First Field Test of the Novel Integration Mapping Tool for COVID-19 Vaccination Integration into National Immunization Programs and Primary Healthcare-A Case Study from Côte d'Ivoire.

INTRODUCTION: With the containment of the COVID-19 pandemic in Côte d'Ivoire, efforts were made to seamlessly integrate COVID-19 vaccination into the national immunization program. A collaborative initiative involving UNICEF, WHO, GAVI, and partner organizations resulted in the creation of the COVID-19 Vaccine Integration Mapping Tool. This paper presents a case study documenting the field testing of the integration mapping tool and assessing the integration of COVID-19 vaccination within primary healthcare and routine immunization in Côte d'Ivoire. The study aims to describe the pilot process, gather feedback on tool usefulness and challenges, and establish integration priorities through roadmap development. METHODS: Under the guidance of the Ministry of Health and Universal Coverage Cabinet, a workshop was conducted with participants from major health programs to field test the tool. Data analysis was performed using Excel, and the results were presented through tables, heat maps, and line graphs. RESULTS: The first-of-its-kind field test of the integration mapping tool in Côte d'Ivoire showcased its potential to bring key partners together to discuss the current state of integration, improve transparency about resource allocation, and enhance data management for the incorporation of COVID-19 vaccination into existing immunization systems. The integration of COVID-19 vaccines in Côte d'Ivoire showed a moderate level of progress, with improvement needed in resource allocation, payment systems, targeting of highest-risk groups and vaccine administration. Support should be increased for target population identification, distribution points, quality of care mechanisms, and health personnel training. Health information systems and access to essential medicines were relatively satisfactory. Integration into existing programs, intersectoral collaboration, national health strategy, communication strategy, community participation, and data utilization require improvement. The post-workshop satisfaction survey gave the tool a score of 7 out of 10. Early lessons from Côte d'Ivoire provide guidance on enhancing integration, focusing on data-driven decision-making, collaboration, stakeholder engagement, and effective leadership. CONCLUSIONS: The field test of the integration mapping tool (IMT) in Côte d'Ivoire is groundbreaking as it exemplifies the transformative potential of innovative tools in immunization practices. Application of the IMT sets a precedent for seamless COVID-19 vaccination integration worldwide, emphasizing data-driven decision-making, collaboration, timing, and leadership. The success of the pilot exercise in Côte d'Ivoire was attributed to political commitment, well-facilitated workshops, assessments, and the fact that the team in the country had previously developed an initial integration plan.

Epidemiology of rubella infection and genotyping of rubella virus in Cote d'Ivoire, 2012-2016.

Rubella is a contagious disease caused by the rubella virus (RuV) that can lead to serious birth defects when women are infected in early pregnancy. This study aimed to describe the epidemiology and genetic diversity of rubella viruses in Cote d'Ivoire (CIV). Blood or oral fluid samples collected from suspected measles cases were first tested for the presence of measles specific IgM antibodies by enzyme-linked immunosorbent assay (ELISA). All measles IgM negative or indeterminate samples were tested for rubella IgM antibody using ELISA. Rubella-IgM-positive samples were tested by real-time reverse transcription polymerase chain reaction (RT-PCR) for the presence of rubella virus RNA. Real-time RT-PCR-positive RNA samples were used as template to amplify the 739 nt region used for rubella genotyping. PCR-positive samples were sequenced and phylogenetic analysis performed. Between 2012 and 2016, 4121 serums and 126 oral fluids were collected through the measles surveillance system. Of these, 3823 and 108 respectively were measles IgM negative or indeterminate. Subsequent testing for rubella found that 690 of 3823 (18%) serum samples and 25 of 108 (23%) oral fluid samples were rubella IgM-positive. The 739 nt segment of the E1 glycoprotein gene was amplified and sequenced for two serums and seven oral fluids samples. Phylogenetic analysis showed that the rubella viruses from CIV belonged to genotypes 1G (eight samples) and 2B (one sample). Rubella virus genotype 2B was found in CIV for the first time. These data contribute to baseline information on rubella virus strains found in CIV before the introduction of rubella vaccine.

[Epidemiology of induced abortion in Côte d'Ivoire]. / Épidémiologie des avortements provoqués en Côte d'Ivoire.

The objective of this study was to examine induced abortion in Côte d'Ivoire. A nationwide cross-sectional descriptive study of induced abortion was carried out in 2007 among 3,057 women aged 15-49 years. The study showed that induced abortion is a widespread practice in Côte d'Ivoire, with a prevalence estimated at 42.5%. The women who had undergone an abortion were generally under 25, unmarried, and illiterate, and had used contraception. More than half (52.1%) of all induced abortions were performed at home by traditional abortionists or were self-induced with plants or decoctions. The main reasons for induced abortion were concern about the reaction of parents (27.7%), age (22.2%), a lack of financial resources (21.3%) and the desire of women to continue their education. More than half of the participants (55.8%) stated that they had suffered complications, which were more common after a home abortion than after a hospital abortion. Political and legal measures or reforms aimed at changing abortion laws in Côte d'Ivoire and better access to family planning are required in order to prevent or treat the social issue of induced abortion.

[Adherence to rabies vaccine treatment for people exposed to rabies in Abidjan (Côte d' Ivoire)]. / Observance du traitement vaccinal antirabique chez les sujets exposés à la rage à Abidjan (Côte d'Ivoire).

This descriptive retrospective study ran from August 2003 to December 2003 at the Rabies Center of the National Institute of Public Health in Abidjan. It covers subjects at risk of rabies transmission during 2004. Identification of participants in the study was made via a census of patients consulting the rabies clinic: a total of 533 subjects were included, predominantly male (54.6%), without gainful employment (57%), with an average age of 26.7 years. Those who lived outside the city of Abidjan accounted for 21.6%. In 88.2% of cases, they were exposed due to a bite. Dogs (90.8%) represented the main species responsible for this kind of exposure. Only 3.2% of these animals had a current valid rabies vaccine. The owner of the animal was not known in 71% of cases. The observance of the recommended immunization schedule for 4 doses was 53.1%. Of the 533 patients registered in the study, 46.9% had stopped treatment vaccine. Some factors have been identified as adversely affecting adherence, such as the vaccination treatment plan of 5 doses, exposure outside the city of Abidjan, unemployment, incurrence of superficial injuries, exposure from an animal bite and lack of immunization of the animal. The results show that the strategies against rabies must focus increasingly on the importance of adherence to treatment and education of the population vis-à-vis the risk of rabies.

Safety of the yellow fever vaccine during the September 2001 mass vaccination campaign in Abidjan, Ivory Coast.

In 2001, a vaccination campaign against yellow fever was carried out in Abidjan, Cote d'Ivoire. During the campaign and 4 weeks after an active surveillance system for adverse events following immunization (AEFI) was set up. More then 2.6 million doses were administered and 87 AEFI were notified. Eight suspected YF cases were reported after vaccination and considered as AEFI. However, none had IgM for YF and all recovered without sequels. This surveillance system provided reassuring data about the safety of the YF vaccine and proved that it is feasible to set up an active surveillance system during a mass campaign.