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Introduction: in Chad, transmission of poliovirus has been interrupted in 2000, but imports from Nigeria and weakness of vaccination coverage are a major risk of disease reactivation. This study aims to investigate knowledge, attitudes and practices of parents of children aged 0 to 5 years on vaccination against polio in Chad., Methods: this cross-sectional study was carried out in the six districts of Abéché. Only households who had children under 5 years of age were included. Data were collected through interviews with parents and guardians of eligible children using a tested and validated questionnaire., Results: we interviewed 210 households. No family had a vaccination record notebook of their children. However, 97% reported vaccinated children who had participated in mass vaccination campaigns. About 97% were aware of poliomyelitis disease and 98% knew vaccination campaign. The most cited channels of information were radio (98%) and vaccinators (72%). Only 3% of parents reported refusing vaccination. There was an association between the negative influence of the relatives and the non-vaccination of children (p = 0.005)., Conclusion: disease and vaccine knowledge is good in Chad despite the existence of rumours about, in particular, vaccine effects. The lack of immunization cards limited the analysis of survey results which were only declarative with a very high declared vaccination rate. Immunization cards are essential for eradication in association with prevention policy., Competing Interests: Les auteurs ne déclarent aucun conflit d’intérêts.

Unlabelled: Assessing vaccination coverage (VC) is a critical part of adherence to immunization guidelines and beyond vaccine effectiveness can fill possible gaps and optimize VC. The aim of this study was to measure annual VC trends (2008-2011) among children 0-6years of age., Methods: An Internet survey was conducted using a self-administrated questionnaire to a representative sample (quota method) of mothers reporting their child's immunization record., Results: Diphtheria-tetanus-poliomyelitis-pertussis VC (complete schedule) was 96.0% at 6 years of age in 2010. Hepatitis B VC (≥1 dose) in the 6- to 11-month-old population increased from 54.6% in 2008 to 80.5% in 2011, but only 34.7% of 6-year-old had received a complete schedule in 2010. Pneumococcal conjugate vaccine VC (complete schedule) increased to 92.7% in the 24- to 35-month-old population. Measles-mumps-rubella (MMR) VC (2 injections) increased in 24- to 35-month-olds from 60.3% in 2008 to 81.0% in 2011. In 2011, 64.2% of 24- to 35-month-olds had received a second dose of MMR vaccine before 25 months vs. 45.4% in 2008. BCG VC in 12- to 35-month-olds was 73.2% in Île-de-France, where vaccination is recommended in all children vs. 15.5% elsewhere (vaccination only recommended in high-risk children)., Conclusion: This study shows a significant improvement of VC in young French children. However, outreach efforts should continue to be made, especially to adolescent and adult populations, in whom VC is very low., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Background: SID (Supplemental Immunization Days) is a special strategy intended to accelerate eradication of poliomyelitis in countries where it is still endemic (India, Afghanistan, and Pakistan in Asia, and Nigeria in Africa). This strategy is also applied in Nigeria's neighbours (Cameroon, Chad, Niger and Benin). Since the poliomyelitis virus was imported from Nigeria in 2001, Chad has reported cases of poliomyelitis every year. After 30 SIDs in Chad and the inaccurate or false attribution of side-effects to polio vaccines, some groups persistently refuse polio vaccination. To ascertain the true coverage of SID, the Ministry of Health and several partners (WHO, UNICEF and Rotary) conduct external coverage evaluations, to identify the under-vaccinated areas where population may be refusing immunization. The nails of the children receiving vaccinations are marked with indelible ink and those markings are the best indicator of the area's actual SID coverage. When coverage investigators arrive and propose vaccination to all children not immunized during SID, mothers who wish to refuse vaccination may claim that the children's markings disappeared after a few days, due to bathing. WHO experts have found that markings applied to their own nails with the WHO-recommended markers persist a few weeks, but others suggested that the markings may disappear much faster among children living in a traditional tropical environment. Until now, the lifetime of these markings has not been tested among children in Africa., Objectives: To determine the lifetime of the fingernail markings after SID and factors that influence this lifetime in children young than 5 years old in Chad., Materials and Methods: This prospective cohort study of 200 children (aged 0 to 59 months) took place from March to May 2009 in Milezi, a health zone north of Ndjamena, the capital of Chad, in central Africa. These children received nail markings on their left little finger with an indelible marker pen provided by WHO. The finger was monitored for 35 days, visually and by photographs, to determine the factors associated with the lifetime of the markings. Kaplan-Meier and log-rank methods were applied to estimate their survival curve and the variables significant for their lifetime; the Cox proportional hazard model was used to determine multivariable-adjusted hazard ratios., Results: Of the 184 children surveyed through the end of the study, the markings disappeared after 35 days of follow-up for 35% of them. The average lifetime of markings on these children was 28 days (SD: 4.95) and was associated, according to the Cox model, with 3 variables: the quality of the marking (RR = 0.335, 95% CI: 0.182-0.617, p < 0.001), playing with soil or mud (RR = 0.38, 95% CI: 0.208-0.697, p = 0.002), and living in different blocks, after stratification for the variable of application of chemical products on the nail. The latter could not be included in the Cox model because it made the markings disappear instantly., Conclusion: WHO experts were right in stating that the lifetime of the markings was sufficient to estimate coverage accurately when external evaluation takes place one or two weeks after SID. The only action found to make markings disappear rapidly was the application of chemical products. Mothers who tell SID attendance evaluation teams that the marking disappeared with bathing are expressing a tacit refusal of vaccination. These evaluations, which take place well before the disappearance of markings, help to determine the precise coverage of SID.

