Published May 7, 2025 | Version v1
Journal article Open

A Methodological Framework for Assessing Cold Chain Integrity and Measles Vaccine Seroconversion in Remote Angolan Health Facilities (2021–2026)

  • 1. Technical University of Angola (UTANGA)
  • 2. Department of Surgery, Technical University of Angola (UTANGA)

Description

This methodology article presents a comprehensive framework for assessing vaccine cold chain integrity and its direct impact on measles vaccine seroconversion in remote Angolan health facilities. The persistent challenge of suboptimal vaccine efficacy in low-resource settings, often attributable to cold chain failures, necessitates robust, context-specific evaluation tools. Our mixed-methods approach, implemented from 2021 to 2026, integrates quantitative and qualitative components to ensure analytical rigour. Continuous temperature monitoring using wireless data loggers across the entire supply chain is combined with serological testing of infant cohorts pre- and post-vaccination. These data are triangulated with structured observations and interviews with healthcare workers to capture operational realities and systemic knowledge gaps. This design precisely quantifies temperature excursions and correlates them with immunogenicity outcomes, while the qualitative data elucidate root causes and vulnerabilities. Preliminary application in selected provinces has demonstrated the framework's feasibility in identifying critical breakpoints—from central storage to final administration—that jeopardise vaccine potency. The methodology's significance lies in its actionable, data-driven approach, moving beyond mere compliance monitoring to actively linking cold chain logistics with clinical outcomes. It provides a replicable model for strengthening immunisation programmes by prioritising evidence-based, targeted interventions, ultimately aiming to improve measles control and support broader public health goals across the continent.

Files

review_bundle.zip

Files (1.7 MB)

Name Size Download all
md5:2cf38c6c52c53d78d88716a397addedb
989.9 kB Download
md5:5695508d33261338a4d8f8ccaaca43d8
91.8 kB Preview Download
md5:0d0af18d7ea454654daa687b227c787f
647.4 kB Preview Download

