Governance matters: Exploring the impact of governance on routine immunization performance in 54 African countries: A 10-year (2012-2021) analysis using linear mixed models.

Background: Immunization coverage across numerous African nations has, unfortunately, shown little improvement and, in some cases, has even decreased over the past decade, leaving millions of children vulnerable to vaccine-preventable diseases. While efforts to improve immunization performance have primarily focused on the health system, effective delivery of immunization services is intricately linked to a country's governance, which, in this context, reflects a government's ability to provide comprehensive services to its citizens. This study investigated the relationship between governance, measured using the Mo Ibrahim Index for African Governance, and the trajectory of immunization coverage for three vaccines in 54 African countries from 2012 to 2021.

Surveillance Review System to Track Progress Towards Polio Eradication in the Horn of Africa.

Background: The risk for importation and reintroduction wild poliovirus in areas that have been cleared of the wild poliovirus in the Horn of Africa will remain if the surveillance systems are weak and porous.

Methods: Consequently, the Horn of Africa Polio Coordinating Office in Nairobi, together with partners conducted surveillance reviews for some of the countries in the Horn of Africa, especially Ethiopia, Kenya and Somalia to identify gaps in the polio surveillance and provided recommendations for improved surveillance. Structured questionnaires collected information about acute flaccid paralysis (AFP) surveillance resources, training, data monitoring, and supervision at provincial, district, and health facility levels.

Evaluation of the Ebola Virus Disease (EVD) preparedness and readiness program in Uganda: 2018 to 2019.

Introduction: the Democratic Republic of Congo (DRC) declared its 10outbreak of Ebola virus disease (EVD) in 42 years on August 1 2018. The rapid rise and spread of the EVD outbreak threatened health security in neighboring countries and global health security. The United Nations developed an EVD preparedness and readiness (EVD-PR) plan to assist the nine neighboring countries to advance their critical preparedness measures.

Cochrane corner: universal screening for SARS-CoV-2 infection.

Introduction: coronavirus disease 2019 (COVID-19) is caused by the novel coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Most people infected with SARS-CoV-2 have mild disease with non-specific symptoms, although a few becoming critically ill with septic shock and multiple organ failure. There is an unknown proportion of infected individuals who remain asymptomatic and infectious.

Cochrane corner: rapid point-of-care antigen and molecular-based tests for the diagnosis of COVID-19 infection.

Introduction: the COVID-19 pandemic, which results from infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), presents important diagnostic challenges. Diagnostic strategies available to identify or rule out current infection, or to identify people in need of care escalation, or to test for past infection and immune response have become available, to reduce household and community transmission. We highlight a Cochrane review, published in September 2020, on the assessment of diagnostic accuracy of point-of-care antigen and molecular-based tests to determine current SARS-CoV-2 infection.

The Pan African Medical Journal in 2019 - a year in review.

Since its inception in 2008, the Pan African Medical Journal (PAMJ) enjoyed an exponential growth, not only in the number and geographical diversity of submissions received, but also in the range of services offered to researchers and professionals across the broad spectrum of biomedical and public health sciences. PAMJ in 2019 is: 2705 manuscripts submitted, a cumulative number of 13874 authors from 85 countries, 994 manuscripts accepted for publication and 774 articles published. The PAMJ in 2019 is also an editorial board of 15 and 46 dedicated reviewers to whom we extend our sincere appreciation.

The HIV/AIDS pandemic will not end by the year 2030 in low and middle income countries.

The recent Lancet Commission-International AIDS Society report: Advancing Global health and strengthening the HIV response in the Era of the Sustainable Development Goals; clearly highlights the fact that the world is NOT on track in ending the AIDS pandemic by 2030. Emphasis on massive and early diagnosis and placement on Combined Anti- Retroviral Therapy (cART) remain key cornerstones in reaching these goals. Effective viral load informed care remains very promising in reducing drug resistance, and improving outcomes in infected persons.

Introduction of the Second Dose of Measles Containing Vaccine in the Childhood Vaccination Programs Within the WHO Africa Region - Lessons Learnt.

Background: WHO recommends all countries to include a second routine dose of measles containing vaccine (MCV2) in their national routine vaccination schedules regardless of the level of coverage with the first routine dose of measles containing vaccine (MCV1). As of Dec 2016, 26 countries in the African Region have introduced MCV2.

Methods: We reviewed the WHO UNICEF coverage estimates for MCV1 and MCV2 in these countries, and the reports of the post introduction evaluation of MCV2 from 11 countries.

Designing and implementing an electronic dashboard for disease outbreaks response - Case study of the 2013-2014 Somalia Polio outbreak response dashboard.

In April 2013, a case of wild polio virus (WPV) was detected in the Somalia capital Mogadishu. This inaugurated what is now referred to as the 2013-2014 Horn of Africa Polio outbreak with cases reported in Somalia, Kenya and Ethiopia. By the notification of the last polio case in August 2014, 223 cases of WPV had been reported in Somalia, Kenya and Ethiopia of which 199 in Somalia alone.

Systematic reviews in context: highlighting systematic reviews relevant to Africa in the Pan African Medical Journal.

