如果没有有效的药物,疫苗是预防新城疫(ND)的基石。采取了不同的策略来增加疫苗接种,但是摄取仍然很低,强调了对新型疫苗递送方法的需求。我们设计并评估了肯尼亚东南部以社区为中心的ND疫苗接种模式的有效性。在模型下,我们通过对养鸡业的结构化培训,提高了小农养鸡户(SCF)的敏感性,生物安全,ND,和它的疫苗接种,在其他方面。我们随后聘请经过培训的社区疫苗接种员(CV)向SCF提供疫苗和/或疫苗接种服务,不花任何代价,在选定的网站上应对服务提供商不足的挑战,疫苗不可用,和无法访问。我们在一年以上的付费和免费疫苗接种框架下测试了该模型,并评估了该模型对疫苗摄取的影响,与ND有关的死亡,和疫苗的可获得性,在其他方面。总的来说,与付费网站相比,我们在免费网站接种了更多的鸡。然而,与免费(28.4±25.9)地点相比,我们在付费的每个家庭的平均鸡只数量(49.4±38.5)明显更高(t=8.4,p<0.0001)。我们记录到接种疫苗的SCF比例显着增加,从31.3%增加到68.4%(χ2(1,N=399)=58.3,p<0.0001),从19.9%增加到74.9%(χ2(1,N=403)=115.7,p<0.0001)在干预前和干预后,分别。每个家庭报告的与ND相关的平均死亡人数从干预前的18.1±31.6下降到干预后的7.5±22.3(t=5.4,p=0.000),干预前后,付费站点(20.9±37.7至4.5±11.2)的减少率高于免费站点(15.0±22.6至10.7±29.7),分别。获得疫苗的农民在干预前和干预后从61.1%显著增加到85.4%(χ2(1,N=399)=31.7,p<0.0001),在免费场所,干预前和干预后从43.6%增加到74.9%(χ2(1,N=403)=38.4,p=0.0001),分别。我们建立了这种干预框架,户主的性别,如果户主在过去12个月内参加了鸡肉生产培训,获取有关ND疫苗接种的信息,上次ND爆发损失的鸡只数量是ND疫苗摄取的重要预测因素。我们的研究结果表明,该模型对SCF具有更广泛的影响和益处。然而,应制定政策,规范将简历纳入正规动物卫生部门。
In the absence of effective drugs, vaccines constitute the cornerstone for the prevention of Newcastle disease (ND). Different strategies have been implemented to increase vaccination, but uptake remains low, underscoring the need for novel vaccine delivery methods. We designed and assessed the effectiveness of a community-centered ND vaccine delivery model in southeastern Kenya. Under the model, we sensitized smallholder chicken farmers (SCFs) through structured training on chicken husbandry, biosecurity, ND, and its vaccination, among other aspects. We subsequently engaged trained community vaccinators (CVs) to deliver vaccines and/or provide vaccination services to SCFs at a cost on one hand and, at no cost on the other, in selected sites to address challenges of inadequate service providers, vaccine unavailability, and inaccessibility. We tested this model under paid and free vaccination frameworks over one year and assessed the model\'s effect on vaccine uptake, ND-related deaths, and vaccine accessibility, among other aspects. Overall, we vaccinated more chickens at free sites compared to paid sites. However, we vaccinated a significantly higher mean number of chickens per household at paid (49.4±38.5) compared to free (28.4±25.9) sites (t = 8.4, p<0.0001). We recorded a significant increase in the proportion of SCFs who vaccinated their chickens from 31.3% to 68.4% (χ2(1, N = 399) = 58.3, p<0.0001) in paid and from 19.9% to 74.9% (χ2(1, N = 403) = 115.7, p<0.0001) in free sites pre- and post-intervention, respectively. The mean number of ND-related deaths reported per household decreased from 18.1±31.6 pre-intervention to 7.5±22.3 post-intervention (t = 5.4, p = 0.000), with higher reductions recorded in paid sites (20.9±37.7 to 4.5±11.2) compared to free sites (15.0±22.6 to 10.7±29.7) pre- and post-intervention, respectively. Farmers with access to vaccines increased significantly from 61.1% to 85.4% (χ2(1, N = 399) = 31.7, p<0.0001) in paid and 43.6% to 74.9% (χ2(1, N = 403) = 38.4, p = 0.0001) in free sites pre- and post-intervention, respectively. We established that type of intervention framework, gender of household head, if the household head attended training on chicken production in the last 12 months, access to information on ND vaccination, and the number of chickens lost to the previous ND outbreak were significant predictors of ND vaccine uptake. Our findings indicate the model has a broader reach and benefits for SCFs. However, policies should be enacted to regulate the integration of CVs into the formal animal health sector.