RESUMO
The emergence and spread of extensively drug-resistant (XDR) typhoid in Karachi, Pakistan led to an outbreak response in Lyari Town, Karachi utilizing a mass immunization campaign with typhoid conjugate vaccine (TCV), Typbar TCV®. The mass immunization campaign, targeted Lyari Town, Karachi, one of the worst affected towns during the XDR typhoid outbreak. Here we describe the strategies used to improve acceptance and coverage of Typbar TCV in Lyari Town, Karachi. The mass immunization campaign with Typbar TCV was started as a school- and hospital-based vaccination campaign targeting children between the age of 6 months to 15 years old. A dose of 0.5 mL Typbar TCV was administered intramuscularly. A mobile vaccination campaign was added to cope with high absenteeism and non-response from parents in schools and to cover children out of school. Different strategies were found to be effective in increasing the vaccination coverage and in tackling vaccine hesitancy. Community engagement was the most successful strategy to overcome refusals and helped to gain trust in the newly introduced vaccine. Community announcements and playing typhoid jingles helped to increase awareness regarding the ongoing typhoid outbreak. Mop-up activity in schools was helpful in increasing coverage. Networking with locally active groups, clubs and community workers were found to be the key factors in decreasing refusals.
RESUMO
Typhoid and other invasive salmonelloses continue to cause an estimated 14.8 million cases and > 200â 000 deaths annually, largely affecting children in low- and middle-income countries. However, recent strides in global policy have paved the way for accelerated progress with prevention and control efforts. To translate these recent advancements at the global level into real impact in communities at the local level, the Coalition against Typhoid, based at the Sabin Vaccine Institute, convened the 11th International Conference on Typhoid and Other Invasive Salmonelloses in Hanoi, Vietnam, in March 2019. Here, we review the significant topics and research discussed at the conference, including diagnostics, environmental surveillance, drug resistance, burden of disease, and vaccines, as well as additional prevention and control interventions.
