Cold Chain Management Research Articles

Redefining Food Sources: Exploring the Disconnect between Goat Farming and Its Perceived Sustainability—A Case Study in Chitima, Mozambique

The objective of this study was to analyze the disconnect between goat farming and its perception as a food source and determine if this is related to the way farmers value goats. We conducted a questionnaire of 1 open and 15 closed questions among (n = 23) goat producers in Bairro Boroma, Province of Tete, Mozambique, and six in-depth interviews with stakeholders of the local goat meat trading chain. The results show that goats have an economic value more than a nutritional value, meaning they preferred trading them instead of allocating them for their own consumption. Conformation and size characteristics were more relevant when buying/selling an animal. All goat producers sold live animals in their household’s backyard, at an average price of USD 19.3 ± 4.6/per animal with an average weight of 20.23 ± 3.41 kg. Finally, goat producers preferred to increase their number of goats rather than cattle due to the ease of husbandry, amount of meat obtained from the carcass and reduced risk of meat spoilage post-slaughter because of their smaller size. The latter is essential within an environment lacking access to drinkable water and electric energy to support cold chain management in meat storage.

A protocol for feasibility of plasma based GeneXpert platform and Dried Blood Spot (DBS) based Abbott platform for HIV-1 viral load testing among the people living with HIV attending ART centers in India.

HIV-1 Viral load (VL) measures efficiency of the antiretroviral therapy (ART) after treatment initiation and helps to diagnose virological failures at an early stage. Current VL assays require sophisticated laboratory facilities. As well as there are other challenges pertaining to insufficient laboratory access, cold-chain management and sample transportation. Hence the number of HIV-1 VL testing laboratories is inadequate in the resource limited settings. The revised national tuberculosis elimination programme (NTEP) in India has developed a vast network of point of care (PoC) testing facilities for diagnosis of tuberculosis and several GeneXpert platforms are functional under this programme. Both the GeneXpert HIV-1 assay and HIV-1 Abbott real time assay are comparable and GeneXpert HIV-1 assay can be used as PoC for HIV-1 Viral load testing. Also, the dried blood spot (DBS) as a sample type has been considered as a good option for HIV-1 VL testing in hard to reach areas. This protocol is therefore developed to assess the feasibility of integrating HIV-1 VL testing among people living with HIV (PLHIV) attending ART centres using the two public health models under the current programme: 1. HIV-1 VL testing using GeneXpert platform and plasma as a sample type, and 2. HIV-1 VL testing using Abbott m2000 platform and DBS as a sample type. This ethically approved feasibility study will be implemented at two moderate to high burden ART centres where VL testing facility is not available in the town. Under Model-1, arrangements will be made to carry out VL testing on the adjacent GeneXpert facility and under Model-2, DBS will be prepared on site and couriered to identified viral load testing laboratories. In order to assess the feasibility, data will be collected on pretested questionnaire pertaining to number of samples tested for VL testing, number of samples tested for tuberculosis (TB) diagnosis and the turnaround time (TAT). In-depth interviews will be conducted among the service providers at ART centre and different laboratories for addressing any issues regarding the model implementation. The proportion of PLHIV tested for VL at ART centres, total TAT for both models including TAT for sample transportation, sample testing and receipt of results as well as proportion of sample rejections and reasons for the same, correlation coefficient between DBS based and plasma based VL testing will be estimated using various statistical tools. If found promising, these public health approaches will be helpful for the policy makers and program implementation in scaling up HIV-1 viral load testing within India.

Assessment of knowledge and skills of cold chain handlers in the post-eVIN period in nainital district

Background: Vaccines are among the most sensitive drugs; they are sensitive to heat and freezing; therefore, they must be stored at the recommended temperature. Thus, it is deemed necessary to study staff’s knowledge and skill level about the modified cold chain of electronic vaccine intelligence network (eVIN) period. Aims and Objectives: The study aims to assess the knowledge and skills of Cold Chain Handlers regarding cold chain, eVIN and vaccine management in district Nainital. Materials and Methods: This cross-sectional study was carried out at 34 Cold Chain Points in district Nainital, Uttarakhand. Pre-structured validated questionnaire was used for this study. Results: Cold chain handlers were deputed at all cold chain points of which about one-third was contributed by the Haldwani block. All 29 females and five males cold chain handlers were literate and mostly had received eVIN training. It was found that except for knowledge about adverse event following immunization, its primary management, hold over time, and keeping dropper in ice-lined refrigerator rest was correctly answered by all of them and skills about the identification and performing tasks were performed splendidly by all 34 (100°). Conclusion: Cold chain handlers need reinforcement in skills and keeping knowledge up to date to keep the cold chain healthy and properly functioning.

