Immunogenicity of Reduced-Dose Monovalent Type 2 Oral Poliovirus Vaccine in Mocuba, Mozambique.

BACKGROUND: The monovalent type 2 oral poliovirus vaccine (mOPV2) stockpile is low. One potential strategy to stretch the existing mOPV2 supply is to administer a reduced dose: 1 drop instead of 2. METHODS: We conducted a randomized, controlled, open-label, noninferiority trial (10% margin) to compared immunogenicity after administration of 1 versus 2 drops of mOPV2. We enrolled 9-22-month-old infants from Mocuba district of Mozambique. Poliovirus neutralizing antibodies were measured in serum samples collected before and 1 month after mOPV2 administration. Immune response was defined as seroconversion from seronegative (<1:8) at baseline to seropositive (≥1:8) after vaccination or boosting titers by ≥4-fold for those with titers between 1:8 and 1:362 at baseline. The trial was registered at anzctr.org.au (no. ACTRN12619000184178p). RESULTS: We enrolled 378 children, and 262 (69%) completed per-protocol requirements. The immune response of mOPV2 was 53.6% (95% confidence interval, 44.9%-62.1%) and 60.6% (52.2%-68.4%) in 1-drop and 2-drop recipients, respectively. The noninferiority margin of the 10% was not reached (difference, 7.0%; 95% confidence interval, -5.0% to 19.0%). CONCLUSION: A small loss of immunogenicity of reduced mOPV2 was observed. Although the noninferiority target was not achieved, the Strategic Advisory Group of Experts on Immunization recommended the 1-drop strategy as a dose-sparing measure if mOPV2 supplies deteriorate further.

Immunogenicity of Reduced-Dose Monovalent Type 2 Oral Poliovirus Vaccine in Mocuba, Mozambique

The global polio eradication initiative (gpei) has made steady progress toward the eradication target since its inception in 1988 [1]. the number of paralytic cases due to wild poliovirus has declined worldwide by >99.9%, and 2 of the 3 wild poliovirus serotypes have been declared eradicated by an independent global certification commission: serotype 2 in 2015 and serotype 3 in 2019 [2, 3]. the gpei has implemented the endgame strategic plan 2013­2018 to accelerate the eradication of wild poliovirus type 1 from its last endemic zones in pakistan and afghanistan. [4]. in addition, the plan called for the sequential removal of the sabin strains from the oral poliovirus vaccine (opv) and the concomitant addition of ≥1 dose of inactivated poliovirus vaccine (ipv) in routine national immunization programs. the removal was needed because the continuing use of live viral vaccines is incompatible with eradication, since these viruses can mutate and recombine, thus reacquiring the neurovirulence and transmission characteristics of wild poliovirus [5]. the burden of paralytic disease caused by vaccine-related polioviruses would not be accepted as the world approaches eradication of wild poliovirus. for example, sabin type 2 was responsible for approximately 40% of the vaccine-associated paralytic poliomyelitis burden and caused 91% of circulating vaccine-derived poliovirus (cvdpv) cases between 2000 and 2016...

Prevalência da malária e factores associados em areas cobertas pela campanha de distribuição massiva de redes mosquiteiras nos distritos de Nacala-A-Velhae Mecuburi na Província de Nampula / Prevalence of malaria and associated factors in areas covered by the mass distribution campaign of mosquito nets in Nacala-A-Velhae Mecuburi districts in Nampula Province

In Mozambique, malaria is still the leading cause of morbidity and mortality, accounting for about 44,0% of cases seen in outpatients and 57,0% of admissions in pediatric wards. The mass distribution of mosquito nets treated with long lasting insecticide (REMILD) is one of the preventive interventions used to reduce the burden of malaria in communities at country level. The study aims to determine the prevalence of and factors associated with malaria in areas covered by a mosquito nets distribution campaign in the districts of Nacala-à-Velha and Mecubúri in Nampula province. Methodology: Descriptive analysis of secondary data was performed using SPSS version 19. The bivariate and multivariate analysis was performed to estimate the probability of the association or not of malaria infection. We estimated the odds ratio (OR) adjusted and unadjusted CI 95% to a level of significance of 5%. Results: A total of 2615 people took part in the study, with a median age of 14 years, interquartile range 10-35 years. Of these 1325 (50,6%) were female. In Nacala-à-Velha 539 people were tested for malaria, and the prevalence of malaria was 44,1%. In Mecubúri, of 598 people tested, the prevalence was 64,7%. The highest prevalence rate in both districts was in the age group of 5-14 years, 63,5% 95% CI (38-82) and 88,1% 95% (76-94) respectively. Factors such as females sexes [OR = 1.79, 95% CI (1.10-2.91)], no access to at least one REMILD [OR = 1:45, 95% CI (1.13-1.88)], and being in the poorest quintile [OR = * 1.72, 95% CI (1.14-2.84)] were associated with malaria infection in the general population. Conclusions and recommendations: malaria prevalence was particularly high in people under 14 years of age in both districts. To reduce the burden of malaria, the NMCP should ensure coverage of REMILD and promote their use, particularly in families with a high risk of infection, such as those who have very low levels of poverty and living further inland districts.