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1.
Neurol Sci ; 45(7): 3517-3519, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38662105

RESUMEN

INTRODUCTION: A potential representation of poliomyelitis is investigated in an Italian artwork. MATERIALS AND METHODS: A 17th century Piedmontese fresco is analyzed by combining historico-medical, palaeopathological and clinical approaches. Alternative diagnoses are considered. RESULTS, DISCUSSION AND CONCLUSIONS: The man appearing in the fresco holding a crutch is characterized by an atrophic left leg reminiscent of poliomyelitic atrophic. Other congenital anomalies or cerebrovascular causes appear less likely. A reflection on the difficulty of retrospectively diagnosis poliomyelitis is offered.


Asunto(s)
Poliomielitis , Poliomielitis/historia , Humanos , Italia , Historia del Siglo XVII , Masculino , Medicina en las Artes/historia , Pinturas/historia
2.
Perspect Biol Med ; 66(1): 145-159, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38662013

RESUMEN

Vaccine hesitancy continues to pose a formidable obstacle to increasing national COVID-19 vaccination rates in the US, but this is not the first time that American vaccination efforts have confronted resistance and apathy. This study examines the history of US vaccination efforts against smallpox, polio, and measles, highlighting persistent drivers of vaccine hesitancy as well as factors that helped overcome it. The research reveals that logistical barriers, negative portrayals in the media, and fears about safety stymied inoculation efforts as early as the 18th century and continue to do so. However, vaccine hesitancy has been markedly diminished when trusted community leaders have guided efforts, when ordinary citizens have felt personally invested in the success of the vaccine, and when vaccination efforts have been tied to broader projects to improve public health and social cohesion. Deliberately cultivating such factors could be an effective strategy for lessening opposition today, when COVID-19's distinctive characteristics make addressing vaccine hesitancy more urgent than it has ever been.


Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Sarampión , Poliomielitis , Viruela , Vacilación a la Vacunación , Humanos , COVID-19/prevención & control , Poliomielitis/prevención & control , Poliomielitis/historia , Historia del Siglo XX , Vacilación a la Vacunación/psicología , Vacilación a la Vacunación/historia , Historia del Siglo XIX , Viruela/prevención & control , Viruela/historia , Sarampión/prevención & control , Sarampión/historia , Historia del Siglo XVIII , Vacunas contra la COVID-19/administración & dosificación , Estados Unidos , SARS-CoV-2 , Historia del Siglo XXI , Vacunación/historia , Vacunación/psicología
3.
Ann Intern Med ; 174(8): 1145-1150, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-33939486

RESUMEN

In the early phase of the COVID-19 pandemic, a dispute arose as to whether the disease caused a typical or atypical version of acute respiratory distress syndrome (ARDS). This essay recounts the emergence of ARDS and places it in the context of the technological transformation of modern hospital care-particularly the emergence of intensive care after the 1952 Copenhagen polio epidemic. The polio epidemic seemed to show the value of manual positive-pressure ventilation, leading to the proliferation of mechanical ventilators and the expansion of intensive care units in the 1960s. This created the conditions of possibility for ARDS to be described and institutionalized within modern intensive care. Yet the centrality of the ventilator to descriptions and definitions of ARDS quickly made it difficult to conceive of the disorder outside the framework of mechanical ventilation and blood gas levels, or to acknowledge the degree to which the ventilator was a source of iatrogenic injury and complications. Moreover, the imperative to understand and treat ARDS with mechanical ventilation set the stage for the early confusion about whether patients with COVID-19 should receive mechanical ventilation. This history offers many crucial lessons about how new technologies can lead to new and valuable therapies but can also subtly shape and constrain medical thinking. Moreover, ventilators not only changed how respiratory disorders were conceived; they also brought new forms of respiratory illness into existence.


Asunto(s)
COVID-19/terapia , Unidades de Cuidados Intensivos/historia , Respiración Artificial/historia , Síndrome de Dificultad Respiratoria/historia , Ventiladores Mecánicos/historia , Cuidados Críticos/historia , Historia del Siglo XIX , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Pandemias , Poliomielitis/historia , Poliomielitis/terapia , Respiración con Presión Positiva/historia , Síndrome de Dificultad Respiratoria/terapia , SARS-CoV-2
4.
J Hist Biol ; 55(1): 115-146, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-35233686

