Aim: We investigated the nature and frequency of adverse events following immunization (AEFI) associated with oral polio vaccines (OPV) in the general population in Kinshasa, Democratic Republic of Congo (DR Congo).Methods: The DR Congo National Pharmacovigilance Centre organized active AEFI surveillance during mass immunization campaigns for the general population from March to June 2011. A patient individual case safety report was used as a questionnaire and addressed to pupils and students from high schools and universities who had any adverse events after OPV administration. We used the preferred term from the WHO Adverse Reaction Terminology for AEFI designation. Here is presented the results of the second step of the mass immunization campaign.Results: A total of 767 patients reported AEFI during the second step. Sex distribution shows that 512 (66·8%) students were females, while 255 (33·2%) were males, giving a female/male ratio 2∶1. The average age was 16·8±5·19 years (ranged: 6–35·5 year...

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Adverse events following immunization with oral poliovirus in Kinshasa, Democratic Republic of Congo: preliminary results

Trust, Mumbai, India; 8. Maine Medical Center, Portland, Maine, USA; 9. Boston Medical Center, Boston, Massachusetts, USA; 10. Johns Hopkins University, Baltimore, Maryland, USA. Received September 23, 2014; accepted December 17, 2014; electronically published January 29, 2015 Infect Control Hosp Epidemiol 2015;36(5):605–608 © 2015 by The Society for Healthcare Epidemiology of America. All rights reserved. 0899-823X/2015/3605-0021. DOI: 10.1017/ice.2015.11

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Adverse events following influenza immunization reported by healthcare personnel using active surveillance based on text messages.

Background: Timely reporting of safety information post vaccination is pivotal for the success of any vaccination program. Reports of adverse events following immunization (AEFI) of 6 different vac...

Reporting of adverse events following immunizations in Ghana – Using disproportionality analysis reporting ratios

Background: Despite the significant role played by vaccines in global health, concerns over vaccine safety have increased tre- mendously over the years. There have been occasions where vaccines have caused rare, adverse reactions some of which have led to hospitalizations and even death. It is therefore important to establish the safety profile of routinely used vaccines in order to allay fears pertaining to their use.
Objectives: This review was aimed at pooling together the safety data of selected vaccines used for routine immunization in Africa, a region of the world with paucity of vaccine safety data.
Methods: Adverse Events Following Immunization safety data was searched for rotavirus, yellow fever, measles, rubella, tuber- culosis (Bacillus Calmette Guerin-BCG), pneumococcal, Haemophilus Influenza type b, polio, meningococcal and the influenza A (H1N1) vaccines in PUBMED, Google Scholar, Clinical trials.gov and Cochrane controlled register of trials databases.
Results: A total of twenty-four serious AEFIs and twenty-three minor AEFIs were identified from the review. The strength of association between AEFIs and vaccine was high for tuberculosis vaccine and moderate for all other vaccines.
Conclusion: Even though AEFIs (including mild and severe) were identified in the review, all the vaccines studied were gener- ally well tolerated.
Keywords: Safety of vaccines; immunization; Africa.

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A review of the safety of vaccines used in routine immunization in Africa.

Australian Department of Health, Perth, Western Australia, Australia; 2. School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Western Australia, Australia; 3. School of Medicine, University of Notre Dame, Fremantle, Western Australia, Australia Address correspondence to Lauren E. Tracey, MPH, Communicable Disease Control Directorate, Western Australian Department of Health, 227 Stubbs Terrace, Shenton Park, Western Australia, 6008, Australia (Lauren.Tracey@health.wa.gov.au).

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S0899823X15000203

The impact of role models on hand hygiene compliance.

