title: Cold chain status at immunisation centres in Ethiopia.
abstract: BACKGROUND
  Child immunisation is among the most cost-effective ways of preventing premature child deaths, and the potency of vaccines, crucial for vaccine efficacy, is dependent on effective management of the cold chain at all levels of vaccine handling.
  
  
  OBJECTIVE
  To assess the status of the cold chain at peripheral vaccine stores in Ethiopia.
  
  
  METHODS
  Institution based cross-sectional survey in two rural and one urban administrative areas were included in the study. Sixty seven health institutions providing static vaccination services were included in the study but cold chain system was assessed fully in only sixty four. Data were collected by interviewing health workers and by directly observing the cold chain equipment and records using structured forms.
  
  
  RESULTS
  Conditions of the cold chain system were described based on 64 of the 67 centres visited, three were excluded because of non-functioning cold chain. Complete temperature record was observed in 37 (57.8%) of the centres. Thermometer was not available in four (6.3%) and thermometer reading was found to be outside the optimal range in another seven (10.9%) centres. Vaccine storage in the refrigerator was not proper in 47 (73.4%) centres. Majority of the centres had neither trained personnel nor budget for maintenance of the cold chain.
  
  
  CONCLUSIONS
  There is a real danger of vaccines losing their potency at these centres even if they were potent on arrival. Relevant training for those handling the cold chain, improving the maintenance conditions of refrigerators and introduction of cold chain monitoring devises are recommended.
authors.affiliation: Department of Community Health, Faculty of Medicine, Addis Ababa University, P.O. Box 2077, Addis Ababa, Ethiopia.
authors.forename: Y
authors.initials: Y
authors.lastname: Berhane
authors.forename: M
authors.initials: M
authors.lastname: Demissie
mesh_terms: D004356:Drug Storage / Q000592:standards* / Q000706:statistics & numerical data*; D005002:Ethiopia; D006801:Humans; D017589:Immunization Programs / Q000592:standards* / Q000706:statistics & numerical data*; D012034:Refrigeration / Q000592:standards* / Q000706:statistics & numerical data*; D014612:Vaccines / Q000737:chemistry* / Q000494:pharmacology / Q000592:standards*
chemical_list: D014612:Vaccines