title: Assessment of cold chain status for immunization in central Ethiopia.
abstract: BACKGROUND
  In order to achieve immunization goals, two factors are necessary; the delivery of potent vaccines to children through properly maintained cold chain systems and achieving high vaccine coverage. Maintaining quality of vaccines has been one of the main challenges of immunization programs in Africa.
  
  
  OBJECTIVE
  To assess the cold chain status and practices in 116 health facilities located in three CCRDA/CORE Group Ethiopia operational districts (woredas).
  
  
  METHODS
  An institution based cross-sectional study was conducted in December 2011 and January 2012 in three districts (woredas) of Oromiya, SNNP and Amhara Regions of Ethiopia, data was collected from 116 health facilities and from the same number of immunization service providers. Multiple logistic regression analysis was carried out to identify factors related to knowledge of cold chain management.
  
  
  RESULTS
  Of 116 visited facilities, only 22 (19%) had functional refrigerators. The remaining facilities transported vaccines from nearby facilities having functional refrigerators. Complete temperature recording of the last month was observed in 13 (59.1%) facilities. Of 22 functional fridges, the thermometer reading was found to be outside the recommended range in 6 (27.3%) on the date of data collection. Vaccine storage in the refrigerator was not proper in 12 (54.5%) facilities. Sixty-five (56%) health workers had satisfactory knowledge on cold chain management. Professional qualification and year of service in the immunization program showed a statistically significant association with knowledge of cold chain management (P < 0.05).
  
  
  CONCLUSIONS
  Vaccines in some facilities were found to be at a high risk of losing their potency. There is an urgent need to improve knowledge and practice on cold chain management through improved supervision and training.
authors.affiliation: CCRDA/CORE Group Polio Project Ethiopia, P.O.Box 5674, Addis Ababa, Ethiopia.
authors.forename: Bezunesh
authors.initials: B
authors.lastname: Rogie
authors.affiliation: Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
authors.forename: Yemane
authors.initials: Y
authors.lastname: Berhane
authors.affiliation: Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
authors.forename: Filimona
authors.initials: F
authors.lastname: Bisrat
mesh_terms: D003430:Cross-Sectional Studies; D004356:Drug Storage; D005002:Ethiopia; D006801:Humans; D017589:Immunization Programs; D023321:Poliovirus Vaccines; D011361:Professional Competence; D012034:Refrigeration
chemical_list: D023321:Poliovirus Vaccines