Additional details

References

  • Adwibowo, A. (2021). Assessments of heavy lift UAV quadcopter drone to support COVID 19 vaccine cold chain delivery for indigenous people in remote areas in South East Asia. medRxiv. https://doi.org/10.1101/2021.01.09.21249494
  • Azam, J.M., Saitta, B., Bonner, K., Ferrari, M.J., & Pulliam, J.R. (2021). Modelling the relative benefits of using the measles vaccine outside cold chain for outbreak response. Vaccine. https://doi.org/10.1016/j.vaccine.2021.08.053
  • Azam, J.M., Saitta, B., Bonner, K., Ferrari, M.J., & Pulliam, J.R. (2021). Modelling the relative benefits of using the measles vaccine outside cold chain for outbreak response. medRxiv. https://doi.org/10.1101/2021.05.19.21257492
  • Chapman, J.M. (2023). Angola. Remaking the World. https://doi.org/10.5810/kentucky/9780813197487.003.0007
  • De Lemos, S.S.A., Da Silva, J.B., & De Sousa, C.A.P. (2022). Estimation of the Odds Ratio in Vaccinated Individuals and Determination of Vaccine Efficacy against Sars-Cov-2 Infection in Angola – Part I. https://doi.org/10.20944/preprints202208.0014.v1
  • De Lemos, S.S.A., Da Silva, J.B., & De Sousa, C.A.P. (2022). Estimation of the Odds Ratio in Vaccinated Individuals and Determination of Vaccine Efficacy against Sars-CoV-2 Infection in Angola – Part I. https://doi.org/10.20944/preprints202208.0014.v2
  • Drissi Bourhanbour, A., & Ouchetto, O. (2021). Morocco achieves the highest COVID-19 vaccine rates in Africa in the first phase: what are reasons for its success?. Journal of Travel Medicine. https://doi.org/10.1093/jtm/taab040
  • Ekwebelem, O., Yunusa, I., Onyeaka, H., Ekwebelem, N., & Nnorom-Dike, O. (2021). COVID-19 vaccine rollout: will it affect the rates of vaccine hesitancy in Africa?. Public Health. https://doi.org/10.1016/j.puhe.2021.01.010
  • Elahi, E. (2021). Angola. World Compendium of Healthcare Facilities and Nonprofit Organizations. https://doi.org/10.1201/9781003274872-10
  • Elahi, E. (2021). Angola. World Compendium of Healthcare Facilities and Nonprofit Organizations. https://doi.org/10.1201/9781003274872-8
  • Elahi, E. (2021). Angola. World Compendium of Healthcare Facilities and Nonprofit Organizations. https://doi.org/10.1201/9781003274872-9
  • Feyisa, D., Ejeta, F., Aferu, T., & Kebede, O. (2022). Adherence to WHO vaccine storage codes and vaccine cold chain management practices at primary healthcare facilities in Dalocha District of Silt'e Zone, Ethiopia. Tropical Diseases, Travel Medicine and Vaccines. https://doi.org/10.1186/s40794-022-00167-5
  • Gastrow, C. (2022). 'If Angola were Libya': protest and politics in Angola. Transformation: Critical Perspectives on Southern Africa. https://doi.org/10.1353/trn.2022.0008
  • Gebretnsae, H., Hadgu, T., Ayele, B., Gebre-egziabher, E., Woldu, M., Tilahun, M., Abraha, A., Wubayehu, T., & Medhanyie, A.A. (2022). Knowledge of vaccine handlers and status of cold chain and vaccine management in primary health care facilities of Tigray region, Northern Ethiopia: Institutional based cross-sectional study. PLOS ONE. https://doi.org/10.1371/journal.pone.0269183
  • Gelaw, A., Belyhun, Y., Wondimeneh, Y., Kokeb, M., Dagnew, M., Amare, A., Mulu, M., Alemayehu, M., & Gelaw, B. (2023). Knowledge and associated factors of healthcare workers on measles vaccine and cold chain management at health institutions in Gondar, Ethiopia. Asian Pacific Journal of Tropical Medicine. https://doi.org/10.4103/1995-7645.368019
  • Iryaningrum, M.R., Cahyadi, A., Damara, F.A., Bandiara, R., & Marbun, M.B.H. (2023). Seroconversion rates in kidney transplant recipients following SARS-CoV-2 vaccination and its association with immunosuppressive agents: a systematic review and meta-analysis. Clinical and Experimental Vaccine Research. https://doi.org/10.7774/cevr.2023.12.1.13
  • Mohammed, S.A., Workneh, B.D., & kahissay, M.H. (2021). Knowledge, attitude and practice of vaccinators and vaccine handlers on vaccine cold chain management in public health facilities, Ethiopia: Cross-sectional study. PLOS ONE. https://doi.org/10.1371/journal.pone.0247459
  • Mohammed, S.A. (2022). Vaccine Wastage and Its Contributing Factors in Public Health Facilities, Ethiopia: Explanatory Sequential Mixed Method Design. Community Medicine & Public Health Care. https://doi.org/10.24966/cmph-1978/1000111
  • Mountjoy, A.B., & Embleton, C. (2023). Angola. Africa. https://doi.org/10.4324/9781032685700-60
  • SA, M. (2022). Vaccine Wastage and its Contributing Factors in Public Health Facilities of Oromia Special Zone, Ethiopia: Explanatory Sequential Mixed Method Design. Vaccines & Vaccination Open Access. https://doi.org/10.23880/vvoa-16000153
  • Sabahelzain, M.M., Moukhyer, M., van den Borne, B., & Bosma, H. (2021). Vaccine hesitancy among Sudanese parents and its association with the uptake of measles vaccine. https://doi.org/10.20944/preprints202112.0313.v1
  • Sabahelzain, M.M., Moukhyer, M., van den Borne, B., & Bosma, H. (2022). Vaccine Hesitancy among Parents and Its Association with the Uptake of Measles Vaccine in Urban Settings in Khartoum State, Sudan. Vaccines. https://doi.org/10.3390/vaccines10020205
  • Sawani, E., & Masinde, L. (2022). Vaccine Cold Chain Management Factors Associated with Measles Outbreak among Children below 5 Years in Oltepesi Location, Kajiado County, Kenya. International Journal of Professional Practice. https://doi.org/10.71274/ijpp.v10i4.202
  • Shaxson, N. (2022). Angola. On the Trail of Capital Flight from Africa. https://doi.org/10.1093/oso/9780198852728.003.0003
  • Shrivastava, P., & P, M. (2023). MEASLES-RUBELLA VACCINE WITH ORAL ZINC VERSUS MEASLES-RUBELLA VACCINE MONOTHERAPY FOR PALMOPLANTAR WARTS. GLOBAL JOURNAL FOR RESEARCH ANALYSIS. https://doi.org/10.36106/gjra/8313837
  • Stoeckel, F., Carter, C., Lyons, B.A., & Reifler, J. (2021). Association of vaccine hesitancy and immunization coverage rates in the European Union. Vaccine. https://doi.org/10.1016/j.vaccine.2021.05.062
  • Uwishema, O., Adriano, L.F., Torbati, T., & Onyeaka, H. (2021). Measles crisis in Africa amidst the COVID‐19 pandemic: Delayed measles vaccine administration may cause a measles outbreak in Africa. Journal of Medical Virology. https://doi.org/10.1002/jmv.27150