Post 01107e : Oral Polio Vaccine Colour

POST 01107E : ORAL POLIO VACCINE COLOUR Follow-up on Post 01050E, 01058E and 01100E (An archive error occurred in this last posting and only attachments were retained in the archives) 17 June 2007 _____________________________________ The first message is from [email=%3Ca%20href=][log in to unmask][/email]">Anil [email=%3Ca%20href=][log in to unmask][/email]">Varshney from India. He rightly points to reluctance from health workers to use OPV that doesn’t look normal. This is followed by contributions from [email=%3Ca%20href=][log in to unmask][/email]">Hans [email=%3Ca%20href=][log in to unmask][/email]">Everts and [email=%3Ca%20href=][log in to unmask][/email]">Jacqueline Fournier-[email=%3Ca%20href=][log in to unmask][/email]">Caruana, both from WHO/ HQ providing answers to Salah Haithami. I have the feeling that this leaves some unanswered questions, at least in my mind. As nobody asked these questions, I will do myself in a comment at the end of this posting. ______________________________________ Hello all, It is pertinent to note that no health worker will administer OPV with changed color irrespective of ph or potency. Change of color denotes degradation of any of the compounds in the OPV by heat or long time (expired OPV)? Regards , Dr Anil Varshney Consultant ------------------- The explanatory note was not meant to suggest that people actually estimate the PH in the field, but that the pH variation leading to a change in the OPV colour from yellow to reddish does not affect the efficacy of the vaccine. The note meant to give some technical background for managers. 1) all OPV supplied by UNICEF comes from pre-qualified manufacturers 2) all batches are seperately tested for approval by the NRA, including the ones with vials with colour change 3) due to a change of PH there can be colour variations between vials, but this is a known phenomenon and does not affect the potency of the vaccine 4) because there is no correlation between the colour and the potency, it would lead to utter confusion and erroneous conclusions if health workers would start judging OPV quality on basis of colour. Hans Everts -------------------- I can understand the reluctance from health workers and parents in giving such yellow OPV while the usual colour is pink. At the question raised by Dr Salah, "Can we estimate the PH from just seeing the colour?", it is easy to answer "yes, we can" since the rationale of adding phenol red is to know the pH at a glance. It's very risky to advise any country to reject yellow OPV, even when only few vials are concerned, as the wastage would increase and we know that the vaccine is still potent. In conclusion, I believe we need to strictly stick with our previous position confirming that the pH variation leading to a change in the OPV colour from yellow to reddish does not affect the efficacy of the vaccine. Thanks, Jackie Jacqueline Fournier-Caruana, WHO/Geneva ------------------------ All living organisms require a certain range of pH to live and grow, usually around the neutral point, the polio virus being no exception. Referring to posting 01058E, we learnt that this range is 6.5 to 7.2. Growing polioviruses obviously calls for pH control and phenol red is used as an indicator, sometimes further added in the formulation. We all agree, phenol red is a pH indicator so it can be assessed at a glance but I am sure that Jackie did not mean that it can be done with any accuracy or reliability. As Hans said, it is not meant to be done by anyone in the field. Thus I have two questions of a different order. The vaccine production industry appears to still be using phenol red. Is it really the case? Because I just find it difficult to believe that it relies on such an indicator for a large scale production in 2007. If the vaccine, given all other conditions met, is to remain perfectly potent whatever its pH and color, and should be used, then what is the purpose of sometimes adding some more red phenol? Is it only cosmetic so that vaccines leave the plant all looking identical? I don’t question that the vaccine is still potent, given such a large security margin in terms of immunogenic dose. I just wonder what is the significance of something that appears to be operationally irrelevant in the field. The moderator ______________________________________________________________________________ All members of the TechNet21 e-Forum are invited to send comments on any posting or to use the forum to raise a new discussion or request technical information in relation to immunization services. 