Early effect of the Covid-19 epidemic on vaccine coverage of major antigens in Guinea: an analysis of the interrupted time series of national immunization coverage

  1. Moustapha Dabo
  2. Yombounaud Samah
  3. Mouctar Kande
  4. Djenou Sompare
  5. Aly Camara
  6. Bah Mamadou Dian
  7. Sekou Solano
  8. Idrissa Baldé
  9. Latou Fabrice
  10. Younoussa Sylla
  11. Iya saidou Condé
  12. Gerard Cristhian Kuotu
  13. Almamy Amara Touré
  14. Magassouba Aboubacar Sidiki

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Abstract

Introduction

Since the declaration of the first case of Covid-19 on March 12, 2020, in Guinea, the number of COVID-19 cases has been increasing day by day despite the state of health emergency and the barrier measures decreed by the Guinean government. This study aimed to assess the early impact of COVID-19 on immunization activities by comparing current trends to trends over the past year when vaccine coverage of major antigens (BCG, OPV, DTC, MMR, IPV, and Td) had improved considerably.

Methods

The study was carried out at the Expanded Vaccination Program (EPI) of the Republic of Guinea from February 2019 to June 2019. It was a comparative retrospective cohort study on the trends in administrative coverage of the different antigens used in the framework of vaccination.

We performed interrupted time series (STI) analysis using the delayed dependent variable model ANCOVA type II Sum Squares with significance for a p-value less than 0.05 to confirm the link between the occurrence of Covid-19 and the collapse of vaccine coverage. These analyzes were performed on global vaccine-preventable disease surveillance data extracted from the District Immunization Data Management Tool (DVD-MT) designed by WHO. Estimates of the target population were obtained from the National Health Information System (SNIS), and surveillance data for Covid-19 patients were obtained from the National Health Security Agency (ANSS).

Results

Overall, the EPI recorded a median vaccination coverage of less than 80% for all the vaccines introduced and the analysis of the interrupted time series shows that the interruption of the vaccination program was significant for all the vaccines. This finding is factual at both the national and district levels. However, there are disparities at this level, even though some districts have yet to report cases of COVID-19 have experienced drop-in vaccination coverage. The comparison of vaccination coverage for DTP3, for example, shows a sharp drop in the prefectures of Yomou, N’Nzérékoré, Macenta, Kankan, Mandiana, Dinguiraye, Mamou, Koubia, Mali, and Conakry, where it varies between 0 and 80% compared to 2019 where it was above 80%.

Conclusion

Our results express the need for a resilient health system that could adapt quickly and effectively to pandemics and which in turn makes it possible to strengthen EPI activities in Guinea during this period of a health crisis, in particular for children.

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  1. ScreenIT

    SciScore for 10.1101/2020.09.11.20192161: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    RandomizationWe have included a default bootstrap model, which runs 1000 replications of the starting model with randomly drawn samples to drive the 95% CI bootstrap.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Place and period of study: The study was carried out in the Extended Immunization Program (EPI) of the Republic of Guinea from February 2020 to June 2020.
    Extended Immunization Program
    suggested: None

    Results from OddPub: Thank you for sharing your code.

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  2. Version published to 10.1101/2020.09.11.20192161 on medRxiv