POST 00814E : OTHER INTERVENTIONS WITH VACCINATION

POST 00814E : OTHER INTERVENTIONS WITH VACCINATION Follow-up on Posts 00789E, 00791E, 00793E, 00798E and 00807E 23 July 2005 _____________________________________ Jenny Meya Nyirenda (mailto:[email protected]) from Zambia, contributes some answers to my questions in Posts 00807E. I admit some of my questions were pretty naïve. However, if integrating with routine immunization is not practical because of age group, then in some other countries, they provide deworming treatments from 12 months, even younger. In one of the presentations, it is said that Zambia targets children 12-59 months. Wouldn't it be a good idea to provide deworming with the measles dose at nine months, for example? Of course the need for successive treatments until age five remains. There are more and more campaigns, even with integrating many interventions into one campaign. I'm not sure that it serves any health promotion or prevention in an active manner. I'm rather afraid that parents will only count more and more on campaigns to get some preventive health care for their children and discharge themselves of their responsibilities on a continuous basis. In industrialized countries, there are no campaigns as such any more, and children generally get immunized. Some parents even exaggerate and run to the pediatrician for a small red spot on a child's skin. But most mothers do bring their children for check-ups regularly. All the interventions that are grouped into a campaign or child health week should be available on a routine basis at health centers. Are they really, and offered? It is likely that in many countries, parents would have to pay something at the health center while in campaigns, it is free, so why not wait for the campaign? So it becomes a vicious circle. I know it will take long until parents bring their children regularly to health centres whether they are ill or not, probably as long as sanitation will take to do the trick for worms. But I believe that this should be the goal. I'm not sure we are moving towards it or away from it. __________________________________________ Dear all, I would like to attempt providing some comments and some of the answers to the questions posed in this posting. My name is Jenny Meya Nyirenda, I was formerly EPI Manager in Zambia where we integrated deworming twice a year either with Child Health Weeks or polio eradication campaigns depending on the time of the year and districts where polio campaign was or was not taking place. 1. Integration of deworming in routine vaccination is feasible but not practical. My experience is that generally only younger infants (0-11 months) are brought for routine immunisations, which leaves out the target age group for deworming (24-59 Months old). 2. Integration with general primary health care services: This will not serve the primary purpose of health promotion and prevention for which mass immunisation campaigns and deworming are conducted. Only the sick presenting with complaints of either vomiting or passing some worms, or those identified through some medical/laboratory tests will have the opportunity of receiving the deworming treatment. Hence a well -looking child will not be captured through this modality. 3. Treating the whole family or mothers only: This would be ideal and only partial solution to the repeated infestations. The challenge would be the logistical requirements of accomplishing this task. How can we reach family members? Unless we conduct a door - to- door campaign. What about the cost of deworming tablets and other logistical arrangements required to mount such a campaign twice a year? Lastly not all children are escorted to the campaign vaccination posts by their mothers. Some are brought by even young siblings and others come on their own. 4. Reducing the reinfestation rate after treating mothers: It is worth noting that children get infested with different types of intestinal worms through various portals of entry. For instance because of poor environmental sanitation, the grounds on which most of these kids play can be heavily infested with hookworm ova/larvae. Some children can get worms just as they play with infested soil around their homes, not necessarily from an adult preparing their meals. Poorly washed vegetables and fruits as well as uncooked meats can also be a source of the infection and not just the unwashed hands of the food handler. Where as treating the family and commercial food handlers would contribute to this cause, environmental sanitations is also key. 5. Net advantage of treating as many as possible at the same time The child health week offers a wide range of interventions. We take advantage of the periodic contacts with both young and older children to promote their health by giving them Vitamin A and prevent illnesses (or their worsening) (such as anaemia, malnutrition) by treating them with deworming tablets and offering retreatment of mosquitoe nets and giving health education talks to guardians about diarrhoea prevention - making drinking water safe & use of ORS etc. ______________________________________________________________________________ Visit the TECHNET21 Website at http://www.technet21.org You will find instructions to subscribe, a direct access to archives, links to reference documents and other features. ______________________________________________________________________________ To UNSUBSCRIBE, send a message to : mailto:[email protected] Leave the subject area BLANK In the message body, write unsubscribe TECHNET21E ______________________________________________________________________________ The World Health Organization and UNICEF support TechNet21. 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