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It is moderated by Claude Letarte and is hosted in cooperation with the Centre de coopération internationale en santé et développement, Québec, Canada (www.ccisd.org ______________________________________________________________________________ =======================================================================Date: Tue, 19 Jun 2007 21:11:32 -0400 Reply-To: [log in to unmask] Sender: Technical network for strengthening immunization services Comments: RFC822 error: MESSAGE-ID field duplicated. Last occurrence was retained. From: TechNet Subject: POST 01108E : NEEDLE REMOVER EVALUATION MIME-version: 1.0 Content-type: text/html; charset=us-ascii Content-transfer-encoding: 7BIT TECHNET21 E-FORUM Technical network for strengthening immunization services Contributions to: [email=%3Ca%20href=][log in to unmask][/email]">[log in to unmask] or use your reply button! __________________________________________________________ POST 01108E : NEEDLE REMOVER EVALUATION 19 June 2007 _____________________________________ NOTE : Adjustments, to be expected, have been made to the Expert database, to solve the few reported problems, especially those concerned with updating one's own data. Some modifications to the design have also been made. We hope that this database will now be fully operational. We thank all those who recently registered and invite potential consultants who haven't done so yet. The message below comes from [email=%3Ca%20href=][log in to unmask][/email]">Huong[email=%3Ca%20href=][log in to unmask][/email]"> Vu, from PATH/ Vietnam, who presents a needle-remover evaluation report. _____________________________________ PATH announces the publication of "Evaluation of a Needle Remover Demonstration Project : A Study from Huong Khe District, Ha Tinh Province, Vietnam." This report (download) provides background, methodology, results, discussion, and references associated with an evaluation of the project. PATH and National Expanded Program for Immunization, the Vietnam Ministry of Health implemented a six-month demonstration project in Huong Khe District, Ha Tinh Province, Vietnam, to assess the acceptability, performance, and impact on waste disposal of a manual needle remover introduced at commune health centers (CHCs). The evaluation identified opportunities for significant improvement in the management of medical waste at CHCs. Needle removers were found to be a technically appropriate and feasible solution for CHCs, accepted by most health workers and managers, and able to address problems of health care waste disposal in rural areas. Based on the results of this demonstration project, the evaluation team recommended broader introduction of needle removers in CHCs located in rural and mountainous regions of Vietnam. Training and maintenance are critical issues for ensuring successful introduction of needle removers. Should they be introduced more broadly, it would be important to strengthen supervision at the CHCs. Before any device can be introduced more broadly, an evaluation must be conducted to ensure that it is compatible with the types of syringes being used in Vietnam. Safety boxes continue to be an important tool for managing sharps waste in Vietnam. However, unreliable supplies (safety boxes are only supplied enough for immunization injections) and lack of final disposal options present challenges for use. Since this study was completed, needle removers have recently been included in draft health care waste management guidelines developed by the Ministry of Health as an option for sharps waste handling in CHCs in Vietnam. For more information about this evaluation conducted in Vietnam, contact [email=%3Ca%20href=][log in to unmask][/email]">Huong[email=%3Ca%20href=][log in to unmask][/email]"> Vu. For more information on needle removers, visit the Needle Remover Resource page published by PATH. This web page is intended to serve as a resource for countries and programs considering the introduction of needle removers. Visit the page Huong Vu, MD, PhD Senior Program Team Leader PATH Hanoi, Vietnam ______________________________________________________________________________ All members of the TechNet21 e-Forum are invited to send comments on any posting or to use the forum to raise a new discussion or request technical information in relation to immunization services. The comments made in this forum are the sole responsibility of the writers and do not in any way mean that they are endorsed by any of the organizations and agencies to which the authors may belong. ______________________________________________________________________________ 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 : [email=%3Ca%20href=][log in to unmask][/email]">[log in to unmask] Leave the subject area BLANK In the message body, write unsubscribe TECHNET21E ______________________________________________________________________________ The World Health Organization and UNICEF support TechNet21. The TechNet21 e-Forum is a communication/information tool for generation of ideas on how to improve immunization services. It is moderated by Claude Letarte and is hosted in cooperation with the Centre de coopération internationale en santé et développement, Québec, Canada (www.ccisd.org ______________________________________________________________________________ =======================================================================Date: Thu, 21 Jun 2007 22:59:49 -0400 Reply-To: [log in to unmask] Sender: Technical network for strengthening immunization services Comments: RFC822 error: MESSAGE-ID field duplicated. Last occurrence was retained. From: TechNet Subject: POST 01109E : SOLAR REFRIGERATOR MIME-version: 1.0 Content-type: text/html; charset=iso-8859-1 Content-transfer-encoding: quoted-printable TECHNET21 E-FORUM Technical network for strengthening immunization services Contributions to: [email=%3Ca%20href=][log in to