Comparison of school based and supplemental vaccination strategies in the delivery of vaccines to 5-19 year olds in Africa - a systematic review [version 1; referees: 2 approved]

Background: Some vaccine preventable diseases (VPDs) still remain a public health burden in many African countries. The occurrence of VPDs in all age groups has led to the realization of the need to extend routine immunisation services to school age children, adolescents and adults. Supplemental imm...

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Main Authors: Eposi C. Haddison, Leila H. Abdullahi, Rudzani Muloiwa, Gregory D. Hussey, Benjamin M. Kagina
Format: Article
Language:English
Published: F1000 Research Ltd 2017-10-01
Series:F1000Research
Subjects:
Online Access:https://f1000research.com/articles/6-1833/v1
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spelling doaj-7df8516ea66e465a876fae3baa902ad32020-11-25T04:00:51ZengF1000 Research LtdF1000Research2046-14022017-10-01610.12688/f1000research.12804.113874Comparison of school based and supplemental vaccination strategies in the delivery of vaccines to 5-19 year olds in Africa - a systematic review [version 1; referees: 2 approved]Eposi C. Haddison0Leila H. Abdullahi1Rudzani Muloiwa2Gregory D. Hussey3Benjamin M. Kagina4Vaccines for Africa Initiative (VACFA), University of Cape Town, Cape Town, South AfricaDivision of Medical Microbiology & Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South AfricaDepartment of Paediatrics & Child Health, Groote Schuur Hospital, University of Cape Town, Cape Town, South AfricaDivision of Medical Microbiology & Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South AfricaVaccines for Africa Initiative (VACFA), University of Cape Town, Cape Town, South AfricaBackground: Some vaccine preventable diseases (VPDs) still remain a public health burden in many African countries. The occurrence of VPDs in all age groups has led to the realization of the need to extend routine immunisation services to school age children, adolescents and adults. Supplemental immunisation activities (SIAs) and school based vaccinations (SBVs) are common strategies used to complement the expanded programme on immunisation (EPI). This review aimed to assess the effectiveness of SIAs compared to SBVs in the administration of vaccines to 5-19 year olds in Africa. Methods: Systematic review methods were used to address our study aim. Several electronic databases were searched up to March 30, 2017 for primary studies investigating the delivery of vaccines via SIAs or SBVs to 5-19 year olds. This search was complemented by browsing reference lists of potential studies obtained from search outputs. Outcomes considered for inclusion were: vaccination coverage, costs of the strategy or its effect on routine immunisation services. Results: Out of the 4938 studies identified, 31 studies met the review inclusion criteria. Both SIAs and SBVs showed high vaccination coverage. However, the SIAs reported higher coverage than SBVs: 91% (95% CI: 84%, 98%) versus 75% (95% CI: 67%, 83%). In most settings, SBVs were reported to be more expensive than SIAs. The SIAs were found to negatively affect routine immunisation services. Conclusions: Both SIAs and SBVs are routinely used to complement the EPI in the delivery of vaccines in Africa. In settings where school enrolment is suboptimal, as is the case in many African countries, our results show SIAs may be more effective in reaching school age children and adolescents than SBVs. Our results re-iterate the importance of evaluating systematic evidence to best inform African authorities on the optimal vaccine delivery strategies targeting school age children and adolescents.https://f1000research.com/articles/6-1833/v1EpidemiologyGlobal HealthHealth Systems & Services ResearchMethods of Clinical Decision-Making
collection DOAJ
language English
format Article
sources DOAJ
author Eposi C. Haddison
Leila H. Abdullahi
Rudzani Muloiwa
Gregory D. Hussey
Benjamin M. Kagina
spellingShingle Eposi C. Haddison
Leila H. Abdullahi
Rudzani Muloiwa
Gregory D. Hussey
Benjamin M. Kagina
Comparison of school based and supplemental vaccination strategies in the delivery of vaccines to 5-19 year olds in Africa - a systematic review [version 1; referees: 2 approved]
F1000Research
Epidemiology
Global Health
Health Systems & Services Research
Methods of Clinical Decision-Making
author_facet Eposi C. Haddison
Leila H. Abdullahi
Rudzani Muloiwa
Gregory D. Hussey
Benjamin M. Kagina
author_sort Eposi C. Haddison
title Comparison of school based and supplemental vaccination strategies in the delivery of vaccines to 5-19 year olds in Africa - a systematic review [version 1; referees: 2 approved]
title_short Comparison of school based and supplemental vaccination strategies in the delivery of vaccines to 5-19 year olds in Africa - a systematic review [version 1; referees: 2 approved]
title_full Comparison of school based and supplemental vaccination strategies in the delivery of vaccines to 5-19 year olds in Africa - a systematic review [version 1; referees: 2 approved]
title_fullStr Comparison of school based and supplemental vaccination strategies in the delivery of vaccines to 5-19 year olds in Africa - a systematic review [version 1; referees: 2 approved]
title_full_unstemmed Comparison of school based and supplemental vaccination strategies in the delivery of vaccines to 5-19 year olds in Africa - a systematic review [version 1; referees: 2 approved]
title_sort comparison of school based and supplemental vaccination strategies in the delivery of vaccines to 5-19 year olds in africa - a systematic review [version 1; referees: 2 approved]
publisher F1000 Research Ltd
series F1000Research
issn 2046-1402
publishDate 2017-10-01
description Background: Some vaccine preventable diseases (VPDs) still remain a public health burden in many African countries. The occurrence of VPDs in all age groups has led to the realization of the need to extend routine immunisation services to school age children, adolescents and adults. Supplemental immunisation activities (SIAs) and school based vaccinations (SBVs) are common strategies used to complement the expanded programme on immunisation (EPI). This review aimed to assess the effectiveness of SIAs compared to SBVs in the administration of vaccines to 5-19 year olds in Africa. Methods: Systematic review methods were used to address our study aim. Several electronic databases were searched up to March 30, 2017 for primary studies investigating the delivery of vaccines via SIAs or SBVs to 5-19 year olds. This search was complemented by browsing reference lists of potential studies obtained from search outputs. Outcomes considered for inclusion were: vaccination coverage, costs of the strategy or its effect on routine immunisation services. Results: Out of the 4938 studies identified, 31 studies met the review inclusion criteria. Both SIAs and SBVs showed high vaccination coverage. However, the SIAs reported higher coverage than SBVs: 91% (95% CI: 84%, 98%) versus 75% (95% CI: 67%, 83%). In most settings, SBVs were reported to be more expensive than SIAs. The SIAs were found to negatively affect routine immunisation services. Conclusions: Both SIAs and SBVs are routinely used to complement the EPI in the delivery of vaccines in Africa. In settings where school enrolment is suboptimal, as is the case in many African countries, our results show SIAs may be more effective in reaching school age children and adolescents than SBVs. Our results re-iterate the importance of evaluating systematic evidence to best inform African authorities on the optimal vaccine delivery strategies targeting school age children and adolescents.
topic Epidemiology
Global Health
Health Systems & Services Research
Methods of Clinical Decision-Making
url https://f1000research.com/articles/6-1833/v1
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