U.S. CDC support to international SARS-CoV-2 seroprevalence surveys, May 2020-February 2022

SARS-CoV-2 seroprevalence surveys provide critical information to assess the burden of COVID-19, describe population immunity, and guide public health strategies. Early in the pandemic, most of these surveys were conducted within high-income countries, leaving significant knowledge gaps in low-and middle-income (LMI) countries. To address this gap, the U.S. Centers for Disease Control and Prevention (CDC) is supporting serosurveys internationally. We conducted a descriptive analysis of international serosurveys supported by CDC during May 12, 2020-February 28, 2022, using an internal tracker including data on the type of assistance provided, study design, population surveyed, laboratory testing performed, and status of implementation. Since the beginning of the pandemic, CDC has supported 72 serosurveys (77 serosurvey rounds) in 35 LMI countries by providing technical assistance (TA) on epidemiologic, statistical, and laboratory methods, financial assistance (FA), or both. Among these serosurvey rounds, the majority (61%) received both TA and FA from CDC, 30% received TA only, 3% received only FA, and 5% were part of informal reviews. Fifty-four percent of these serosurveys target the general population, 13% sample pregnant women, 7% sample healthcare workers, 7% sample other special populations (internally displaced persons, patients, students, and people living with HIV), and 18% assess multiple or other populations. These studies are in different stages of implementation, ranging from protocol development to dissemination of results. They are conducted under the leadership of local governments, who have ownership over the data, in collaboration with international partners. Thirty-four surveys rounds have completed data collection. CDC TA and FA of SARS-CoV-2 seroprevalence surveys will enhance the knowledge of the COVID-19 pandemic in almost three dozen LMI countries. Support for these surveys should account for current limitations with interpreting results, focusing efforts on prospective cohorts, identifying, and forecasting disease patterns over time, and helping understand antibody kinetics and correlates of protection.

Factors contributing to routine immunization performance in Ethiopia, 2014.

INTRODUCTION: An increasing trend of routine immunization performance has generally been observed over the past decade in Ethiopia. However, the improvement is irregular with wide disparity among and within regions. This study analyzes health facility characteristics contribution to immunization performance in Ethiopia. METHODS: We conducted a cross-sectional study and compared characteristics of health facilities in good and poor performing zones. We used administrative coverage reports and Personal Digital Assisted (PDA) supervisory data collected by WHO EPI field officers using a standardized structured checklist. We selected 48 zones and 302 health facilities based on immunization performance data and supervisory data on potential variables. RESULTS: Logistics regression was used to identify independent contributors to good immunization performance. On logistics regression we found that: actions by higher levels in conducting supervision (Odds Ratio (OR) =4.15. 95% Confidence Interval (CI) = 1.85, 9.32, p value <0.01] and providing written feedback (Odds Ratio (OR) =4.35. 95% Confidence Interval (CI) = 2.27, 8.33, p value <0.01) , and provision of immunization services by the health facility itself for catchment population under each health unit (Odds Ratio (OR) =20.15. 95% Confidence Interval (CI) = 2.24, 181.38, p value =0.01) and absence of stock out of vaccines (Odds Ratio (OR) =0.44. 95% Confidence Interval (CI) = 0.23, 0.83, p value =0.01) are the likely significant factors contributing to good immunization performance in Ethiopia. CONCLUSION: Ensuring availability of immunization services in all health facilities, regular supervision and written feedback and improved stock management are essential factors contributing to good immunization performance.

Effects of polio eradication activities on routine immunization: lessons from the 2013 outbreak response in Somali region of Ethiopia.

INTRODUCTION: Ethiopia experienced several WPV importations with a total of 10 WPV1 cases confirmed during the 2013 outbreak alone before it is closed in 2015. We evaluated supplemental immunization activities (SIAs), including lessons learned for their effect on the routine immunization program during the 2013 polio outbreak in Somali regional state. METHODS: We used descriptive study to review documents and analyse routine health information system reports from the polio outbreak affected Somali regional state. RESULTS: All data and technical reports of the 15 rounds of polio SIAs from June 2013 through June 2015 and routine immunization coverages for DPT-Hib-HepB 3 and measles were observed. More than 93% of the SIAs were having administrative coverage above 95%. The trend of routine immunization for the two antigens, over the five years (2011 through 2015) did not show a consistent pattern against the number of SIAs. Documentations showed qualitative positive impacts of the SIAs strengthening the routine immunization during all courses of the campaigns. CONCLUSION: The quantitative impact of polio SIAs on routine immunization remained not so impressive in this study. Clear planning, data consistencies and completeness issues need to be cleared for the impact assessment in quantitative terms, in polio legacy planning as well as for the introduction of injectable polio vaccine through the routine immunization.