Two research projects seek to improve immunization practices.

PAHO is collaborating with Cuba and Bolivia in conducting 2 separate studies designed to improve immunization practices. The study in Cuba seeks to determine the seroprevalence of polio neutralizing antibodies (types 1, 2, and 3) in children under 5 years of age. All Cuban children under 5 will have received between 0 and 8 doses of oral polio vaccine (OPV), depending on their age. This will allow researchers to estimate the seroconversion rates of polio neutralizing antibodies for each number of doses. Because little is known about seroconversion rates of polio neutralizing antibodies to greater than 5 doses of OPV, and because it is believed that 3-4 doses of OPV by routine services may not be adequate to eradicate polio globally, the study's findings will have important ramifications for global efforts to eradicate polio. PAHO will assist the study by providing materials and financial support. In Bolivia, PAHO will assist a project designed to increase tetanus toxoid vaccine coverage of pregnant women in undeserved areas while reducing the risk of infection (such as hepatitis B and HIV) that may be transmitted through improperly sterilized syringes and needles. In order to prevent transmission, the project will utilize a nonreusable injection device called UniJect, which was developed by the Program for Appropriate Technology in Health (PATH). Both PAHO and PATH will assist the Bolivian Ministry of Health in carrying out the project, whose objectives will include developing a training program for birth attendants, evaluating the acceptability of UniJect by both mothers and attendants, and evaluating the field performance and design of the device.