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Semakula M, Niragire F, Nsanzimana S, Remera E, Faes C. Spatio-temporal dynamic of the COVID-19 epidemic and the impact of imported cases in Rwanda. BMC Public Health 2023; 23:930. [PMID: 37221533 DOI: 10.1186/s12889-023-15888-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/12/2023] [Indexed: 05/25/2023] Open
Abstract
INTRODUCTION Africa was threatened by the coronavirus disease 2019 (COVID-19) due to the limited health care infrastructure. Rwanda has consistently used non-pharmaceutical strategies, such as lockdown, curfew, and enforcement of prevention measures to control the spread of COVID-19. Despite the mitigation measures taken, the country has faced a series of outbreaks in 2020 and 2021. In this paper, we investigate the nature of epidemic phenomena in Rwanda and the impact of imported cases on the spread of COVID-19 using endemic-epidemic spatio-temporal models. Our study provides a framework for understanding the dynamics of the epidemic in Rwanda and monitoring its phenomena to inform public health decision-makers for timely and targeted interventions. RESULTS The findings provide insights into the effects of lockdown and imported infections in Rwanda's COVID-19 outbreaks. The findings showed that imported infections are dominated by locally transmitted cases. The high incidence was predominant in urban areas and at the borders of Rwanda with its neighboring countries. The inter-district spread of COVID-19 was very limited due to mitigation measures taken in Rwanda. CONCLUSION The study recommends using evidence-based decisions in the management of epidemics and integrating statistical models in the analytics component of the health information system.
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Affiliation(s)
- Muhammed Semakula
- I-BioStat, Hasselt University, Hasselt, Belgium.
- College of Business and Economics, Centre of excellence in Data Science, Bio-statistics, University of Rwanda, Kigali, Kigali, Rwanda.
- Rwanda Biomedical Centre, Ministry of Health, Kigali, Rwanda.
| | - François Niragire
- Department of Applied Statistics, University of Rwanda, Kigali, Kigali, Rwanda
| | | | - Eric Remera
- Rwanda Biomedical Centre, Ministry of Health, Kigali, Rwanda
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Nchinjoh SC, Saidu Y, Agbor VN, Mbanga CM, Jude Muteh N, Njoh AA, Ndoula ST, Nsah B, Edwige NN, Roberman S, Zamir CS. Factors Associated with Zero-Dose Childhood Vaccination Status in a Remote Fishing Community in Cameroon: A Cross-Sectional Analytical Study. Vaccines (Basel) 2022; 10:vaccines10122052. [PMID: 36560465 PMCID: PMC9784537 DOI: 10.3390/vaccines10122052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022] Open
Abstract
Background: Cameroon's suboptimal access to childhood vaccinations poses a significant challenge to achieving the Immunization Agenda 2030 goal-ranking among the top 15 countries with a high proportion of zero-dose (unvaccinated) children worldwide. There are clusters of zero-dose children in pockets of communities that traditionally miss essential healthcare services, including vaccination. The Manoka Health District (MHD) is home to such settlements with consistently low vaccination coverages (DPT-HepB-Hib-1: 19.8% in 2021) and frequent outbreaks of vaccine-preventable diseases (VPD). Therefore, the absence of literature on zero-dose children in this context was a clarion call to characterize zero-dose children in fragile settings to inform policy and intervention design. Methodology: This cross-sectional analytical study involved 278 children, 0-24 months of age, selected from a 2020 door-to-door survey conducted in the two most populous health areas in an archipelago rural district, MHD (Cap-Cameroon and Toube). We used R Statistical Software (v4.1.2; R Core Team 2021) to run a multivariable logistic regression to determine zero-dose associated factors. Results: The survey revealed a zero-dose proportion of 91.7% (255) in MHD. Children who were delivered in health facilities were less likely to be zero-dose than those born at home (AOR: 0.07, 95% CI: 0.02-0.30, p = 0.0003). Compared to children born of Christian mothers, children born to minority non-Christian mothers had higher odds of being zero-dose (AOR: 6.55, 95% CI: 1.04-41.25, p = 0.0453). Children born to fathers who are immigrants were more likely to be zero-dose children than Cameroonians (AOR: 2.60, 95% CI = 0.65-10.35, p = 0.0016). Younger children were likely to be unvaccinated compared to older peers (AOR: 0.90, 95% CI: 0.82-1.00, p = 0.0401). Conclusions: In the spirit of "leaving no child behind," the study highlights the need to develop context-specific approaches that consider minority religious groups, immigrants, and younger children, including newborns, often missed during vaccination campaigns and outreaches.