Health research serves to answer questions concerning health and to accumulate facts (evidence) required to guide healthcare policy and practice. However, research designs vary and different types of healthcare questions are best answered by different study designs. For example, qualitative studies are best suited for answering questions about experiences and meaning; cross-sectional studies for questions concerning prevalence; cohort studies for questions regarding incidence and prognosis; and randomised controlled trials for questions on prevention and treatment.

Contribution of Contact Sampling in Increasing Sensitivity of Poliovirus Detection During A Polio Outbreak-Somalia, 2013.

Background.  In May 2013, a wild poliovirus type 1 (WPV1) outbreak reported in Somalia provided an opportunity to examine the contribution of testing contacts to WPV detection. Methods.

Proceedings of the African Field Epidemiology Network (AFENET) Scientific Conference 17-22 November 2013 Addis Ababa, Ethiopia: plenaries and oral presentations.

Biennially, trainees and graduates of Field Epidemiology and Laboratory Training Programs (FELTPs) are presented with a platform to share investigations and projects undertaken during their two-year training in Applied Epidemiology. The African Field Epidemiology Network (AFENET) Scientific Conference, is a perfect opportunity for public health professionals from various sectors and organizations to come together to discuss issues that impact on public health in Africa. This year's conference was organized by the Ethiopian Health and Nutrition Research Institute in collaboration with the Ethiopia Ministry of Health, Ethiopian Public Health Association (EPHA), Ethiopia Field Epidemiology Training Program (EFETP), Addis Ababa University (AAU), Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET) and AFENET.

Immunizing nomadic children and livestock--Experience in North East Zone of Somalia.

Nomads and pastoralists represent around 30% of the population of North East zone of Somalia (Puntland) and have very limited access to basic health including immunization. During the 2013-2014 polio outbreak in Somalia, an increase number of polio cases notified health services among these underserved communities highlighted the urgent need to devise innovative strategies to reach them. Harnessing the high demand for veterinary services among pastoralist communities, the Ministry of Health and the Ministry of Livestock, with support from UNICEF, WHO and FAO launched an integrated human and animal vaccination campaign on 19 October 2014.

Effectiveness of oral polio vaccination against paralytic poliomyelitis: a matched case-control study in Somalia.

Background: After the last case of type 1 wild poliovirus (WPV1) was reported in 2007, Somalia experienced another outbreak of WPV1 (189 cases) in 2013.

Methods: We conducted a retrospective, matched case-control study to evaluate the vaccine effectiveness (VE) of oral polio vaccine (OPV). We retrieved information from the Somalia Surveillance Database.

Polio outbreak investigation and response in Somalia, 2013.

Background: For >2 decades, conflicts and recurrent natural disasters have maintained Somalia in a chronic humanitarian crisis. For nearly 5 years, 1 million children <10 years have not had access to lifesaving health services, including vaccination, resulting in the accumulation by 2012 of the largest geographically concentrated cohort of unvaccinated children in the world. This article reviews the epidemiology, risk, and program response to what is now known as the 2013 wild poliovirus (WPV) outbreak in Somalia and highlights the challenges that the program will face in making Somalia free of polio once again.

Progress toward polio eradication--Somalia, 1998-2013.

Since the 1988 resolution of the World Health Assembly to eradicate polio, significant progress has been made toward achieving this goal, with the result that only Afghanistan, Nigeria, and Pakistan have never successfully interrupted endemic transmission of wild poliovirus. However, one of the greatest challenges of the Global Polio Eradication Initiative has been that of maintaining the polio-free status of countries in unstable regions with weak healthcare infrastructure, a challenge exemplified by Somalia, a country in the Horn of Africa region. Somalia interrupted indigenous transmission of wild poliovirus in 2002, 4 years after the country established its national polio eradication program.

Economic evaluation of a Child Health Days strategy to deliver multiple maternal and child health interventions in Somalia.

Introduction: Child Health Days (CHDs) are increasingly used by countries to periodically deliver multiple maternal and child health interventions as time-limited events, particularly to populations not reached by routine health services. In countries with a weak health infrastructure, this strategy could be used to reach many underserved populations with an integrated package of services. In this study, we estimate the incremental costs, impact, cost-effectiveness, and return on investment of 2 rounds of CHDs that were conducted in Somalia in 2009 and 2010.

Somalia: supporting the child survival agenda when routine health service is broken.

Somalia, one of the most unstable countries in the world, has been without a permanent government for nearly 2 decades. With a health system in total disarray, coverage of basic health interventions remains low and, maternal and child mortality is among the highest in the world. Health partners jointly outlined an integrated package of critical child survival interventions to be delivered through a population-based delivery strategy known as Child Health Days (CHDs), to reduce child mortality.

Measles control and elimination in Somalia: the good, the bad, and the ugly.

Despite enormous challenges, Somalia has been successfully implementing accelerated measles control activities since 2005. Through innovative strategies and with the support of local and international partners, the country has shown potentials of implementing measles mortality reduction activities in complex emergencies. Measles incidence has been reduced by >80% after the measles catch-up campaigns of 2005-2007, and national reported measles routine immunization coverage with first dose measles containing vaccine has reached 59% for the first time in 2009.