SEARCH · PubMed Health

Results for “Cold Chain”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 235 records · Page 13Linked to original sources

PubMed2001

Development of a thermoresistant tissue culture rinderpest vaccine virus.

The currently used Plowright's tissue culture rinderpest vaccine (RBOK strain) gives full protection and lifelong immunity, but it is highly thermolabile and requires maintenance of cold chain from vaccine production till delivery. Keeping in view the need for a thermostabile vaccine in tropical developing countries with limited refrigeration facilities, we passaged serially the RBOK strain of rinderpestvirus (RPV) at gradually elevated temperature up to 40 degrees C to obtain a thermoresistant RPV (TR-RPV) mutant. The thermoresistance (thermostability) and antigenicity of TR-RPV were compared with those of the vaccine virus by various methods, confirming the acquired properties. Thus, the infectivity titres of the TR-RPV mutant and vaccine virus were determined after incubation for various times at 37 degrees C. Regression analysis indicated that TR-RPV had a half-life of 1.81 hr and a degradation constant of 0.1656, while the parent vaccine virus had a half-life of 1.11 hr and a degradation constant of 0.2686. In capture ELISA with four different monoclonal antibodies (MAbs) to the N protein of RPV, TR-RPV showed a 10-fold higher reactivity with one MAb as compared to the vaccine virus. Although TR-RPV did react also with the other three MAbs, its reactivity was only 4-5 times higher than that of the vaccine virus. A treatment of the virus with Triton X-100 resulted in 2-4 times higher reactivity with the MAbs. The 35S-methionine-labeled vaccine virus-and TR-RPV-infected Vero cell lysates showed 6 polypeptide bands with identical pattern of migration in polyacrylamide gel electrophoresis in the presence of SDS (SDS-PAGE). Radioimmunoprecipitation assay (RIPA) of the TR-RPV and vaccine virus with a rabbit anti-RPV immune serum (RHIS) and bovine anti-RPV hyperimmune serum (BHIS) showed the presence of four identical antigenic proteins, namely H, N, F and M, for both viruses. It can be concluded that TR-RPV has indeed retained the antigenic properties of the parental vaccine virus besides acquiring thermoresistance.

Animals↗

PubMed1996

Technology to save millions, extends vaccine outreach programs. Vaccine management.

Program for Appropriate Technology in Health (PATH), Seattle, Washington, has collaborated in developing a technology that improves the delivery of vaccines in the developing world. HEATmarker is a vaccine vial label which changes color with exposure to heat over time. This allows health workers to verify--at time of use--that each vial of vaccine is in usable condition and has not lost its potency due to heat exposure. Vaccine vial monitors (VVMs) have recently been mandated on all oral polio vaccine purchased and distributed by UNICEF throughout the world. "Vaccine vial monitors will revolutionize the way vaccines are delivered, enabling them to be administered in remote areas, outside the reach of the traditional 'cold chain' that extends from manufacturer to consumer. As a result, millions more children in remote parts of the world will have access to oral polio and other vaccines," states Peter Evans of the World Health Organization (WHO), Global Programme for Vaccine and Immunization. Evans adds, "WHO expects that $10 million a year will be saved for oral polio vaccine alone." VVMs will enable health workers to use vaccine that would otherwise have been discarded. Until now, health workers disposed of any polio vaccine that may not have been properly refrigerated in transport or that had been opened but not used because they were unable to tell if it was potent. In the future, WHO intends to require VVMs on vaccines for measles, hepatitis B, and other childhood diseases, which will result in millions more lives and dollars being saved.

Americas↗

PubMed2002

The impact of the Global Polio Eradication Initiative on the financing of routine immunization: case studies in Bangladesh, C te d'Ivoire, and Morocco.

To determine if the Global Polio Eradication Initiative (PEI) affected financing of routine immunization programmes, we compared sources and uses of funds for routine immunization programmes and PEI activities in Bangladesh, C te d'Ivoire, and Morocco for the years 1993-98. We also examined funding trends for these years in these countries and assessed the effect of the initiative on the availability of specific resources in national immunization programmes, such as cold-chain equipment and personnel time spent on activities related to national immunization days and surveillance of poliomyelitis and acute flaccid paralysis. We found that all three governments and the majority of donors and international organizations continued to fund routine immunization programmes at levels similar to those before the PEI. Trend analysis also indicated that financing for routine immunization in each of the countries continued to increase after the PEI was introduced. The results show that the PEI did not reduce funding for routine immunizations in these countries.