RESUMEN

This essay argues that the racialized geopolitics of the rhesus monkey trade conditioned the trajectory of tissue culture in polio research. Rhesus monkeys from north India were important experimental organisms in the American "war against polio" between the 1930s and 1950s. During this period, the National Foundation for Infantile Paralysis (NFIP) expended considerable effort to secure the nonhuman primate for researchers' changing experimental agendas. The NFIP drew on transnational networks to export hundreds of thousands of rhesus monkeys from colonial and later postcolonial India amid the geopolitical upheavals of World War II, the 1947 Partition, and the Cold War. In this essay, I trace how NFIP officials' anxieties about the geopolitics of the monkey trade configured research imperatives in the war against polio. I show how their anxieties more specifically shaped investment in tissue culture techniques as a possible means of obviating dependence on the market in monkeys. I do so by offering a genealogy of the contingent convergence between the use of rhesus monkeys and HeLa cell cultures in the 1954 Salk vaccine trial evaluation. Through this genealogy, I emphasize the geopolitical dimensions of the search for the "right" experimental organisms, tissues, and cells for the "job" of scientific research. The technical transformation of polio research, I argue, relied on the convergence of disparate, racialized biomedical economies.


Asunto(s)
Poliomielitis , Animales , Células HeLa , Humanos , Pruebas Inmunológicas , Macaca mulatta , Poliomielitis/historia , Poliomielitis/prevención & control , Vacuna Antipolio de Virus Inactivados , Estados Unidos
5.
J Hist Med Allied Sci ; 76(2): 167-190, 2021 Apr 08.
Artículo en Inglés | MEDLINE | ID: mdl-33624793

RESUMEN

A number of states, starting with California, have recently removed all non-medical exemptions from their laws requiring vaccinations for schoolchildren. California was also one of the earliest states to include a broad non-medical, or personal, belief exemption in its modern immunization law, which it did with a 1961 law mandating polio vaccination for school enrollment, Assembly Bill 1940 (AB 1940). This paper examines the history of AB 1940's exemption clause as a case study for shedding light on the little-examined history of the personal belief exemption to vaccination in the United States. This history shows that secular belief exemptions date back further than scholars have allowed. It demonstrates that such exemptions resulted from political negotiation critical to ensuring compulsory vaccination's political success. It challenges a historiography in which antivaccination groups and their allies led late-nineteenth and early-twentieth century opposition to vaccination mandates while religious groups drove mid-twentieth century opposition. It also complicates the historiographic idea of a return to compulsion in the late 1960s, instead dating this return a decade earlier, to a time when belief exemptions in polio vaccination mandates helped reconcile the goal of a widely vaccinated population with the sacrosanct idea of health as a personal responsibility.


Asunto(s)
Política de Salud/historia , Negativa a la Vacunación/historia , Vacunación/historia , California , Política de Salud/legislación & jurisprudencia , Historia del Siglo XX , Humanos , Poliomielitis/historia , Poliomielitis/prevención & control , Vacunación/psicología , Negativa a la Vacunación/psicología , Negativa a la Vacunación/estadística & datos numéricos
6.
Med Anthropol Q ; 34(4): 504-524, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-32529703

RESUMEN

The author analyzes the aftermath of Edward Hooper's suggestion that the trial of an oral polio vaccine (OPV) in the Belgian colonies of Africa engendered the pandemic form of the AIDS virus, HIV-1. In response to Hooper's book, The River (1999), the Royal Society in London held a conference to debate the origins of HIV. Examination of the quick dismissal of the OPV theory opens a space for legitimately challenging the widely held belief that the vaccine contamination question was convincingly resolved. This article interrogates the relationship between historiography and the making of scientific facts and history, suggesting that historians have been too credulous of scientists' testimony. The further result of the lack of a thorough analysis of the evidence backing the OPV hypothesis has resulted in a missed opportunity to read The River as one of the few detailed accounts of the immense social, political, technological, and interspecies infrastructure constituted by Cold War vaccine production. This biomedical infrastructure dramatically changed the geographic and interspecies mobility of viruses in ways that may be impossible to reconstruct. Yet these potential transmission routes remain crucial to acknowledge. The COVID-19 pandemic draws attention to the critical importance of studying The WetNet, a concept coined by the author to name the conceptual and material infrastructures of inter- and intraspecies fluid bonding.


Asunto(s)
Infecciones por VIH/historia , VIH-1 , Poliomielitis/historia , Vacuna Antipolio Oral/historia , África , Animales , Antropología Médica/historia , COVID-19/epidemiología , COVID-19/transmisión , Cultura , Infecciones por VIH/epidemiología , Infecciones por VIH/transmisión , Historia del Siglo XX , Humanos , Internacionalidad , Poliomielitis/epidemiología , Poliomielitis/prevención & control , Vacuna Antipolio Oral/inmunología , SARS-CoV-2 , Vacunación/historia
7.
Bull Hist Med ; 94(4): 690-698, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33775947

RESUMEN

This essay reconsiders epidemic narratives through the lens of polio to examine temporal shifts and overlapping and conflicting temporalities and assess some of the stakes in how we conceptualize the epidemic dramaturgy. I argue that while the dramaturgy of epidemics serves as a thread around which people, state actors, and institutions organize experiences, responses, and expectations, consideration of the multiplicity of epidemic temporalities is crucial in understanding how medical practice and knowledge are shaped and transferred, particularly with attention to actors that might be rendered invisible by the conventional narrative arc.