Cold chain experts look to future during latest ASHP forum.

ASHP’s third Executive Forum on Cold Chain Management convened virtually March 28 to share strategies for anticipating and responding to drug product integrity and supply challenges in an evolving marketplace. The meeting was the third in a series of events that brought together cold chain experts and pharmacy leaders to share ideas on optimizing the handling, storage, and transportation of medications. Forum attendees represented health systems, specialty pharmacies, wholesalers, distributors, pharmaceutical manufacturers, federal pharmacy, and other stakeholders. The March 28 session was moderated by Jason Chou, system vice president of pharmacy operations for Ochsner Health in New Orleans, LA. The main discussion topics were: In an opening poll, 76% of forum participants indicated they felt somewhat prepared for future cold chain requirements, and 6% said they were very prepared. Amanda Frick, senior clinical manager of Vizient’s Center for Pharmacy Practice Excellence, opened the forum with an overview of anticipated storage requirements for drug products that are expected to enter the market in the near future. Frick said the developmental pipeline includes a growing share of vaccines and other products that will require cold storage and transit.

Health Systems Determinants of Delivery and Uptake of Maternal Vaccines in Low- and Middle-Income Countries: A Qualitative Systematic Review.

Maternal vaccination is considered a key component of the antenatal care package for improving maternal and child health. Low- and middle-income countries (LMICs) fall short of global targets to prevent maternal and neonatal deaths, with a disproportionate burden of vaccine-preventable diseases. Strategies towards ending preventable maternal mortality necessitate a health systems approach to adequately respond to this burden. This review explores the health systems determinants of delivery and uptake of essential maternal vaccines in LMICs. We conducted a qualitative systematic review of articles on maternal vaccination in LMICs, published between 2009 and 2023 in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Thematic analysis was conducted to identify key themes in the literature, interpreted within a conceptual framing that explores the systems determinants influencing maternal vaccines. Our search yielded 1309 records, of which 54 were included, covering 34 LMICs. Most of the included studies were from South America (28/54) and included pregnant women as the primary study population (34/54). The studies explored influenza (25/54) and tetanus toxoid (20/54) vaccines predominantly. The findings suggest that systems hardware (lack of clear policy guidelines, ineffective cold-chain management, limited reporting and monitoring systems) are barriers to vaccine delivery. Systems software (healthcare provider recommendations, increased trust, higher levels of maternal education) are enablers to maternal vaccine uptake. Findings show that formulation, dissemination and communication of context-specific policies and guidelines on maternal vaccines should be a priority for decision-makers in LMICs.

A prospective assessment of the time required to obtain one unit of fresh whole blood by civilian phlebotomists and Army laboratory technicians (68 K).

Resuscitation with blood products improves survival after major hemorrhage. Blood product administration at or near the point-of-injury (POI) amplifies this benefit. Size, weight, and cold-chain management challenges all limit the amount of blood medics can carry. Warm fresh whole blood (WFWB) transfusions from a pre-screened donor within the unit represent an alternative source of blood at the POI. We measured the time required for civilian and Army technicians performing phlebotomy frequently to obtain one unit of blood to serve as a goal metric for combat medics being trained in this skill. We gathered demographic and experience data along with proportion of first intravenous cannulation attempt success, time to blood flow initiated, and time to unit draw complete. We prospectively enrolled 12 civilian phlebotomy technicians and 10 Army laboratory technicians performing whole blood collections on 50 and 68 donors respectively. The mean time from setup to needle insertion was 3.7 min for civilians versus 4.2 min for Army technicians. The mean time from blood flowing to the bag being full was 10.7 min versus 8.4 min for civilians versus Army technicians respectively. The mean bag weights were 514 g versus 522 g. First-pass intravenous cannulation success was 96% versus 98% respectively. We found a high first intravenous cannulation attempt success among both the civilian and Army technicians. Medians times were <5 min to obtain venipuncture and <11 min to obtain one unit. These findings provide time-based benchmarks for potential use during transfusion training among military medics.