Bangladesh↗

PubMed1992

[Cause analysis of measles incidence in National Diseases Surveillance System in 1990].

This paper described the time and areas distribution of 875 measles cases in DSP in 1990 and discussed relationship between vaccination and measles cases. Through studying cases in several points with high morbidity, the authors found that there was no high immunization coverage. It must have been the first chance of measles incidence. Further more the immunization technics and cold chain were found unqualified, which were thought to be the second chance.

Age Factors↗

PubMed2004

[An innovative approach combining human and animal vaccination campaigns in nomadic settings of Chad: experiences and costs].

The purpose of this report is to describe a network of public health care workers, veterinarians and nomadic pastoralists that was set up in Chad to increase vaccination coverage to nomadic children and women who had rarely been vaccinated before. The objectives of the project were to provide human vaccination in conjunction with existing veterinary services, to evaluate the feasibility and limitations of such campaigns, to determine what other services could be provided concurrently, and to estimate the savings for public health care cases in comparison with carrying out vaccination separately. In a series of 12 vaccination campaigns in the Chari-Baguirmi and Kanem districts, more than 2100 children, 2100 women and 52000 cattle were fully immunized. These results confirmed the feasibility of joint campaigns in nomadic settings and provided important experience for improving organization. Information-Education-Communication (IEC) campaigns adapted to the realities of the pastoral setting were an important factor in mobilizing nomadic pastoralists for attendance at vaccination clinics. The savings in logistics costs (i.e., personnel, transportation and cold chain costs excluding vaccine costs) was 15% in Gredaya where 3 out of 6 campaigns were carried out together with veterinarians and 4% in Chaddra/Am Dobak where only 1 out of 6 campaigns was carried out in conjunction with veterinarians. The cost per fully immunized child (FIC) was considerably higher in Chaddra/Am Dobak than Gredaya (EUR 29.2 vs. EUR 11.5). The joint vaccination campaign approach is innovative, appreciated by nomadic pastoralists and less expensive than separate vaccination. By using the mobility of veterinarians in remote zones far from health care facilities, vaccination can be provided to nomadic children and women in countries with limited resources.

Adolescent↗

PubMed2005

HIV testing technologies after two decades of evolution.

Over the past two decades, HIV diagnostics have been essential in detecting and monitoring infection, and continue to play a major role in saving lives throughout the world. As technology evolved, screening, confirmatory, and HIV monitoring assays have been improved and offer better alternatives to address blood screening, surveillance, diagnosis, and patient management. Molecular methods are critical in detecting early infection and for managing patients on anti retroviral therapy whose viral infection may become resistant to therapy. In addition, modifications to conventional methods have introduced new assays, such as sensitive/less sensitive (detuned) assays that can estimate when someone was infected, thereby providing a useful tool for epidemiologic incidence estimates and enrollment into specific intervention programmes for recently infected persons. Many of the newly evolving technologies are essential for use in resource-limited countries because they can address cost issues, limited infrastructure, and a lack of formally trained personnel. Newer rapid HIV kits can be stored in a wide range of temperatures (2-30 degrees C) to address cold-chain issues, can use easily-collected fingerstick blood and oral fluids, and have one-step procedures that are relatively foolproof. Manual CD4 lymphocyte count assays that require only a light microscope and haemacytometer and more simple assays to estimate viral load are appropriate for developing countries where sophisticated instrumentation cannot be supported. Technologic advances with HIV diagnostics continue to address outstanding and new issues associated with diagnosis and the monitoring of infection by providing more simplified, cost-effective, and accurate testing throughout the world.

AIDS Serodiagnosis↗

PubMed1992

A low-cost, community-based measles outbreak investigation with follow-up action.