Asunto(s)
Epidemias/historia , Literatura Moderna/historia , Poliomielitis/historia , Historia del Siglo XX , Humanos , Poliomielitis/epidemiología
8.
Bull Hist Med ; 94(4): 700-709, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33775948

RESUMEN

This essay argues that considering disability and disability history needs to be part of any history of epidemics. Recent scholarship has shown the many intersections of disability history and history of medicine. This essay argues that disability plays many roles in an epidemic from establishing pre-existing conditions, to affecting the acute phase of the disease, to creating lingering disabilities in the long aftermath. Histories of epidemics that ignore the many ways in which disability affects the experience of an epidemic are incomplete.


Asunto(s)
COVID-19/historia , Personas con Discapacidad/historia , Epidemias/historia , Historiografía , Poliomielitis/historia , Viruela/historia , COVID-19/epidemiología , Historia del Siglo XX , Humanos , Poliomielitis/epidemiología , Viruela/epidemiología
9.
Przegl Epidemiol ; 74(3): 550-560, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33576593

RESUMEN

The work presents pioneering activities of Polish orthopedists in the interwar period who were the first to propose methods of surgical and physical treatment of the effects of poliomyelitis. It also discusses the activities undertaken by the Ministry of Health and the National Rehabilitation Specialist, prof Wiktor Dega, in the early 1950s in order to fight the effects of the Heine-Medin disease epidemic in Poland. They worked on the creation of a network of rehabilitation centres throughout the country, training of medical personnel, development of uniform procedures that would provide the patient with appropriate treatment in the acute state of the disease and during the following years of its consequences. In addition to treating, it was possible for the sick children to get a profession that would allow them to start working. The authors show that dealing with the effects of Heine-Medin disease had a significant impact on the development of rehabilitation in Poland.


Asunto(s)
Epidemias/historia , Poliomielitis/epidemiología , Poliomielitis/historia , Poliomielitis/rehabilitación , Rehabilitación/historia , Rehabilitación/organización & administración , Adolescente , Niño , Preescolar , Femenino , Historia del Siglo XIX , Historia del Siglo XX , Humanos , Lactante , Masculino , Polonia/epidemiología
10.
Can Bull Med Hist ; 36(1): 112-130, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30901270

RESUMEN

Following Canada's largest polio epidemic in 1953, Station 67 at the University of Alberta Hospital (UAH) in Edmonton became home to patients who contracted the virus. As young as nine years old, some of these patients lived at the UAH for more than three decades. Akin to wartime services, the epidemic banded together families, patients, doctors, nurses, community members, and later respiratory, physical, and occupational therapists. The nature of the disease, the government response, and the social and economic climate dramatically affected the lived experiences of patients in Alberta's fight against polio. Drawing on archival research and oral interviews, this article argues that it was the agency and resilience of patients, the contributions of healthcare providers to rapid developments in acute and convalescent care, and the dedication of families that were primarily responsible for the recovery and reintegration of polio patients back into the community.


Asunto(s)
Integración a la Comunidad/historia , Hospitales de Convalecientes/historia , Poliomielitis/historia , Alberta , Historia del Siglo XX , Humanos , Poliomielitis/rehabilitación , Poliomielitis/terapia
11.
Can Bull Med Hist ; 36(2): 444-468, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31518178

RESUMEN

During the early 1950s, Canada's efforts to prevent polio became heavily influenced by developments in the United States. America's foremost polio charity, the National Foundation for Infantile Paralysis, sponsored University of Pittsburgh researcher Dr. William McD. Hammon to evaluate the efficacy of a human blood fraction, gamma globulin (GG), to prevent paralytic polio. When the resulting clinical trial data appeared to show that the blood fraction offered some protection against the disease, Canadians embraced the concept for reasons of historical trust, parental demand, and public health pragmatism. They established Canada's first national immunization program to fight polio before the vaccine, as well as developed a plan to produce, evaluate, and distribute GG to epidemic areas. Despite being an expensive enterprise for a geographically vast and sparsely populated nation, Canada's GG program was extended to citizens and it became an important response to polio before a safe and effective vaccine was licensed. Although the blood fraction was not as effective at preventing polio paralysis as researchers had anticipated, its systematic use reveals how Canadian health leaders drew on transnational relationships to reduce the incidence of disease.


