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BACKGROUND: Epidemics of meningococcal disease constitute a major public health challenge in Africa, affecting mostly the 24 countries of the meningitis belt. These epidemics led to a call for a call for a safe, effective and affordable conjugate vaccine against the major serogroup responsible for recent epidemics by leaders of the region. OBJECTIVE: This paper documents experiences with efforts at eliminating epidemic meningitis in the African Region. METHOD: The meningoccocal serogroup A conjugate vaccine was developed, licensed and offered to more than 235 million people through mass vaccination campaigns in 16 countries since 2010. Future plans include providing the vaccine to the remaining countries in the African Meningitis Belt and, to implement the vaccine into routine national infant immunization programme and to organise catch-up immunization campaigns every 5 years for unvaccinated <5 year-olds who had missed their routine vaccinations. RESULTS: The success of the project is evidenced by the large declines in cases of group A meningococcal disease since 2010, with no cases reported in vaccinated persons across the 16 countries, reflecting the highly effective nature of the vaccine. The successful control of serogroup A meningococcal disease has highlighted the need to tackle other meningococcal serogroups through development of polyvalent conjugate vaccines with the aim of eliminating epidemics of meningococcal meningitis in the African region.
RESUMO
INTRODUCTION: Cameroon's cities have a growing concentration of target children not adequately covered by routine immunization programmes. METHODS: We conducted a descriptive cross-sectional study, based on exhaustive sampling of legal health care facilities offering routine immunization services in the health district of Djoungolo (city of Yaoundé). The evaluation of the immunization programmes was based on the "Reaching Every District" approach. RESULTS: Out of the 70 health care facilities that participated in the study, 3 (4.3%) had an updated microplan for routine immunization. Out of the 63 (89.4%) health care facilities with functional refrigerator, 12 (19.0%) vaccinated employing a fixed strategy on daily basis. Fifty-seven (81.0%) health care facilities did not conduct immunization sessions employing advanced strategy. Community participation in routine immunization programs was effective in 1 out of 12 districts health areas. A steadily updated vaccine tracking curve was available in 6 (8.5%) health facilities. CONCLUSION: The "Reaching Every District" approach implemented in Djoungolo health care district doesn't provide adequate coverage of a maximum rate of targeted children. The effectiveness of realistic microplanning, the regularity of vaccination sessions employing fixed and advanced strategies, action-oriented data monitoring, community revitalization plan to promote immunization are ways to improve the provision of vaccination services in this district.