An outbreak of measles in Kampala, Uganda, in 1990 raised concern about the effectiveness of the measles vaccine that was used. The Uganda EPI programme and the medical office of the Kampala City Council therefore conducted a community-based investigation, with door-to-door interviews in two selected communities. They revealed 68 measles cases ranging in age from 5 months to 12 years; the highest age-specific attack rate (32%) was found in children aged 12 to 23 months. BCG immunization coverage was high (85%), but measles immunization coverage was moderate (48%). One community, served by a mobile clinic, presented a vaccine efficacy of only 55%. Responses by mothers revealed that many had failed to have their children completely immunized because of a lack of information, and not because of difficulties in access to the service. In a follow-up, community leaders initiated monthly checking of immunization cards of both children and mothers. The low vaccine efficacy found in one of the communities resulted in a thorough assessment of the city's cold chain. This community-based approach proved to be cost-effective and practical for identifying the obstacles to effective immunization delivery.

Child↗

PubMedDate not supplied

Changing trend of SSPE over a period of ten years.

Sub acute sclerosing pan-encephalitis (SSPE) is a slowly progressive inflammatory disorder of the central nervous system. A decline in frequency has been noticed in most of the developed countries, whereas it continues to be high in developing countries. Though a number of studies have been carried out, the exact trend of SSPE is still not clear. Hence the present study was carried out to analyze the trend of SSPE over the past ten years in and around Chandigarh. A total of 205 patients with clinical features suggestive of SSPE were enrolled for the study during Jan'92 to Dec. 2001. Measles specific antibodies were detected in blood and CSF by HAI method. 114 patients were found to be positive for measles specific HAI antibody with a male preponderance. The number of SSPE cases were found to be more during the period 1992-95 in comparison to the next 6 years (p < 0.05). The high incidence of SSPE in our country could be due to improper vaccine coverage, poor cold chain maintenance or circulation of atypical measles virus strain.

Adolescent↗

PubMed2003

Measles outbreak in a vaccinated population in Dhankutta.

A measles outbreak occurred in Dhankutta town in year 2056 Falgun to 2057 Baishak (3 months). A total of 130 cases were registered at the Dhankutta District Hospital. A large proportion of the cases had severe disease with complications and were admitted at the hospital. None of the patients registered at the hospital died. Interestingly, 50.0% of cases were in higher age group (10 years and above) which is an unusual trend in developing countries. All the cases gave history of measles vaccination, which points towards the need for investigation of vaccine efficacy and cold chain efficiency.

Adolescent↗

PubMed2005

The key role of vaccine vial monitors in routine and mass immunisation.

The vaccine vial monitor is an excellent monitoring device to assure that only non-heat damaged vaccine is administered to women and children. They help to extend access to immunisation, they increase the efficiency and reduce wastage in the cold-chain and, when visible on all vaccine vials of all types, they will help to streamline distribution systems for immunisation services of the 21st century in all developing countries.

Child↗

PubMed2006

Current trends in safety assurance for tissue grafts used in burn treatment.

The author presents a summary of current safety standards for allogeneic and xenogeneic biological skin grafts. The fundamental document relevant to allogeneic transplants, establishing the minimal level of safety guaranteed in European Union states, is the European Parliament and Council Directive (2004/23/EC) from March 31st 2004. This Directive determines that grafts will be prepared by a licensed or accredited tissue bank, and that this arrangement must be put in place by the member states within 2 years. In the Czech Republic licensing of tissue banks took place immediately after issuance of the Directive. Licensing was also a condition for product reimbursement by insurance companies. To gain a licence, tissue banks had to fulfil many safety criteria associated with screening of living or deceased donors for health suitability, providing traceability of the donor-recipient route, prevention of secondary and cross-contamination during processing and storage of the harvested tissues, proof of product microbiology check up, and cold chain control. The Tissue Bank of the Faculty Hospital in Hradec Králové is one of the two tissue banks that gained the broader type of 'multifunctional' licence and was granted registration number MTB 006. Obtaining the licence was facilitated by completion of a new workplace project conceived as a combination of cryogenic and clean-room technology. Currently, this tissue bank prepares cryopreserved dermoepidermal and dermal grafts as well as amnion and chorioamnion grafts. All tissue banks will have to renew their licences again according to the conditions established by a new law about human tissues and cells which is currently in preparation. Neither the Directive of the European Parliament nor the Transplantation Law of the Czech Republic regulates the issue of xenografts. Since availability of allogeneic biological covers is limited, it is significant that the WHO perspective on the use of xenogeneic biological covers, as established in 2005, is positive. This attitude should also be taken in the Czech Republic. The directives of the European Union pertinent to medical devices of biological origins can be applied only to devitalized tissues--and moreover, the domestic pig is not on the risk animal list. The author presumes that to guarantee safe use of viable xenografts it is necessary to follow the general principles of quality control as applied in the workplace for many years, as well as general medicinal product safety principles, including strict veterinary control of breed of animals whose tissues are used for the preparation of xenografts.

