The COVID-19 pandemic had a profound impact on healthcare systems and services, including routine immunization (RI). To date, there is limited information on the effects of the COVID-19 pandemic on RI in West African countries such as Sierra Leone, which had already experienced public health emergencies that disrupted its healthcare system. Here, we describe the impact of the COVID-19 pandemic on the RI of key antigens in Sierra Leone.
METHODS METHODS
We used vaccination data from the District Health Information System for BCG, measles-rubella 1 and 2, and pentavalent 1 and 3 antigens. We compared 2019, 2020, 2021, and 2022 annual coverage rates for the selected antigens at the national and district levels. We used the Pearson chi-square test to assess the difference between annual coverage rates between 2019 and 2020, 2020-2021, and 2021-2022.
RESULTS RESULTS
National coverage rates for all antigens declined in 2019-2020, notably measles-rubella 1 and pentavalent 3 (-5.4% and - 4.9%). Between 2020 and 2021, there was an overall increase in coverage (+ 0.2% to + 2.5%), except for measles-rubella 2 (-1.8%). Measles-rubella antigens rebounded in 2021-2022, while others decreased between - 0.5 and - 1.9% in coverage. Overall, all district-level coverage rates in 2022 were lower than those in 2019. Most districts decreased between 2019 and 2022, though a few had a continuous increase; some had an increase/recovery between 2020 and 2021; some districts had recovered 2019 levels by 2022.
CONCLUSION CONCLUSIONS
The COVID-19 pandemic impacted Sierra Leone's national BCG, measles-rubella, and pentavalent antigen immunization, which were not fully restored in 2022. Most districts experienced notable coverage declines during the pandemic, though a few reached or surpassed 2019 rates in 2022. Examining pandemic impact can benefit from a focus beyond the national level to identify vulnerable regions. Sierra Leone's post-pandemic RI reestablishment needs targeted strategies and continual investments for equitable access and coverage, as well as to prevent vaccine-preventable diseases.

Identifiants

pubmed: 38970039
doi: 10.1186/s12889-024-19221-2
pii: 10.1186/s12889-024-19221-2
doi:

Substances chimiques

BCG Vaccine 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1795

Informations de copyright

© 2024. The Author(s).

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Auteurs

Umaru Sesay (U)

KIT Royal Tropical Institute, Amsterdam, The Netherlands. sesayumaru4@gmail.com.
National Surveillance Program, Directorate of Health Security and Emergencies, Emergency Operation Center, National Public Health Agency, Wilkinso Road, Freetown City, Sierra Leone. sesayumaru4@gmail.com.
Sierra Leone Field Epidemiology Training Program, Emergency Operation Center, National Public Health Agency, Wilkinson Road, Freetown City, Sierra Leone. sesayumaru4@gmail.com.

Hector Mario Serna-Chavez (HM)

KIT Royal Tropical Institute, Amsterdam, The Netherlands.

Gebrekrstos Negash Gebru (GN)

Sierra Leone Field Epidemiology Training Program, Emergency Operation Center, National Public Health Agency, Wilkinson Road, Freetown City, Sierra Leone.
Africa Field Epidemiology Network, Freetown City, Sierra Leone.

Jia Bainga Kangbai (JB)

Department of Environmental Health, Njala University, Bo City, Sierra Leone.
Tulane University School of Public Health and Tropical Medicine, New Orleans, USA.

Uzoma Ogbonna (U)

Sierra Leone Field Epidemiology Training Program, Emergency Operation Center, National Public Health Agency, Wilkinson Road, Freetown City, Sierra Leone.

James Sylvester Squire (JS)

National Surveillance Program, Directorate of Health Security and Emergencies, Emergency Operation Center, National Public Health Agency, Wilkinso Road, Freetown City, Sierra Leone.

Mirjam Irene Bakker (MI)

KIT Royal Tropical Institute, Amsterdam, The Netherlands.

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