Capacity building of public health laboratories in Afghanistan: challenges and successes [2007-2011]

The continuing state of conflict and the resulting devastation of infrastructure have made Afghanistan exceptionally vulnerable to disease epidemics. The paper reports initiatives by the United States Naval Medical Research Unit No. 3 to promote capacity building in a number of key medical laboratories and enable the Afghans to detect emerging and re-emerging diseases of public health importance. Equipment, supplies and laboratory staff training were critical for disease diagnosis and fulfilment of obligations of the International Health Regulations 2005. Accordingly, many diseases outbreaks were recently identified, including avian and pandemic influenza, febrile illness, watery diarrhoea, jaundice and leishmaniasis. Clinical samples and disease vectors were collected for analysis, and microbial isolates were obtained for further characterization. The expanded range and enhanced accuracy of laboratory procedures have facilitated selected local laboratories to monitor, detect, identify, assess, contain and respond to public health threats. Nevertheless, policies of sustainability and infectious diseases control need continuous support and emphasis

Study of adverse events of A/H1N1 vaccine among health care staff in selected provinces of Afghanistan, 2010

At the end of March 2010 an A/H1N1 vaccination campaign was conducted in Afghanistan using donated vaccines. However, no surveillance system for detection of adverse events following immunization was in place. We report a cross-sectional, descriptive survey in 4 provinces of Afghanistan to assess the rate of adverse events among health care staff immunized with A/H1N1 monovalent vaccine 4 weeks after vaccination. Using random sampling proportionate to size, 350 staff [mean age 36 years, range 16-65 years] were surveyed using a questionnaire. The highest self-reported rates of adverse events were pain at the injection site [53%], fever in the first 3 days after immunization [40%], body pain [39%], tiredness [33%], swelling at the injection site [29%] and redness at the injection site [28%]. More females than males suffered adverse reactions and the rates varied across different provinces, ranging from 79% in Balkh to 23% in Kabul