Evaluation of introduction of the Haemophilus influenzae vaccine in Côte d'Ivoire / Évaluation de l'introduction du vaccin anti-haemophilus influenzae en Côte d'Ivoire.

Introduction: Côte d'Ivoire introduced the Haemophilus influenzae type b vaccine into the EPI in March 2009. Following this introduction, an evaluation was conducted in 2012 in order to evaluate the vaccine introduction process. Methods: Data collection methods consisted of document review, structured interviews and direct observation. This study collected information from six health region officials, 12 health districts and 36 healthcare institutions. Seventy-two mothers or child carers were also interviewed. Collected data were processed and analysed by Excel, Epi Info and SPSS. Results: A vaccine introduction plan was developed, but was not communicated at the operational level. The planned training for district health care providers was conducted eighteen months after introduction of the vaccine. None of the vaccinating centres had communication support about the new vaccine. Temperature recording was regularly performed in 92% of district deposits and 68% of vaccinating centres. Deteriorated vaccines were observed in 6% of vaccinating centres. Only 3.5% of parents had been informed about introduction of the vaccine. Increased immunization coverage for the third dose of pentavalent vaccine was observed in one half of health districts. Conclusion: Evaluation of the introduction of Haemophilus influenzae type b vaccine highlightsthe strengths and weaknesses of the health system and provides lessons for the introduction of other vaccines into the expanded programme on immunization.

[Estimated costs of the expanded program of immunization in the health district of Grand Bassam, Cote d'Ivoire]. / Estimation des coûts du programme élargi de vaccination dans le district sanitaire de Grand Bassam, Côte d'Ivoire.

The vaccines of the Expanded Immunization Program are administered free of charge to beneficiaries. However, these vaccines are purchased by countries and partners of immunization. These costs need to be estimated to be better understood. We conducted a descriptive cross-sectional study of the costs of the Expanded Immunization Program in the health district of Grand-Bassam from January 1 to December 31, 2006, with questions aiming to understand the costs from the point of view of the state and partners. We aimed to determine costs by level of expenditure, calculate the cost per child who received 3 doses of vaccine against Diphtheria-Tetanus-Pertussis-Hepatitis B and cost per strategy. Vaccines and injection supplies accounted for 49% of recurrent costs. Vehicles and motorcycles for transport accounted for 73% of non-recurrent costs. The recurrent cost per child who received 3 doses of the vaccine was 10 797 FCFA (16 euros). The recurrent cost per dose administered was 1,041 FCFA (1,58 euros) for the fixed strategy, 4,232 FCFA (6,45 euros) for the outreach strategy and 4,058 FCFA (6,18 euros) for the mobile strategy. Because of the scarcity of financial resources, the Côte d'Ivoire government must strengthen efficient public-health measures, including vaccination.

[Chronic malnutrition among children under five years of age in the northern part of Côte d'Ivoire]. / Malnutrition chronique chez les enfants de moins de 5 ans au nord de la Côte d'Ivoire.

The malnutrition of children under five years of age constitutes a major public health problem in most developing countries. A cross-section study was carried in 2003 in the northern part of Côte d'Ivoire to determine the prevalence of chronic malnutrition and to identify risk factors among children under five years of age living in urban and rural areas of the northern part of Côte d'Ivoire. A total of 292 and 268 children under five years of age residing respectively in urban and rural areas were included in the study. Their median age was 24 months. Chronic malnutrition was more frequent in children from rural areas (39.9%) than in those living in urban areas (16.7%). Malnutrition was significantly associated with the type of food consumed by children under two years of age in urban areas, and it was strongly linked to emaciation of the mother and presence of childhood fever in rural areas. In light of these results, we advocate a healthy diet and adequate health status for the mother and child to improve the nutritional status of children. Moreover, these results need to be completed and complemented by further studies for more detailed information to contribute to a better definition of actions to fight efficiently against malnutrition among children of the northern part of Côte d'Ivoire.