Cases of the A(H1N1) 2009 influenza were first recorded in Ghana in July 2009. In June 2010 when prioritized vaccination against the novel A(H1N1) 2009 influenza virus started in the country, health workers were among the selected groups to receive the vaccination. The aim of this study was to determine the distribution and types of adverse events reported following immunization of healthcare workers at the Korle-Bu Teaching Hospital from the day vaccination started until 1 week after the end of vaccination. Safety data collected during the A(H1N1) 2009 influenza vaccination of health workers at the Korle-Bu Teaching Hospital (Accra, Ghana) were used for this study. All workers aged 18 years and over were eligible for vaccination. For uniformity, 0.5 mL of Pandemrix® (equivalent to 3.75 μg of hemagglutinin antigen) was administered intramuscularly into the deltoid muscle of the left arm. Each vaccinee was issued with a card and was advised to report any adverse events following immunization (AEFI) to designated health workers for follow-up. Incidence rates of adverse events were estimated and compared with the Pandemrix® Summary of Product Characteristics (SPC) A total of 5870 people (64.9 % females) with a mean age of 34.0 years were vaccinated. In total, 140 vaccinees reported adverse events. The mean age among vaccinees reporting adverse events was 36.1 years. The overall incidence of vaccinees reporting adverse events and the overall incidence of adverse events was 232 (95 % CI 199–320) per 10,000 people and 930 (95 % CI 820–1070) per 10,000 people, respectively. In particular, we found no difference in the way males reported AEFI compared with females (Chi-squared [χ2] = 0.59; p > 0.2), and we did not find any association between age as a categorical variable and vaccine adverse event reporting (χ2 = 5.24; p > 0.1). There were only three serious cases that led to hospitalization. All three cases occurred within 24 hours of receiving the vaccine. The incidence rates for the various reported events were all lower compared with those in the Pandemrix® SPC, but while injection-site pain was the most frequent in the SPC and other foreign studies, we recorded headache as the most frequent. Even fatigue, muscle/joint aches and fever had higher incidence rates compared with injection-site pain. Tachycardia (n = 6), tinnitus (n = 1) and decreased appetite (n = 4) were reported although were not included in the SPC. The most prominent adverse events reported were headaches, dizziness, muscle and joint aches, weakness, fever and injection-site pain. Although similar events were reported in other studies, the incidence was different and there were a few differences in the most frequently reported events. More studies of a similar nature should be encouraged in low- and medium-income countries to bridge the information gap with the developed world.

Incidence of adverse events among healthcare workers following H1N1 Mass immunization in Ghana: a prospective study

Introduction Glaucoma is the leading cause of irreversible blindness worldwide. In Ghana, 19.4% of all blindness recorded is due to glaucoma. Reducing intraocular pressure medically (using eye drops) is the evidence-based therapeutic option. Objective To determine the rational use and undertake cost analysis of anti-glaucoma drugs among patients attending clinic at the Lions International Eye Centre (LIEC), Korle-Bu Teaching Hospital. Methods In this cross-sectional study, we reviewed all prescriptions presented to the pharmacy unit from 01/12/2015 to 31/03/2016. The dispensed drops were classified, and all anti-glaucoma drugs were identified. This was followed by cost analysis. Results A total of 588 prescriptions were captured, 27.3% (161/588) contained an anti-glaucoma medication. The mean number of anti-glaucoma medications was 1.71 of which 52.7% was prescribed to females. Prostaglandin analogs (PGA) were the most prescribed (37% (102/276)), followed by beta blockers (25.4% (70/276)), carbonic anhydrase group of medicines (16.3% (45/276)), combined beta blockers (11.2% (31/276)), alpha agonists (8.7% (24/276)) and miotics (1.4% (4/276)). The median (IQR) cost of anti-glaucoma therapy per prescription per month was GHC 65.00 (GHC38.5-GHC140) about [US$16.25 (US$ 9.6-US$35)]. Azopt (Brimonidine) was the most expensive with daily treatment cost of GHC 5.8 (about US$ 1.45), whilst the least expensive drug with a daily treatment cost of GHC 0.14 (about US$ 0.035) was timolol eye drops. Conclusion Prostaglandin analogs though expensive remain the most preferred treatment for managing glaucoma at the Korle-Bu Eye Centre in Ghana. This may adversely affect treatment among the poor since prostaglandins analogs are currently not covered by insurance.