A Study on Knowledge of Health Workers on Vaccine Storage, Distribution, and Cold Chain Management in Yemen

The success of the Expanded Programme on Immunization (EPI) over the years is attributed to the immunization supply chain, effective logistics systems, and the health professionals who run them. Gaps in knowledge and practices still exist in developing countries and countries with conflict. Due to the paucity of information regarding the subject in humanitarian settings, this study was carried out. This descriptive cross-sectional study was carried out among health workers at the four levels of the healthcare system in 6 governorates in Yemen. A total of 536 health workers provided responses to the online questionnaire between February and May 2022. The study showed that 515(96.1%) and 521(97.2%) of the respondents, respectively, knew the recommended temperature range for storage of Rota and pentavalent vaccines at the health facility. Most respondents, 415(77.4%) and 413(77.0%) knew the recommended storage temperature for measles and BCG, respectively, and 466(86.9%) knew they could be stored at a negative temperature when the need arises. Over two-thirds of respondents only receive vaccines 411(76.7%), and 124(23.1%) receive and distribute vaccines. Vaccine distribution included the use of refrigerated vehicles (15.2%), cold boxes (32.8%), and vaccine carriers (41.6%), both with conditioned ice packs. Despite the protracted and complex humanitarian situation in Yemen, Health workers demonstrated good knowledge and practices of vaccine storage, distribution, and cold chain management, which contributed to the sustenance of immunization services. There is a need for required investment in a cost-effective and sustainable last-mile vaccine distribution approach to ensure equitable availability of vaccines at health facilities and prevent any missed opportunity. Keywords: Cold chain, Distribution, Vaccine storage, Knowledge.

Evaluation of Cold Chain Equipment Platform Solar Fridges Project in Upper Nile State Republic of South Sudan

BACKGROUND: A cold chain is a temperature-controlled supply chain with uninterrupted chain of activities that maintain a given temperature range that keep and maintain the quality of vaccines. Vaccines move through complex procedures and processes that require special attention and care. Effective cold chain systems require efficient end-to-end vaccine storage, handling, and stock management to maintain vaccines under strict temperature control of between 2 &amp;deg;C and 8 &amp;deg;C (for almost all vaccines). &#x0D; &#x0D; METHODS: A descriptive cross-sectional study design and mixed (qualitative and quantitative) research approach is employed to conducting the research. Data were collected through face to face in-depth interviews and questionnaires from Vaccinators and key persons from IPs. Prior to data collection, ethical approval was obtained from national Ministry of Health, Directorate of planning and M&amp;amp;E, and the University of Rwanda, Research Committee Board. Accordingly, data were collected after seeking the personal consent sought from the participants. &#x0D; &#x0D; RESULTS: The key findings from this study showed that the cold chain coverage has been improved compared to the result obtained in EPI coverage survey conducted in 2017. The results revealed that inadequate availability of EPI cold technicians, lack of fridge spare parts, trained staff, and adequate vaccine forecasting was the major challenges at county and the health facility level. &#x0D; &#x0D; CONCLUSIONS: The main factor that contributed positively in strengthening vaccines supply chain system in the Upper Nile State was the substantive increase in cold chain coverage. However, the role of the CCEOP in improving immunization coverage is still doubted due to lack of regular preventive maintenance, spare parts, and EPI technicians. The major challenges that affect the vaccines relevance, effectiveness, efficiency and sustainability were found to be mainly poor vaccines handling, due to inadequate knowledge on cold chain management.