Burns↗

PubMed1995

Evaluation of BCG vaccination: an intervention study in Rail Region, Saudi Arabia.

Inspection of 300 infants attending a primary health care (PHC) center at Hail region showed that 18.8% of children failed to develop BCG reations. This directed attention to inspect the process of vaccination at hospitals in which 80% of deliveries and BCG vaccination took place. Defects in the process of vaccination and cold chain system were noticed. Reorganization of the process of vaccination in addition to training the staff responsible for vaccination were done. A survey was followed to evaluate failure of BCG vaccination before and after the intervention. We checked 4145 infants two to twelve months of age, for any reaction at the site of BCG vaccination. After intervention vaccination failure dropped from 20.4% to 4.9% for infants vaccinated in hospitals (p = 0.00001), and from 7.9% to 3.2% for those vaccinated in health centers (p = 0.01). Moreover, before intervention success of BCG vaccination was significantly higher in PHC centers (92.1%) than in hospitals (79.6%). This difference became insignificant after intervention because success of BCG vaccination in hospitals has increased up to 95.1% compared to 96.8% in health centers. Inspection of all infants for BCG reaction is continued as a part of routine work at PHC centers, and re-vaccination of those who failed to develop reation to BCG is conducted without any reported complications.

BCG Vaccine↗

PubMed1991

Extent of occurrence of the six vaccine preventable diseases in vaccinated/unvaccinated children.

Sixty two children who were diagnosed to be suffering from any of the six vaccine preventable diseases were studied to know their vaccination status prior to the occurrence of these diseases. A total of 33.9% of these children had developed these diseases inspite of full immunization. Nearly 75% of immunized children had received the vaccine from Government sources. The break-up diseases among the children studied was tetanus (35.5%), poliomyelitis and pulmonary tuberculosis (22.6% each), measles (11.3%), diphtheria (6.4%) and pertussis (1.6%). The vaccinated children who developed poliomyelitis belonged to a relatively higher age group. Seventy one per cent of measles cases developed bronchopneumonia as a complication. Seventy five per cent of the mortality in the children studied was due to tetanus neonatorum. Since one third of the children studied had developed diseases inspite of full immunization, it is inferred that closer monitoring of the Cold Chain System and intensive surveillance at peripheral levels are required.

Age Factors↗

PubMed1991

[Efficacy evaluation of measles vaccine in fields].

The result of determining the effectiveness of measles vaccine is reported. It included 196 samples of measles vaccine from 1986 to 1989 in Xiangfang City. There were 14 samples found unqualified. Thus we took the relevant measures and the result was rather good. The investigation confirmed that the cold-chain equipment now available had played a guarantee role for the quality of vaccines. In addition, we analysed the cause of the measles vaccine with low titre. The influences of different districts and seasons on the stability of vaccine had been studied. Some measles vaccine were of low titre but rather high level in HIAb. This problem was investigated and discussed theoretically.

Antibodies, Viral↗

PubMed1991

Support systems, facilities and staffing of clinics in Mhala, Gazankulu--are they adequate?

A study comprising in-depth interviews of sisters in all 15 rural clinics in the Mhala district of Gazankulu showed them to experience major problems with support systems: radiophone communication was unreliable (and even absent in 3 clinics); transport was inadequate; the cold chain was not well maintained and essential drugs and equipment were absent (only 1 clinic had all the equipment to manage a neonatal resuscitation adequately). There were also serious deficiencies in facilities, lack of running water and electricity posing the most serious problems (resulting in deliveries and suturing of episiotomies by candlelight). Other pressing problems include inadequate waiting space and patient privacy. Staffing at the clinics fell well below what is required, yet the commitment of staff was often inspiring. The state of the clinics must be seen within the constraints of 'homeland' policy and the unequal distribution of the country's health care resources. Despite these limitations the clinic service can be improved. Recommendations are made for this, concentrating on improving support structures rather than on the more costly improvement of facilities.