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Cost Analysis and Rational Use of Anti Glaucoma Therapy in A Tertiary Hospital in Ghana

The World Health Organization (WHO) addressed drug utilization as the marketing, distribution, prescription and use of drugs in a society, considering its consequences, either medical, social, (and) or economic. The increasing importance of drug utilization studies as a valuable investigative resource in pharmacoepidemiology has bridged it with other health related areas, such as public health. Surveillance of drug use by the doctors within the institution as well as in the community is assuming an increasingly key role in therapeutics. This was a cross-sectional study of prescription pattern and drug utilization trends at the Lions International Eye Centre (LIEC) of the Korle Bu Teaching Hospital and adherence to the standard prescription form at the Eye Centre. Prescriptions that were presented to the LIEC pharmacy unit within the period from October 2015 to March 2016 were captured and reviewed. The total number of drugs in the 588 prescriptions was 1265. The average number of drugs per prescription was 2.1. Drug dosage, route of administration, frequency, and duration of treatment record were mentioned in 95.01% (1202/1265), 97% (1227/1265), 98.46% (1240/1265) 96.05% (1215/1265) of the prescriptions respectively. Anti-glaucoma medicines were the most prescribed 21.8% (276/1265), Prescribing by generic name slightly dominated with 51.1% (645/1265) of the total number of drugs prescribed. Use of Ophthalmic antibiotics alone and the use of ophthalmic antibiotics in combination with other medicines were 13.5% (171/1265) and 11.9% (142/1265) respectively.: The findings of this study revealed that the drug utilization pattern was not in line with the recommended standard values of WHO prescribing indicators even though the level of compliance to the requirements on the standard prescription form of the hospital for drug prescribers was remarkably high. The availability of key medicines should be improved whilst generic prescribing from EDL should also be encouraged.

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Drug Utilization Study in Ophthalmology Outpatient Department of a Tertiary Care Hospital in West Africa

http://www.cell.com/article/S240584402304272X/pdf

Advanced pharmacy practice of a doctor of pharmacy student at an allied surgical ward in a hospital in Africa

Introduction: Stroke is associated with high mortality. It is the main neurological cause of mortality and the most important cause of disability worldwide. In the year 2007, Stroke was the third cause of admission at the Korle-Bu Teaching Hospital, and the number one cause of death. Objective: To determine the probability of survival (case-fatality rates) of stroke patients admitted at the Korle- Bu Teaching Hospital during the period 2007. Method: A Retrospective descriptive study of Surgical/Medical Emergency, SME and the Medical wards admissions and discharges from 1st January 2007 to 31st December, 2007. Results: A total of 250 hospitalized stroke patients were identified, of which 68(27%) were from the SME and 182(72%) from the medical wards. The mean age (SD) was 57.6(14.7) and 52% were males. Case fatality rate was 52% at the SME versus 35% at the Medical wards) whilst the risk of death in males expressed as risk ratio (RR) was 2.1, (95% CI 0.70-5.6) vs. RR=1.3, (95% CI 0.73-2.5) in females and the median survival time was 2days (95% CI 1.5-2.4) versus 7 days (95% CI 6.3-7.6) at the SME and Medical respectively. The type of admission and stroke outcome was significant P=0.01 (95%CI 0.02-0.14). Conclusion: Stroke was associated with high mortality. The risk of dying from stroke was higher at the SME Findings were independent of stroke subtype, stroke onset and any associated co-morbidities. 

Charles Nii Kwade Ofei-Palm

Papers

Incidence of adverse events among healthcare workers following H1N1 Mass immunization in Ghana: a prospective study

Cost Analysis and Rational Use of Anti Glaucoma Therapy in A Tertiary Hospital in Ghana

Drug Utilization Study in Ophthalmology Outpatient Department of a Tertiary Care Hospital in West Africa

Advanced pharmacy practice of a doctor of pharmacy student at an allied surgical ward in a hospital in Africa

Case Fatality Rate and Prognosis of Stroke Hospitalized Patients: A retrospective hospital-based study at the Korle Bu Teaching Hospital