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Affiliation(s)
- Sangwe Clovis Nchinjoh
- Clinton Health Access Initiative Inc., Yaounde P.O. Box 2664, Cameroon
- Faculty of Medicine, The Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem 91120, Israel
- Correspondence: ; Tel.: +237-678-687-939
| | - Yauba Saidu
- Clinton Health Access Initiative Inc., Yaounde P.O. Box 2664, Cameroon
- Institute for Global Health, University of Siena, 53100 Siena, Italy
| | - Valirie Ndip Agbor
- Clinton Health Access Initiative Inc., Yaounde P.O. Box 2664, Cameroon
- Nuffield Department of Population Health, University of Oxford, Oxford OX1 2JD, UK
| | | | | | - Andreas Ateke Njoh
- Expanded Program on Immunization, Cameroon Ministry of Public Health, Yaoundé P.O. Box 2084, Cameroon
- School of Global Health and Bioethics, Euclid University, Bangui BP 157, Central African Republic
| | - Shalom Tchofke Ndoula
- Expanded Program on Immunization, Cameroon Ministry of Public Health, Yaoundé P.O. Box 2084, Cameroon
| | - Bernard Nsah
- Clinton Health Access Initiative Inc., Yaounde P.O. Box 2664, Cameroon
| | | | - Sveta Roberman
- Faculty of Medicine, The Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem 91120, Israel
- The Gordon Academic College of Education, Haifa 3570503, Israel
| | - Chen Stein Zamir
- Faculty of Medicine, The Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem 91120, Israel
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Measles epidemic in Southern Vietnam: an age-stratified spatio-temporal model for infectious disease counts. Epidemiol Infect 2022; 150:e169. [PMID: 36093597 PMCID: PMC9980966 DOI: 10.1017/s0950268822001431] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Measles resurged in Vietnam between 2018 and 2020, especially in the Southern region. The proportion of children with measles infection showed quite some variation at the provincial level. We applied a spatio-temporal endemic-epidemic modelling framework for age-stratified infectious disease counts using measles surveillance data collected in Southern Vietnam between 1 January 2018 and 30 June 2020. We found that disease transmission within age groups was greatest in young children aged 0-4 years whereas a relatively high between-group transmission was observed in older age groups (5-14 years, 15-24 years and 25+ years groups). At the provincial level, spatial transmission followed an age-dependent distance decay with measles spread mainly depending on local and neighbouring transmission. Our study helped to clarify the measles transmission dynamics in a more detailed fashion with respect to age strata, time and space. Findings from this study may help determine proper strategies in measles outbreak control including promotion of age-targeted intervention programmes in specific areas.
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Nguyen THT, Nguyen TV, Luong QC, Ho TV, Faes C, Hens N. Understanding the transmission dynamics of a large-scale measles outbreak in Southern Vietnam. Int J Infect Dis 2022; 122:1009-1017. [PMID: 35907478 DOI: 10.1016/j.ijid.2022.07.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 07/21/2022] [Accepted: 07/21/2022] [Indexed: 10/16/2022] Open
Abstract
OBJECTIVES During 2018-2020, Southern Vietnam experienced a large measles outbreak of over 26,000 cases. We aimed to understand and quantify the measles spread in space-time dependence and the transmissibility during the outbreak. METHODS Measles surveillance reported cases between 1/2018 and 6/2020, vaccination coverage, and population data at provincial level were used. To illustrate the spatiotemporal pattern of disease spread, we employed the endemic-epidemic multivariate time series model decomposing measles risk additively into autoregressive, spatiotemporal, and endemic component. Likelihood-based estimation procedures were performed to determine the time-varying reproductive number Re of measles. RESULTS Our analysis shows that measles incidence was associated with vaccination coverage heterogeneity and spatial interaction between provincial units. The risk of infections was dominated by between-province transmission (36.1% to 78.8%), followed by local endogenous transmission (4.1% to 61.5%) whereas the endemic behavior had a relatively small contribution (2.1% to 33.4%) across provinces. In the exponential phase of the epidemic, Re was above the threshold with a maximum value of 2.34 (95%CI: 2.20-2.46). CONCLUSION Local vaccination coverage and human mobility are important factors contributing to the measles dynamics in Southern Vietnam and the high risk of inter-provincial transmission is of most concern. Strengthening disease surveillance is recommended, and further research is essential to understand the relative contribution of population immunity and control measures in measles epidemics.