unmask][/email]">[log in to unmask] or use your reply button! __________________________________________________________ POST 01109E : SOLAR REFRIGERATOR Follow-up on Posts 01019E, 01027E, 01032E, 01037E, 01045E, 01095E and 01102E21 June 2007 _____________________________________ This posting contains two contributions. The first comes from [email=%3Ca%20href=][log in to unmask][/email]">Søren [email=%3Ca%20href=][log in to unmask][/email]">Spanner from UNICEF/India. The second is from [email=%3Ca%20href=][log in to unmask][/email]">Gregory [email=%3Ca%20href=][log in to unmask][/email]">Kiluva from UNICEF Supply Division _____________________________________ All the Solar Powered Refrigerators, listed in the PIS are working perfectly well. Provided that: The system is correctly sized. Installation is done as per manufactures recommendations Maintenance is done as per manufactures recommendations. Proper training of users. As for the size, if you need 30l buy 30l, if you need 50l buy 50l. A bigger SPR is more expensive than a small, like a house, car or whatsoever. As for Jharkhand, I could not disagree more see the reasons above. Solar panels might be stolen, so might generators. Many of the generators I have seen, in the same area are idle because of lack of fuel. I would question the cost effectiveness of the generator solution. Soren Spanner Project Officer Cold Chain Health Section, UNICEF, India Country Office, New Delhi -------------------------- Dear All, I have read the two contributions on this post and would like first to respond to Lydie. The three numbers you refer to in the Supply Catalogue refer to [log in to unmask] or use your reply button! __________________________________________________________ POST 01112E : COSTS - REQUEST FOR INFORMATION 25 June 2007 _____________________________________ I am looking for recent data on refrigeration energy and maintenance costs. I have some information from Emmanuel Taylor and Bob Davis and am wondering if anybody else has done work in this area. Specifically I am looking for the following: - Bottled gas prices/gas refrigerator running costs. - Kerosene prices/kerosene refrigerator running costs. - Electricity prices/ electric refrigerator running costs. - Lifetime maintenance costs for gas, kerosene, electric and solar refrigerators. - Any available data on cold room maintenance costs. Regards, Andrew [email=]Andrew[/email] [email=]Garnett[/email] ______________________________________________________________________________ All members of the TechNet21 e-Forum are invited to send comments on any posting or to use the forum to raise a new discussion or request technical information in relation to immunization services. The comments made in this forum are the sole responsibility of the writers and do not in any way mean that they are endorsed by any of the organizations and agencies to which the authors may belong. ______________________________________________________________________________ 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 : [email=%3Ca%20href=][log in to unmask][/email]">[log in to unmask] Leave the subject area BLANK In the message body, write unsubscribe TECHNET21E ______________________________________________________________________________ The World Health Organization and UNICEF support TechNet21. The TechNet21 e-Forum is a communication/information tool for generation of ideas on how to improve immunization services. It is moderated by Claude Letarte and is hosted in cooperation with the Centre de coopération internationale en santé et développement, Québec, Canada (www.ccisd.org ______________________________________________________________________________ =======================================================================Date: Wed, 27 Jun 2007 11:17:48 -0400 Reply-To: [log in to unmask] Sender: Technical network for strengthening immunization services Comments: RFC822 error: MESSAGE-ID field duplicated. Last occurrence was retained. From: TechNet Subject: POST 01113E : APPREHENDED PANDEMIC MIME-version: 1.0 Content-type: text/html; charset=us-ascii Content-transfer-encoding: 7BIT TECHNET21 E-FORUM Technical network for strengthening immunization services Contributions to: [email=%3Ca%20href=][log in to unmask][/email]">[log in to unmask] or use your reply button! __________________________________________________________ POST 01113E : APPREHENDED PANDEMIC 27 June 2007 _____________________________________ The recent spread of avian influenza in wild birds and poultry may be a precursor to the emergence of a human pandemic. While it is accepted that in 1918 the virus originated in birds, it is debated whether it went directly to humans, or transited in mammals where the virus was reassorted (type of mutation). Nevertheless, countries have started to prepare for such a pandemic. A set of activities identified in the World Health Organization's (WHO's) new Global pandemic influenza action plan to increase vaccine supply requires immediate and sustained action and funding, if the world is to be prepared for an influenza pandemic to which there would be almost universal susceptibility. FluRadar reports on an article recently published in the Public Library of Science (Medicine) online journal that questions