KNOWLEDGE OF HEALTHCARE PROVIDERS IN EXPANDED PROGRAM ON IMMUNIZATION, SA’ADAH, YEMEN

Background: After achieving high vaccination coverage, vaccine failure may occur. The sufficient knowledge of the workers in the expanded program of immunization (EPI) is one of the factors that affect in preventing this failure. In Saada, Yemen, there is no information about the knowledge of workers in the EPI. This study seeks to assess the knowledge of those in charge of immunization in Sa’adah, Yemen. Method: This prospective cross-sectional study was performed to assess healthcare providers (HCPs) knowledge regarding EPI. It was conducted on 60 HCPs in 60 H.F of 11 districts in Sa’adah Governorate, Yemen during 1 June – 30 July 2019. Appropriate interviewing pre-tested questionnaire was used to collect data from HCPs working in EPI. It includes the following: socio-demographic characteristics, knowledge about; cold chain and the method and time of administration of the vaccine and shake test. Face to face interview used to collect information. Data entering and cleaning were done using Microsoft Excel 2019 and exported to SPSS version 26, p-value less than 0.05 were considered significant. Differences in samples means were evaluated by chi-square test. Results: Age is one of the determining factors for knowledge of cold chain management (FET=0.040*), and the total knowledge score for of HCPs was (26.7%, 65%, and 8.3%) for good, fair, and poor knowledge, respectively. Conclusion: Only twenty-six-point seven of HCPs had a good knowledge score. Constant technical support and on job training to improve the HCPs knowledge about immunization are extremely recommended. Peer Review History: Received: 20 December 2022; Revised: 5 February 2023; Accepted: 3 March, Available online: 15 March 2023 Academic Editor: Dr. Emmanuel O. Olorunsola, Department of Pharmaceutics &amp; Pharmaceutical Technology, University of Uyo, Nigeria, olorunsolaeo@yahoo.com Received file: Reviewer's Comments: Average Peer review marks at initial stage: 5.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. Muhammad Zahid Iqbal, AIMST University, Malaysia, drmmziqbal@gmail.com Dr. Olanrewaju Rita-Marie Awotona, Legacy University, Banjul , The Gambia, olanrewajuadegbola@gmail.com Rola Jadallah, Arab American University, Palestine, rola@aauj.edu Similar Articles: TETANUS IMMUNIZATION AMONG PREGNANT WOMEN: COVERAGE RATE AND RATE OF PROTECTION AT TIME OF DELIVERY EVALUATION OF THE IMMUNE RESPONSE TO POLIO VACCINE IN MALNOURISHED CHILDREN IN SANA'A CITY

Developing a Conceptual Framework Model for Effective Perishable Food Cold-Supply-Chain Management Based on Structured Literature Review

This paper reviews the literature on perishable food cold-chain management (FCCM) in order to assess its current state, pinpoint its knowledge gaps, and suggest a framework for addressing the issues faced by this industry. This work examines 103 academic articles on the topic of the perishable food supply chain published in various journals between 2001 and 2022. Research publications were selected from two reputed databases—Scopus and Web of Science. The study finds that the current trend in FCCM is toward sustainable FCCM, which offers financial, ecological, and social benefits. However, sustainable FCC practices are more common in wealthy nations but are still lacking in developing countries. High lead times, costs, waste, order returns, complaints, and dissatisfied consumers are the results of a fragmented market and the associated proliferation of chain intermediates. The authors have also developed a conceptual framework based on the findings that illustrates the interconnected nature of the food cold-chain facilities, collaboration among food cold-chain (FCC) stakeholders, concern among FCC stakeholders, economic enhancement, fulfilment of FCC stakeholders’ responsibilities, and overall functioning of the FCC. This study may be helpful to FCC professionals, food regulators, government authorities, and researchers because it gives a concise picture of the state of research in the field.

Cold chain management: a perspective from the US Defense Logistics Agency

Cold chain management: a perspective from the US Defense Logistics Agency

Assessment of factors affecting vaccine cold chain management in routine immunization session sites in North 24 Parganas, West Bengal A Scopic Review

Assessment of factors affecting vaccine cold chain management in routine immunization session sites in North 24 Parganas, West Bengal A Scopic Review

Digital transformation for cold chain management in freight forwarding industry

During the pandemic, the attention and demand for cold chain increased owing to considerable use of low-temperature logistics in transporting perishable goods and vaccines. To ensure the shipping performance for reduced damage, logistics companies are required to track continually and repetitively the status of shipments daily. However, typing various air waybills for searching the shipping status is a cause of frequent errors. Also, tracking the shipping status is labor-intensive, resource intensive, inefficient and repetitive. Moreover, repetitive tasks result in low employee satisfaction. Therefore, robotic process automation (RPA) applications have gained the attention of practitioners in the cold chain logistics industry. This study contributes to (i) determining possible areas requiring automation through the workflow study on cold chain logistics and (ii) streamlining the operation by the develop a robotic process automation bots. A case study tested and evaluated the performance of two unattended RPA bots applied in a freight forwarder company to check shipment status and temperature conditions. The results determined that implementing RPA in the workflow reduces significant data processing time. With the implementation of proposed RPA bots, the company can better comprehend its shipping performance of logistics and can get an immediate notification from RPA bots when an abnormal situation occurs with regard to a shipment.

Assessment of cold chain and vaccine management practices in cold chain points of Bilaspur, Chhattisgarh: a cross-sectional study

Background: To maintain the immunization effectiveness, and uninterrupted availability of vaccine functional cold chain is required. This can be achieved by continuous monitoring and supervision. The objective was to assess the functionality and monitoring of cold chain points of Bilaspur district of Chhattisgarh. Methods: A cross-sectional study conducted in the month of January 2021 in 15 old and new cold chain points, which were selected randomly from all the five blocks of district. Block level “supportive supervision of cold chain and vaccine management” checklist was used to collect the data. The data was presented in frequency and percentages. Results: The key findings were shortage of staff, placement of cold chain equipment and ice packs not as per the guidelines, irregular monthly review of temperature, and periodic monitoring with available documentation. Conclusions: There were shortfalls in the basic components of cold chain which requires immediate attention from the officials.