Vaccination can achieve global eradication of transmissible diseases presenting certain features, i.e., low incidence of inapparent forms, existence of a single stable pathogen, strictly human reservoir, inter-human transmission involving no vector, and availability of an effective well-tolerated low-cost vaccine. After the triumphant eradication of smallpox demonstrated the feasibility of universal immunization, the WHO launched a vaccination program against poliomyelitis. Although total eradication of poliomyelitis has proven to be a more difficult challenge, it will likely be achieved provided that necessary funding is provided and that the government commitment in affected countries is strong. No other global eradication programs are currently planned even though there are several potentially eradicable diseases including measles and rubella. These two diseases have practically been eliminated in industrialized countries. In developing countries, WHO objectives now call for controlling measles by vaccination to reduce fatalities and attempting to eliminate neonatal tetanus that was, until only recently, a major cause of newborn mortality.

Available facts on morbidity and mortality due to PEV diseases for children under 5 years come from routine facts in Bamako District. The Present study through population investigation proposed to evaluate indicators. It was about a transversal investigation realised about 1014 children less than 5 year living in Bamako (on October 2000). The selection of children has been made by boring after stratification of the district based on socio-economic level and stabilization of population of different sectors. According to study, the global incidence rate of target patients of PEV is about 4.93% +- 1.33%. These rate were about 4.14% +- 1.22% for measles which is the 1st cause of morbidity among target patients of PEV, 0.69% +- 0.50% for whooping cough, 0.903% +- 0.19 for poliomyelitis and 0% for neo natal tetanus. For tuberculosis of which evolution have been appreciated trough counting of antituberculosis clinic register (DAT) during 10 years (1990-1999), its tendency was increasing. The death rate registered during investigation was related to measles with an estimated rate of 4.93% +- 4.31%. Results analysis, global incidence of PEV target patients was in decrease at Bamako district. At vaccinated patients against measles (64.3%) and whooping cough (57.14%) is in favour for an investigation about effective vaccinal.

Objectives: Trend in immunization coverage of 28 months old children in Geneva, 1995-2000., Methods: Comprehensive analysis of routinely collected child immunization cards. Sample survey of non-responding parents., Results: Among 25,288 children (response rate, 91%) immunization coverage (three doses) was 96% for diphtheria and tetanus, 94% for whooping-cough and poliomyelitis and 84% for Haemophilus influenzae. Immunization coverage was 88% for measles (one dose). There was no significant change over time., Conclusions: Immunization coverage can be monitored by routinely collecting data from child immunization cards. Measles vaccination coverage is too low to prevent epidemics in Geneva.

Objective: The authors had for aim to study the regional variations of vaccination coverage in adult population., Methods: Cross-sectional epidemiological study, including a representative sample of 2122 general practitioners and analyzed according to eight French regions., Results: Six thousand two hundred sixty-nine patients, 44 +/- 15 old, were included in the study. 90.5% of the patients were vaccinated against diphtheria, 94.4% against tetanus, and 92.6% against poliomyelitis. No difference between regions was noted but the rate of patients with up to date vaccination strongly differed, ranging from 54.8% (Paris/Ile de France) to 64.3% (South West) for diphtheria, from 60.4% (Paris/Ile de France) to 73% (South West) for tetanus, and from 58.8% (Paris/Ile de France) to 69.8% (South West) for poliomyelitis. Vaccination coverage against measles, parotiditis, hepatitis A and B, typhoid fever, yellow fever also significantly differed between regions and the only ones evenly distributed were vaccination against tuberculosis, meningococcus, and pneumococcus., Conclusion: These results show insufficient vaccination coverage against diphtheria, tetanus, and poliomyelitis in all regions and show other important variations in vaccination coverage between regions, especially for hepatitis A and B.