Journal of Vaccines & Vaccination

Highlighting delays in childhood immunization in low-income countries during conflict: Example from a study in Sierra Leone, West Africa

6^th Euro Global Summit and Expo on Vaccines & Vaccination

August 17-19, 2015 Birmingham, UK

Charles Senessie, George N Gage and Erik von Elm

Scientific Tracks Abstracts: J Vaccines Vaccin

Abstract:

Introduction: The Afro-European Medical and Research Network (AEMRN) is a Non-Governmental and non-profit
Organisation with a strong vision of helping to improve the quality of life for people from and living in resource limited
settings. The President of AEMRN and team undertook the above mentioned study in Sierra Leone West Africa to highlight
this very important issue of delayed immunisation in low income countries and worse when compounded by wars. Sierra
Leone underwent a decade of civil war from 1991 to 2001. From this period few data on immunization coverage are available,
and conflict-related delays in immunization according to the Expanded Program on Immunization (EPI) schedule have not
been investigated. We studied delays in childhood Immunization in the context of civil war in a Sierra Leonean community.
Background: Sierra Leone has undergone a decade of civil war from 1991 to 2001. From this period few data on immunization
coverage are available, and conflict-related delays in immunization according to the Expanded Programme on Immunization
(EPI) schedule have not been investigated. We aimed to study delays in childhood immunization in the context of civil war in
a Sierra Leonean community.
Methods: We conducted an immunization survey in Kissy Mess-Mess in the Greater Freetown area in 1998/99 using a twostage
sampling method. Based on immunization cards and verbal history we collected data on immunization for tuberculosis,
diphtheria, tetanus, pertussis, polio, and measles by age group (0-8 / 9-11 / 12-23 / 24-35 months). We studied differences
between age groups and explored temporal associations with war-related hostilities taking place in the community.
Results: We included 286 children who received 1690 vaccine doses; card retention was 87%. In 243 children (85%, 95%
confidence interval (CI): 80-89%) immunization was upto date. In 161 of these children (56%, 95% CI: 50-62%) full ageappropriate
immunization was achieved; in 82 (29%, 95% CI: 24-34%) immunization was not appropriate for age. In the
remaining 43 children immunization was partial in 37 (13%, 95% CI: 9-17) and absent in 6 (2%, 95% CI: 1-5). Immunization
status varied across age groups. In children aged 9-11 months the proportion with age inappropriate (delayed) immunization
was higher than in other age groups suggesting an association with war-related hostilities in the community.
Conclusions: Only about half of children under three years received full age-appropriate immunization. In children born
during a period of increased hostilities, immunization was mostly inappropriate for age, but recommended immunizations
were not completely abandoned. Missing or delayed immunization represents an additional threat to the health of children
living in conflict areas. Hence delays in immunisation of children is among the numerous problems facing the population in
effective adhering to the vaccine schedule leading to the children not being properly immunised for age and hence them being
ultimately ill. This illness from preventable childhood illnesses further places huge economic burden on the entire family
sinking them further into poverty. The cycle can be broken by highlighting this problem and discussing ways to minimise its
impact on the vulnerable population.

Biography :

Charles Senessie is a Medical Doctor and has lectured Dermato-Venereology at the Department of Medicine, College of Medicine in Sierra Leone, was deputy
head of College of Medicine medical team at the Connaught University teaching hospital in Freetown and Director of the Vinel Community hospital in Freetown
Sierra Leone.In Switzerland he has worked as a Research Assistant at the Institute of Social and Preventive Medicine (ISPM), University of Bern, Physician at
the University Children’s Hospital in beider Basel (UKBB) and part time Private Practitioner in Zollikofen. He has Worked as Consultant for the World Health
Organization (WHO) Headquarters Geneva on several projects. He is currently working at the Division of Clinical Trials at Swissmedic in Bern Switzerland. He has
concluded postgraduate studies in Epidemiology from University of London. He is currently pursuing PhD studies in International Health Research from Trident
University International in the United States of America and a second PhD in Public Health from Walden University in USA. He is founder and President of the Afro-
European Medical and Research Network and also CEO of Senessie Low-Income Countries Healthcare and Consultancy Services.