System and site readiness for conducting active surveillance of adverse Events following Immunization in Addis Ababa, Ethiopia.
No Thumbnail Available
Date
2021-06
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Abeba University
Abstract
Background: Vaccine pharmacovigilance (PV) aims to detect, assess, comprehend, communicate
and manage adverse events following immunization (AEFI). To help distinguish vaccine related
AEFIs from coincidental occurrences, an active PV prospective surveillance programs (e.g. hospitalbased
sentinel sites) are needed. We describe our experience in assessing system and facility
readiness for implementing a pilot active AEFI PV in Addis Ababa, Ethiopia.
Method: Three hospitals were selected for this study after objectively evaluating all the government
hospitals in Addis Ababa using parameters ;ongoing collaborations with the Ethiopian Food and
Drug Authority (EFDA), previous experience in research, being referral government hospital and
proximity to key AEFI stakeholders in Addis Ababa. We developed a readiness assessment together
with scoring tool and system readiness assessment tool by adapting published framework. The site
assessment was conducted via in person interview of specific departments in each hospital while a
desk review of AEFI guideline, Expanded Program for Immunization (EPI) guideline, EFDA and
Ethiopian Public Health Institute (EPHI) website was done for system readiness.
Results: Three out of thirteen (23.1%) hospitals in Addis Ababa met the criteria for our site
assessment. During the system readiness assessment, we found that essential components were in
place, Specific regulation and proclamation on AEFI surveillance except mentioning responsibility
of every stakeholder on the guideline was, however absent. Based on the scoring tool, Tikur Anbessa
Specialized Hospital (TASH) scored 94 out of 155 (60.6%), Saint Paul Hospital Millennium Medical
College scored 75 out of 155 (48.38%) and Gandi Memorial Hospital scored 62 out of 155 (40%).
Paper-based records were used by all departments except those of laboratory and radiology in TASH
and SPHMMC. International Classification of Disease (ICD) 9/10 coding was only used in TASH.
Copies of national AEFI guidelines were not present in all departments and reporting forms were
found only in 4 departments surveyed across the three hospitals. Staff at both Gandi Memorial
Hospital and SPHMMC reported absence of training on AEFI surveillance.
Conclusion: TASH has the highest score after assessing readiness for piloting active AEFI
surveillance. We also identified the following areas for improvement in all hospitals to ensure
successful implementation: training, making guideline and reporting forms available, and ensuring a
system that accommodates paper-based and electronic record systems.
Description
Keywords
Immunization,System