Improving community based AEFI (Adverse Events Following Immunization) reporting rate through telephone “beep” in a Cameroon health district: a randomized field trial

INTRODUCTION: AEFIs underreporting is one of different barriers to achieving objectives of pharmaco vigilance of vaccine worldwide. Studies describe it as being related to limited awareness of health personnel and of vaccinees or of their parents. The objective was to assess the effect of telephone “beep” on community based reporting rates of AEFIs during routine immunization sessions in a Cameroon Health District. METHODS: It was a randomized control trial implemented during routine EPI in Biyem-Assi health district (Cameroon). Parents of vaccinated children were randomly assigned: i) to receive the telephone contact of the investigation team and was advised to ‘'beep’‘(short phone call not picked up) the investigators team in the case any medical incidence occurs within the 30 days following the immunization (intervention group) or; ii) to return to the health facility in case any medical incidence occurs within the same period (control group). The main outcome was AEFI incidence rate. RESULTS: 236 parents were assigned to the intervention group and 235 to the control group. Of 1192 doses of EPI vaccines administered, 20 AEFIs (392 AEFIs/100000 doses/week) were reported within 30 days after vaccine administration. These included 19 (829 AEFIs/100000 doses/week) AEFIs in the intervention group and 1 (43 AEFIs/100000 doses/week) AEFI in the control group. The AEFIs reporting rate in the intervention group was significantly higher than that in the control group [RR = 18.9; CI95 (2.5; 140.0) (P=0.0004)]. CONCLUSION: The use of telephone “beep” significantly increases at affordable cost community based AEFI reporting rate in routine EPI.