vaccination strategies in the event of a pandemic. In "Optimizing the Dose of Pre-Pandemic Influenza Vaccines to Reduce the Infection Attack Rate", authors Steven Riley, Joseph T. Wu and Gabriel M. Leung conclude that it would be better to give smaller doses to more people than target specific groups. Read the full text and/or an interesting commentary by Christophe Fraser Can these conclusions have wider implications that just the framework of preparedness to a potential influenza pandemic, for example for the administration of other vaccines? Share your ideas and comments! ______________________________________________________________________________ All members of the TechNet21 e-Forum are invited to send comments on any posting or to use the forum to raise a new discussion or request technical information in relation to immunization services. The comments made in this forum are the sole responsibility of the writers and do not in any way mean that they are endorsed by any of the organizations and agencies to which the authors may belong. ______________________________________________________________________________ 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 : [email=%3Ca%20href=][log in to unmask][/email]">[log in to unmask] Leave the subject area BLANK In the message body, write unsubscribe TECHNET21E ______________________________________________________________________________ The World Health Organization and UNICEF support TechNet21. The TechNet21 e-Forum is a communication/information tool for generation of ideas on how to improve immunization services. It is moderated by Claude Letarte and is hosted in cooperation with the Centre de coopération internationale en santé et développement, Québec, Canada (www.ccisd.org ______________________________________________________________________________ =======================================================================Date: Fri, 29 Jun 2007 19:05:28 -0400 Reply-To: [log in to unmask] Sender: Technical network for strengthening immunization services Comments: RFC822 error: MESSAGE-ID field duplicated. Last occurrence was retained. From: TechNet Subject: POST 01114E : STOCK MANAGEMENT SOFTWARE MIME-version: 1.0 Content-type: text/html; charset=us-ascii Content-transfer-encoding: 7BIT TECHNET21 E-FORUM Technical network for strengthening immunization services Contributions to: [email=%3Ca%20href=][log in to unmask][/email]">[log in to unmask] or use your reply button! __________________________________________________________ POST 01114E : STOCK MANAGEMENT SOFTWARE 29 June 2007 _____________________________________ Technet21 policy is to the effect of not posting advertisement on its site or e-forum. We already asked in the past whether we should make this rule more flexible. The message below is indeed advertisement. After consulting Secretariat however, it was decided to post it. The reason is that the product is offered free-of-charge to individuals from developing countries or to non-profit organisations. 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We still have a long way to go, but we think the current version is usable, and we would appreciate feedback on what needs changing for future versions. Location management features include: * Management by volume. Define volumes for locations and for each item. * Report on space used and free space at each location. * Quick visual feedback on whether stock about to be ordered will fit at the nominated locations. Same for goods receipting operations. Helpful links: * Home page * Demo version * User guide * Location management tutorial * Other documentation mSupply remains free for use in single-user mode if: - you are in a developing country - your organisation is not-for-profit mSupply has been in use in developing countries since 1998. It is now used in over 20 countries, primarily in pharmaceutical warehouses, and in hospital dispensaries. Best regards, [email=%3Ca%20href=][log in to unmask][/email]">Craig [email=%3Ca%20href=][log in to unmask][/email]">Drown Sustainable Solutions Kathmandu, Nepal Auckland, New Zealand ______________________________________________________________________________ All members of the TechNet21 e-Forum are invited to send comments on any posting or to use the forum to raise a new discussion or request technical information in relation to immunization services. The comments made in this forum are the sole responsibility of the writers and do not in any way mean that they are endorsed by any of the organizations and agencies to which the authors may belong. ______________________________________________________________________________ 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 : [email=%3Ca%20href=][log in to unmask][/email]">[log in to unmask] Leave the subject area BLANK In the message body, write unsubscribe TECHNET21E ______________________________________________________________________________ The World Health Organization and UNICEF support TechNet21. The TechNet21 e-Forum is a communication/information tool for generation of ideas on how to improve immunization services. It is moderated by Claude Letarte and is hosted in cooperation with the Centre de coopération internationale en santé et développement, Québec, Canada (www.ccisd.org