S Rao

S Rao, B Unnikrishnana ( 2012) a cross sectional study was conducted on evaluation, awareness, practice and management of cold chain at the Primary Health Care Centers in Dakshina Kannada District of Coastal South India. 70 PHCs Cold chain equipment and maintenance process was noted following direct observation on uninformed visits. Data regarding the knowledge and practices of cold chain management was obtained by interviewing the medical officers using structured pretested questionnaire. The results was, Ice lined refrigerators and deep freezers were available in 69 (98.6%) and 67(95.8%) of centers. Dial thermometer was present in all the centers. Cold boxes, frozen packs and automated voltage stabilizers were available in 68(97.2%) centers. Improper vaccine storage was observed in 7 (10%) centers. Majority of medical officers had knowledge and correct practices in fields like ideal equipment, OPV administration, vaccine requiring diluents but only 47 (61.8%) medical officers had correct practice of defrosting the deep freezers. Inappropriate vaccine storage practices and poor knowledge in some fields of cold chain management may harmfully affect the quality of administered vaccine. So the relevant training for those handling the cold chain is recommended.
Jyothi J (2012- 2013), a cross sectional study was conducted to assess the functioning and effectiveness of cold chain in urban Primary Health Centers of Bangalore, India. Data was collected from 30 PHC, by using observational checklist. Among the 27 Primary Health Centers studied, 1 centre didn’t have Ice line refrigerator or Deep freezer, 13 centers didn’t have deep freezer. In 22 centers, Cold Chain equipment were attached to stabilizer, 7 centers placed equipment as per standard norms, 3 centers had not maintained temperature charts, 3 centers didn’t have thermometers. 10 centers showed discrepancy in recorded temperature. Vaccines at the session site were in zipper pouch in vaccine carrier at 23 centers. There are a lot of weaknesses and gaps in cold chain maintenance, thus arising the doubt of strength/effectiveness and safety of vaccines administered. To improve the situation constant monitoring and supervision, periodic training of personnel is necessary.
Buledi R, Butt ZA et.al. (May- July 2012), A cross-sectional study was conducted on status of cold chain in routine immunization centre’s of the Expanded Programme on Immunization in Quetta, Pakistan. Data was collected from 42 health facilities by interview and checklist to assess cold chain maintenance of routine EPI vaccines. The result was, out of 42 health facilities, staff of 13(30%) wrongly indicated that measles and Bacillus Calmette -Guerin were cold sensitive vaccines. Temperature of the ice-lined refrigerators was not maintained twice daily in 18(43%) centers. There were no voltage stabilizers and standby power generators in 31(74%) and 38(90%) centers, respectively. Vaccine arrangement was found to be inappropriate in ice-lined refrigerators of 38(90%) centers and ice packs were incorrectly used in carriers in 22(52%) centers. Although the majority of health staff had adequate knowledge, there were weaknesses in practice of maintaining the cold chain.
Raglione D, Bezerra GA et.al. (2011 -2012), a descriptive study was conducted on evaluation of the cold chain for vaccine conservation in randomly selected 24 primary healthcare centers in the South and Midwest regions of São Paulo city, Brazil. The data were collected from the health workers on their vaccine conservation knowledge/practice and observed the local infrastructure, using a developed form and interview. The result was, 24 PHC evaluated were administered by Social Organizations; all of them had vaccine storage chambers; 5 PHC reported using their maximum storage capacity; 9 PHC were classified as having sufficient knowledge/practice and 15 as having regular knowledge/practice. In these PHC, cold chain utilization was close to its maximum capacity; many health workers did not have basic knowledge about vaccine conservation.
Wiysonge et al., (2012), was conducted a study in South Africa concludes the nurses who face numerous challenges in the management of the cold chain of vaccines despite the many advances in immunization. Some of these challenges include insufficient financial resources, a shortage of human resources and a lack of knowledge of nurses regarding vaccine management. These inefficiencies will lead to vaccines becoming compromised and degraded. As a result, these vaccines will no longer be potent and will not be beneficial to children. To overcome this challenge to maintaining the cold chain for vaccine must be effectively.
Ashutosh Shrivastava, Neeraj Gupta et. al. ( January 2011) conducted a study on caution needed in using oral polio vaccine beyond the cold chain: Vaccine vial monitors may be unreliable at high temperatures vaccine vials with VVMs were incubated (10 vials for each temperature). In an incubator at different temperatures at 37, 41, 45 and 49.5°C. Time-lapse photographs of the Vaccine Vial Monitors on vials were taken hourly to look for their discard-point. The result shows that, at 37°C and 41°C the VVMs worked well. At 45°C, vaccine potency is known to drop to the discard level within 14 hr whereas the VVM discard point was reached at 16 hr. At 49.5°C the VVMs reached discard point at 9 hr when these should have reached it at 3 hr .Absolute reliance cannot be placed on VVM in situation where environmental temperatures are high. Caution is required when using ‘outside the cold chain’ (OCC) protocols