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Affiliation(s)
- Thi Huyen Trang Nguyen
- Hasselt University, 3500 Hasselt, Belgium; The Pasteur Institute in Ho Chi Minh City, 70000 Ho Chi Minh City, Vietnam.
| | - Thuong Vu Nguyen
- The Pasteur Institute in Ho Chi Minh City, 70000 Ho Chi Minh City, Vietnam
| | - Quang Chan Luong
- The Pasteur Institute in Ho Chi Minh City, 70000 Ho Chi Minh City, Vietnam
| | - Thang Vinh Ho
- The Pasteur Institute in Ho Chi Minh City, 70000 Ho Chi Minh City, Vietnam
| | | | - Niel Hens
- Hasselt University, 3500 Hasselt, Belgium; The University of Antwerp, 2000 Antwerp, Belgium
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Yuan C, Wang C, Zhu K, Li S, Miao Z. Measles Epidemiology and Viral Nucleoprotein Gene Evolution in Shandong Province, China. J Med Virol 2022; 94:4926-4933. [PMID: 35711081 DOI: 10.1002/jmv.27941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 05/18/2022] [Accepted: 06/14/2022] [Indexed: 11/07/2022]
Abstract
Measles, caused by measles virus (MeV), has not been eradicated in many regions and countries, threatening human health. Thus, it is beneficial for measles elimination to understand measles epidemiology and molecular evolution of key viral genes, such as nucleoprotein (N) gene. Based on public data, measles epidemiological information and MeV N gene sequences reported in Shandong Province, China were comprehensively collected and systematically analyzed. The results showed a positive correlation between population density and measles incidence (r = + 0.31), while negative correlations were found between measles incidence and healthcare condition (r = - 0.21) as well as average routine vaccination rate (r = - 0.11). Additionally, the predominant lineage of MeV in Shandong was formed by genotype H1 strains, and the time of the most recent common ancestor of the N gene of MeV genotype H1 in Shandong traced back to 1987 (95% highest posterior density, 1984-1990) with relatively rapid evolution (mean rate, 1.267×10-3 substitutions/site/year). The genetic diversity of MeV N gene increased with the substantial emergence of major divergent clades of genotype H1 before 2005 and then remained relatively stable. In summary, these findings provided a significant insight into the measles elimination. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Chuang Yuan
- School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230026, China.,School of Life Sciences, Shandong First Medical University, Tai'an, Shandong, 271000, China
| | - Cheng Wang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Shandong, 250002, China.,National Institute of Health Data Science of China, Shandong University, Shandong, 250002, China
| | - Kongfu Zhu
- School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230026, China
| | - Song Li
- School of Basic Medicine, Shandong First Medical University, Tai'an, Shandong, 271000, China
| | - Zengmin Miao
- School of Life Sciences, Shandong First Medical University, Tai'an, Shandong, 271000, China
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Ngwa CH, Doungtsop BCK, Bihnwi R, Ngo NV, Yang NM. Burden of vaccine-preventable diseases, trends in vaccine coverage and current challenges in the implementation of the expanded program on immunization: A situation analysis of Cameroon. Hum Vaccin Immunother 2021; 18:1939620. [PMID: 34197271 PMCID: PMC8920166 DOI: 10.1080/21645515.2021.1939620] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The discovery and development of vaccines remain one of the major successes of global health with millions of lives saved every year through routine vaccination. Although vaccines provide a safe and cost-effective solution to vaccine-preventable diseases (VPDs), VPDs are still a serious public health problem in most parts of the world, especially in sub-Saharan Africa (SSA) and Asia. In this review, we discuss the burden of VPDs and vaccine coverage several decades after the introduction of the Expanded Program on Immunization (EPI) in Cameroon. We also discuss how different factors affect the implementation of the EPI, highlighting context-specific factors such as the ongoing civil conflict in Cameroon, and the presence of other infectious diseases like COVID-19.
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Affiliation(s)
- Che Henry Ngwa
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Languages and Literature, Lund University, Lund, Sweden
| | | | | | - Ngo Valery Ngo
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Niendum Mediatrice Yang
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Lazarus DD, Afolayan FID, Mamo G, Dinga JN, Akinbobola J, Duedu KO, Tshifhiwa N, Kassa T, Nene V, Dieye Y, Oumouna M. African Vaccinology Network (AfVANET): an African network by African scientists. Pan Afr Med J 2020; 37:66. [PMID: 33244329 PMCID: PMC7680220 DOI: 10.11604/pamj.2020.37.66.21688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 07/13/2020] [Indexed: 11/11/2022] Open
Affiliation(s)
- David Dazhia Lazarus
- Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa.,National Veterinary Research Institute, Vom, Plateau, Nigeria
| | | | - Gezahegne Mamo
- College of Veterinary Medicine and Agriculture, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Jones Akinbobola
- Faculty of Veterinary Medicine, Department of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - Kwabena Obeng Duedu
- Department of Biomedical Sciences, University of Health and Allied Sciences, Ho, Ghana
| | | | - Tesfaye Kassa
- School of Medical Laboratory Science, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Vish Nene
- International Livestock Research Institute, Nairobi, Kenya
| | - Yakhya Dieye
- University Cheikh Anta Diop and Pasteur Institute, Dakar, Senegal
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