Cold chain management practices of non-vaccine commodities in public health facilities of Rwenzori Region, Western Uganda

BackgroundDespite the evidence that cold chain management practices affect the potency and effectiveness of both vaccines and non-vaccine commodities, most of the researches in Uganda focus on vaccines. This study assessed the cold chain management practices of non-vaccine cold chain commodities in public health facilities of the Rwenzori Region, Uganda.MethodsA cross-sectional study was conducted in a random sample of 69 level III and IV health facilities. The respondents were store managers at health facilities. Data on stock and storage management practices and level of knowledge on cold chain management were assessed. Data were collected and entered into Microsoft excel 2017, cleaned, and later exported into IBM SPSS version 26 for analysis. The management practices were graded as poor (< 50% score), fair (50–75% score), or good (> 75% score).ResultsResults from the 69 facilities indicated that the stock management practices were graded as fair for lesser than half of the facilities 28 (40.6%). Few facilities were correctly filling stock cards 20 (29%) and conducting physical inventories 19 (27.5%). The refrigerator storage management practices were fair for nearly half of the facilities 32 (46.4%). Among the facilities that had a refrigerator 53 (76.8%), 39 (70.9%) utilized it for storing both vaccines and non-vaccine commodities. The cold chain management practices at service delivery points were fair for 32 (46.4%) health centers. A larger proportion of the participants 69 (65%) had knowledge of cold chain storage. Most of the participants 47 (67.8%) were knowledgeable about the heat sensitivity of the cold chain commodities, however, almost half (48.1%) of them lacked knowledge on refrigerator use.ConclusionThe management practices for non-vaccine cold chain commodities in health centers were fair. More than a third of the facility store managers lacked knowledge on cold chain management practices for non-vaccine commodities. There is a need to strengthen the capacity of the facilities’ store managers and provide equipment specific for non-vaccine cold chain commodities.

COVID‐19 vaccine wastage: A challenge to achieving herd immunity in Nigeria

AbstractThe emergence of the COVID‐19 pandemic has overburdened many health‐care systems in the world, particularly in Nigeria and other African countries with fragile public health system. Since the emergence of the pandemic, Nigeria has been struggling to restore the impact on its health‐care system as the country keeps recording a growing number of cases and deaths. Vaccination has been the most efficient strategy towards curbing the COVID‐19 pandemic, particularly in countries like Nigeria where preventive measures were poorly strategised or implemented. The country was able to secure some doses of the COVID‐19 vaccine through donations, but concerns have been raised as up to 1 million doses of the vaccine were wasted due to delays in importations and poor cold chain management system. This wastage can pose a challenge to achieving COVID‐19 herd immunity in Nigeria. The causative factors of the vaccine wastage in Nigeria must therefore be tackled in order to effectively curb the COVID‐19 outbreak and consequently achieve herd immunity through massive vaccination. The government in collaboration with World Health Organisation and Africa Centre for Disease Control should facilitate and fast track the safe delivery of the vaccines to Nigeria. Misconceptions about COVID‐19 and its vaccine should be tackled to encourage the vaccine acceptance. The challenges faced by the vaccine supply chain system should be properly addressed by providing adequate funding and security, improved power supply, good vaccine infrastructure and improved vaccine data management in order to facilitate the safe and timely distribution of adequate vaccines across the country.

E-grocery delivery channels: acceptance of the click and collect solutions

ABSTRACT Over the last decades, e-grocery has spread less quickly than other retail e-channels due to technical (logistics, cold chain management) and commercial reasons (little acceptance by consumers) thus remaining a niche phenomenon. The Covid19 pandemic has given a boost to the development of e-grocery as many brick-and-mortar supermarkets chains have deployed specific industrial projects to provide omnichannel grocery shopping solutions. Rather than focusing on an online strategy only, brick-and-mortar companies have indeed adopted strategies such as the click and collect delivery models. While the technological, organisational and business dimensions of such solutions have been widely explored, there are still few studies exploring the acceptance of these specific solutions by customers as the new normal grocery shopping. This study aims at investigating the acceptance and intention to use of these solutions by the customers of a prominent supermarket chain in Italy. The Unified Theory of Acceptance and Use of Technology was adopted for the study. An online purchase frequency moderator was added to the model to check whether there are differences among retail and grocery purchases.

