Healthcare providers' knowledge, experience and challenges of reporting adverse events following immunisation: a qualitative study

Background: Healthcare provider spontaneous reporting of suspected adverse events following immunisation (AEFI) is central to monitoring post-licensure vaccine safety, but little is known about how healthcare professionals recognise and report to surveillance systems. The aim of this study was explore the knowledge, experience and attitudes of medical and nursing professionals towards detecting and reporting AEFI. Methods: We conducted a qualitative study, using semi-structured, face to face interviews with 13 Paediatric Emergency Department consultants from a tertiary paediatric hospital, 10 General Practitioners, 2 local council immunisation and 4 General Practice nurses, recruited using purposive sampling in Adelaide, South Australia, between December 2010 and September 2011. We identified emergent themes related to previous experience of an AEFI in practice, awareness and experience of AEFI reporting, factors that would facilitate or impede reporting and previous training in vaccine safety. Thematic analysis was used to analyse the data. Results: AEFI reporting was infrequent across all groups, despite most participants having reviewed an AEFI. We found confusion about how to report an AEFI and variability, according to the provider group, as to the type of events that would constitute a reportable AEFI. Participants’ interpretation of a “serious” or “unexpected” AEFI varied across the three groups. Common barriers to reporting included time constraints and unsatisfactory reporting processes. Nurses were more likely to have received formal training in vaccine safety and reporting than medical practitioners. Conclusions: This study provides an overview of experience and beliefs of three healthcare professional groups in relation to identifying and reporting AEFI. The qualitative assessment reveals differences in experience and awareness of AEFI reporting across the three professional groups. Most participants appreciated the importance of their role in AEFI surveillance and monitoring the ongoing safety of vaccines. Future initiatives to improve education, such as increased training to health care providers, particularly, medical professionals, are required and should be included in both undergraduate curricula and ongoing, professional development.Adriana Parrella, Annette Braunack-Mayer, Michael Gold, Helen Marshall and Peter Baghurs

Évaluation de la capacité vectorielle de

Cent quatre vingt-deux Glossina tachinoidesont été infectées avec Trypanosoma congolense type « savane ». Les taux d'infection ont été évolués par examen microscopique et par PCR. L'émission des trypanosomes par salivation provoquée a été étudiée selon différentes techniques de détection des parasites qui ont été comparées. Les résultats des dissections ont révélé un fort pourcentage d'infections immatures. La technique PCR appliquée sur les proboscis a confirmé les résultats parasitologiques. Les expériences de salivation ont montré une grande variabilité, inter et intra-individuelle, dans l'émission des trypanosomes lors des sondages. La technique PCR a été équivalente à l'examen microscopique pour détecter les trypanosomes dans les salivats. La méthode de xénodiagnostic inverse s'est révélée la moins performante des trois pour détecter les glossines infectantes. L'ensemble de ces résultats a permis de préciser la capacité vectorielle de G. tachinoides vis-à-vis de T. congolense type « savane » au laboratoire, et de donner des éléments supplémentaires de compréhension au rôle de cette glossine dans Tépidémiologie de la maladie

Diarrhea: case definition and guidelines for collection, analysis, and presentation of immunization safety data

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Chironomidae (Insecta: Diptera) Collected from Hydrilla Verticillata (Hydrocharitaceae) and other submersed aquatic Macrophytes in Lake Bisina and other Ugandan Lakes

A survey of the aquatic weed Hydrilla verticillata was conducted in selected Kenyan and Ugandan lakes, and emerging chironomid adults were collected from samples of Hydrilla and seven other aquatic macrophytes. Hydrilla was absent from Lake Victoria, in sites where it previously occurred. Hydrilla was found in four of nine lakes examined in Uganda, i.e. Bisina, Kyoga, Bunyonyi and Mutanda. From 7424 collected chironomid adults, 43 species were identified, 21 (49%) representing new Ugandan records. Thirty-nine (91%) of the species were found on Hydrilla. Three species represent probable undescribed taxa. At our primary site, Lake Bisina, the genera Tanytarsus and Dicrotendipes dominated the chironomid community, comprising 76% of emerged adults. A species accumulation curve for chironomid species associated with Lake Bisina macrophytes suggested that further plant sampling would uncover additional species. Polypedilum wittei, formerly considered for possible biological control of Hydrilla, was not specific to that plant, emerging from six of the seven other species of submersed macrophytes we sampled. A second candidate Polypedilum species, P. dewulfi, was not found in Uganda. No insectrelated damage to Hydrilla was observed. Chironomid data were compared between Uganda collections and those from a concurrent, similar study in lake Tanganyika. Alpha- and ß-diversity values indicated that the chironomid communities on aquatic plants from Lake Bisina and Lake Tanganyika (Burundi) were markedly different. Studies of chironomids and other invertebrates associated with macrophytes in other African lakes will add significantly to knowledge of the natural history of these important aquatic environments.Keywords: Lake Victoria, weed, biodiversity, biological control, Lake TanganyikaJournal of East African Natural History 101(1): 29–66 (2012

Herbivory OF hydrilla verticillata by Cichlid fish in Lake Bisina, Uganda

The aquatic macrophyte, Hydrilla verticillata is a serious invasive plant in many countries. In East and Central Africa, H. verticillata is present in some water bodies, but not considered a weed. Hydrilla verticillata leaves collected in this region often appear to be chewed, and many stems are missing their apical meristems. Based on this damage, we hypothesized that fish were responsible. To test this hypothesis, fish were collected in Lake Bisina, Uganda, their stomach contents examined, and plant damage putatively caused by fish was quantified. Seventeen species of cichlid fish were collected and H. verticillata leaf tissue was found in the stomachs of four species, demonstrating that fish consumed H. verticillata. A survey of plant damage in the same lake revealed that the majority of branches were missing apical meristems, and about half of nodes had leaf damage. Eight of the fishes we collected are on the list of threatened species maintained by the International Union for the Conservation of Nature, but only one of these was included in the justification for designation of Lake Bisina as a wetland of international importance (RAMSAR site). We recommend that the other seven species be added to the RAMSAR justification.Keywords: Fish herbivory, Hydrilla, Uganda, cichlids, threatened speciesJournal of East African Natural History 100(1&2): 113–121 (2011