Ambulatory Care Facilities↗

PubMed1990

Cluster survey for vaccination coverage in Sohag Governorate, October 1989.

This cluster survey for vaccination coverage in Sohag Governorate was carried out for the six vaccine preventable diseases in children below 2 years and tetanus toxoid for pregnant mothers. It reveals that vaccination coverage in Sohag is still far below the universal child immunization goal of 80% coverage by the year 1990. Fully vaccinated children were 17.2%. Vaccination coverage was better in urban (44.8%) than in rural areas (7%). Vaccination coverage was higher in males (67.6%) than in females (32.4%). Measles had the best level of coverage (66.1%) while B.C.G. was the least (20.9%). Fifty percent of mothers were covered by two doses of tetanus toxoid. The most common reasons for drop out were unaware of need for return for second and third doses (32.6%) and vaccine not available (21.7%). Evaluation of most important vaccination activities to be performed in link with the cold chain in the thirty health units of the thirty cluster areas of Sohag Governorate was performed.

BCG Vaccine↗

PubMed1990

Worldwide status of poliomyelitis in 1986, 1987 and 1988, and plans for its global eradication by the year 2000.

In 1986, a total of 28,951 cases of poliomyelitis were reported to WHO by 175 countries/areas. For 1987, 35,685 cases were reported by 168 countries/areas. Reporting is incomplete for 1988, based on data available as of December 1989. Trends in regional incidence rates for poliomyelitis over a 15-year period from 1974 to 1988 suggest a decline in the incidence of the disease, especially since 1982. However, the reported data underreport actual disease incidence. During 1986, 1987 and 1988, the Expanded Programme on Immunization (EPI) estimates that 200,000-250,000 cases of paralytic poliomyelitis occurred each year. With the current level of polio immunization coverage, it is estimated that 360,000 cases of paralytic poliomyelitis were prevented in 1988. In 1974, when the EPI was started, it was estimated that less than 5% of children in the developing world were adequately immunized against six common childhood diseases, including poliomyelitis. In 1988 (based on data available as of December 1989) 67% of children worldwide received a full course of polio vaccine before 12 months of age. The progress of the EPI has provided optimism that poliomyelitis can be eradicated. In May 1988, the Forty-first World Health Assembly committed WHO to the global eradication of poliomyelitis by the year 2000. The eradication of poliomyelitis will represent, along with the eradication of smallpox, a fitting gift from the XXth to the XXIst century. To reach this goal, action will be required in several main areas. Immunization coverage will need to be raised and sustained in every district. Vaccine quality must be assured by using vaccines which meet WHO requirements and maintaining the cold chain. Surveillance must be strengthened so that prompt, regular reporting of suspected cases leads to disease-containment measures. Additional actions include improving laboratory diagnostic capabilities, developing special training materials, increasing public awareness, supporting rehabilitation services and conducting essential research.

Forecasting↗

PubMed1989

Specific antibody response towards predicted epitopes of the epidermal growth factor receptor induced by a thermostable synthetic peptide adjuvant conjugate.

Applying computer-assisted epitope prediction to the amino-acid sequence of the epidermal growth factor receptor (EGFR), the extracytoplasmic domain EGFR(516-529) was selected as a putative antigenic region. EGFR(516-529) was synthesized on a solid-phase matrix and N-terminally linked to the low mol. wt adjuvant tripalmitoyl-S-glyceryl-cysteinyl-serine (Pam3 Cys-Ser). The conjugation to this B cell and macrophage-activating lipopeptide considerably enhanced the immunogenicity of the EGFR peptide. Using the conjugate Pam3 Cys-Ser-EGFR(516-529), a peptide-specific monoclonal antibody was produced. By flow cytometry and immunoprecipitation the antibody was demonstrated to recognize EGFR on A431 cells, expressing large numbers of EGFR. With this novel approach synthetic immunogens can be prepared which could serve as thermostable synthetic vaccines with great potential in countries where a functional cold chain cannot be maintained.

Adjuvants, Immunologic↗