Vaccine Cold Chain Management and Associated Factors in Public Health Facilities and District Health Offices of Wolaita Zone, Ethiopia.

Vaccines are medical products with a short shelf life and are easily damaged by deviations in temperature from the recommended ranges. Vaccines lose their quality if the cold chain system is not properly managed. Cold chain management is still a major challenge in developing countries, including Ethiopia. Thus, this study aimed to assess vaccine cold chain management and associated factors at public health facilities and district health offices. A facility-based cross-sectional study design was applied from March 1-28, 2021. One hundred and thirty-six health institutions were selected by simple random sampling method. Data was collected using the observation check list and interviewer-administered pre-tested structured questionnaires. Data was analyzed using SPSS version 25. The binary logistic regression was employed and those variables with a p-value less than 0.25 in the bivariate analysis were used for multivariable logistic regression. Then multivariate analysis at a p-value <0.05 and AOR with 95% CI was used to measure the degree of association between independent variables and the outcome variable. The study indicates that 83 (61%) public health facilities had good cold chain management practice at 95% CI (52.2-68.4). Experience greater than 2 years (AOR=2.8, 95% CI=1.13-6.74), good knowledge on cold chain management (AOR=3.02, 95% CI=1.2-7.4), training on cold chain management (AOR=1.86, 95% CI=1.36-9.84), and supportive supervision on cold chain management (AOR=2.71, 95% CI=1.1-7.14) were statistically significantly associated with good cold chain management practice. The result of the study indicated that there was low cold chain management practice in the study area. Strengthening the knowledge of healthcare workers and supportive supervision on cold chain management by giving training and monitoring their practice toward cold chain management may help to improve the cold chain management practice.

Knowledge and associated factors of healthcare workers on measles vaccine and cold chain management at health institutions in Gondar, Ethiopia

Objective: To assess the knowledge of healthcare workers on the measles vaccine and its cold chain management. Method: An institutional-based cross-sectional study was conducted from February 1 to March 30, 2022 in Gondar City Administration public health institutions among 165 healthcare workers. Data were collected using a structured questionnaire. In addition, an on-spot observation checklist was used to assess the availability, status and management of the cold chain. A logistic regression model was used to assess the relationship between the outcome and predictor variables. Crude and adjusted odds ratios were calculated with 95% confidence intervals. Results: Overall, 87 (52.7%; 95% Cl 44.8%-60.5%) of the healthcare workers had unsatisfactory knowledge regarding the measles vaccine and its cold chain management. One hundred thirty-six (82.4%) healthcare workers correctly mentioned the recommended range of temperature (2-8 °C) for measles vaccine storage. Healthcare workers aged 18-29 years (P=0.001) and 30-44 years (P=0.014) were observed as determinants of unsatisfactory knowledge on the measles vaccine and its cold chain management. One hundred and five (63.6%) of the healthcare workers did not correctly mention the type of measles vaccine used in routine immunization. More than one-third (36.4%) of the healthcare workers perceived that the measles vaccine is not safe and could cause measles. Conclusions: More than half of the healthcare workers in the study area had unsatisfactory knowledge on the measles vaccine and its cold chain management. It is necessary to provide technical support and in-service training for healthcare workers to ensure optimal immunization effectiveness.

Environmental and Qualitative Monitoring of a Transoceanic Intermodal Transport of Melons

To supply the off-season melon market, Europe imports from distant markets in other countries, mainly Brazil. Cold transportation takes at least 15–20 days, thus increasing the risk of quality losses. Moreover, product deliveries, especially in international markets, can result in supply chain inefficiencies that negatively affect carbon footprint and expected freshness. Implementing quality sensors and advanced cold chain management could help to reduce these problems. The objective of this work was to monitor a real transoceanic intermodal transport of melons (Brazil to Spain), through the implementation of multi-distributed environmental sensors (15 ibuttons loggers) to evaluate the remaining shelf-life (RSHL) of melons at destination. The sensors’ location within the cargo reached a maximum variability range of 4 °C. Using digital sensors to track temperature variations, it was verified that in different locations in the container, the melon RSHL at the end of the journey, was nine days and 19 h in colder spots, while in the hottest spot, the RSHL was reduced to five days and 22 h. This fact has substantial implications for improved tracking of temperature to maintain fruit quality for market, potentially reducing waste, and contributing to higher profit margins for international food supply chains.