Browsing by Author "Cameron, Neil"

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    Evaluating measles vaccination coverage in high incidence areas of the Western Cape Province, following the mass vaccination campaign
    (2012) Bernhardt, Gina Leanne; Coetzee, David; Cameron, Neil
    Measles virus is known to be one of the most contagious of infectious agents and despite considerable progress towards elimination, a number of Sub-Saharan African countries experienced epidemics in 2009-2011, including South Africa, in which there were over 18 000 confirmed cases. The South African measles vaccination programme started in 1975 with 1 dose schedule, and from 1996-8 has followed the World Health Organization-United Nations Children’s Fund strategy. This includes a 2 dose routine vaccination schedule for children at 9 and 18 months of age, supplementary mass vaccination campaigns (MVCs) for children conducted 4 yearly, improved case management and casebased laboratory surveillance. Administrative monitoring of routine vaccination coverage is problematic, and often overestimated, because of denominator and numerator inaccuracies. The potential for a significant outbreak in the Western Cape Province was therefore not recognized. Over 2000 cases were confirmed in the Western Cape epidemic which began in September 2009 and peaked in March 2010. The Metropole district was mainly affected and over 60% of the cases were under 5 years of age, with 29% aged 6 to 11 months. A MVC, against measles had already been planned; however as a result of the epidemic the targeted age group for measles vaccination was extended from 9 to 59 months, to include children from 6 months to 15 years. This was conducted nationally from 12 to 23 April 2010.
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    Is the Western Cape at risk of an outbreak of preventable childhood diseases? Lessons from an evaluation of routine immunisation coverage
    (2008) Corrigall, Joanne; Coetzee, David; Cameron, Neil
    OBJECTIVE: To determine the routine immunisation coverage rates in children aged 12 - 23 months in the Western Cape. DESIGN: Cross-sectional Household Survey using an adaptation of the '30 by 7' cluster survey technique. SETTING: Households across the Western Cape. SUBJECTS: A total of 3 705 caregivers of children aged 12 - 23 months who had been living in the Western Cape for at least 6 months. OUTCOME MEASURES: Vaccination status (1 = fully vaccinated; 0 = partially vaccinated) as recorded on a Road-to-Health card or by history. Reasons for not vaccinating were established from a questionnaire. RESULTS: The immunisation coverage was 76.8% for vaccines due by 9 months and 53.2% for those due by 18 months. The reasons given for not being immunised were clinic-related factors (47%), lack of information (27%), caregiver being unable to attend the clinic (23%), and lack of motivation (14%). Of the clinic factors cited, the two commonest ones were missed opportunities (34%) and being told by clinic staff to return another time (20%). CONCLUSION: While the coverage indicates that a great deal of good work is being done, the coverage is insufficient to prevent outbreaks of measles and other common childhood conditions, including polio. The coverage is too low to consider not running periodic mass campaigns for measles and polio. It will need to be sustainably improved before introducing rubella vaccine as part of the Expanded Programme on Immunisations (EPI) schedule. The reasons given by caregivers for their children not being immunised are valuable pointers as to where interventions should be focused.