Asunto(s)
Programas de Inmunización/historia , Poliomielitis/historia , Poliomielitis/prevención & control , gammaglobulinas/uso terapéutico , Canadá , Historia del Siglo XX , Programas de Inmunización/organización & administración
12.
PLoS Biol ; 13(6): e1002172, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-26090784

RESUMEN

Sustained and coordinated vaccination efforts have brought polio eradication within reach. Anticipating the eradication of wild poliovirus (WPV) and the subsequent challenges in preventing its re-emergence, we look to the past to identify why polio rose to epidemic levels in the mid-20th century, and how WPV persisted over large geographic scales. We analyzed an extensive epidemiological dataset, spanning the 1930s to the 1950s and spatially replicated across each state in the United States, to glean insight into the drivers of polio's historical expansion and the ecological mode of its persistence prior to vaccine introduction. We document a latitudinal gradient in polio's seasonality. Additionally, we fitted and validated mechanistic transmission models to data from each US state independently. The fitted models revealed that: (1) polio persistence was the product of a dynamic mosaic of source and sink populations; (2) geographic heterogeneity of seasonal transmission conditions account for the latitudinal structure of polio epidemics; (3) contrary to the prevailing "disease of development" hypothesis, our analyses demonstrate that polio's historical expansion was straightforwardly explained by demographic trends rather than improvements in sanitation and hygiene; and (4) the absence of clinical disease is not a reliable indicator of polio transmission, because widespread polio transmission was likely in the multiyear absence of clinical disease. As the world edges closer to global polio eradication and continues the strategic withdrawal of the Oral Polio Vaccine (OPV), the regular identification of, and rapid response to, these silent chains of transmission is of the utmost importance.


Asunto(s)
Poliomielitis/historia , Poliomielitis/transmisión , Epidemias , Geografía Médica , Historia del Siglo XX , Humanos , Incidencia , Modelos Teóricos , Poliomielitis/epidemiología , Estaciones del Año , Estados Unidos/epidemiología
13.
JAMA ; 330(20): 1937-1938, 2023 11 28.
Artículo en Inglés | MEDLINE | ID: mdl-37906186

RESUMEN

This Arts and Medicine feature reviews The Autumn Ghost, an historical retelling of the 1952 polio epidemic in Copenhagen, Denmark, which catalyzed developments in anesthesia and respiratory support procedures that are still in use today.


Asunto(s)
Cuidados Críticos , Poliomielitis , Humanos , Cuidados Críticos/historia , Dinamarca/epidemiología , Epidemias/historia , Poliomielitis/epidemiología , Poliomielitis/historia , Poliomielitis/prevención & control , Historia del Siglo XX
14.
Emerg Infect Dis ; 23(2): 258-263, 2017 02.
Artículo en Inglés | MEDLINE | ID: mdl-27861118

RESUMEN

In 2014, inactivated poliovirus vaccine (IPV) campaigns were implemented in Nigeria and Pakistan after clinical trials showed that IPV boosts intestinal immunity in children previously given oral poliovirus vaccine (OPV). We estimated the effect of these campaigns by using surveillance data collected during January 2014-April 2016. In Nigeria, campaigns with IPV and trivalent OPV (tOPV) substantially reduced the incidence of poliomyelitis caused by circulating serotype-2 vaccine-derived poliovirus (incidence rate ratio [IRR] 0.17 for 90 days after vs. 90 days before campaigns, 95% CI 0.04-0.78) and the prevalence of virus in environmental samples (prevalence ratio [PR] 0.16, 95% CI 0.02-1.33). Campaigns with tOPV alone resulted in similar reductions (IRR 0.59, 95% CI 0.18-1.97; PR 0.45, 95% CI 0.21-0.95). In Pakistan, the effect of IPV+tOPV campaigns on wild-type poliovirus was not significant. Results suggest that administration of IPV alongside OPV can decrease poliovirus transmission if high vaccine coverage is achieved.


Asunto(s)
Poliomielitis/epidemiología , Poliomielitis/prevención & control , Vacuna Antipolio de Virus Inactivados/inmunología , Poliovirus/inmunología , Femenino , Geografía Médica , Historia del Siglo XXI , Humanos , Programas de Inmunización , Incidencia , Masculino , Nigeria/epidemiología , Evaluación de Resultado en la Atención de Salud , Pakistán/epidemiología , Poliomielitis/historia , Vacuna Antipolio de Virus Inactivados/administración & dosificación , Prevalencia , Vacunación
15.
J Infect Dis ; 213 Suppl 3: S136-9, 2016 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-26655842

RESUMEN

BACKGROUND: The security-challenged states of Adamawa, Borno, and Yobe bear most of the brunt of the Boko Haram insurgency in Nigeria. The security challenge has led to the killing of health workers, destruction of health facilities, and displacement of huge populations. To identify areas of polio transmission and promptly detect possible cases of importation in these states, polio surveillance must be very sensitive. METHODS: We conducted a retrospective review of acute flaccid paralysis surveillance in the security-compromised states between 2009 and 2014, using the acute flaccid paralysis database at the World Health Organization Nigeria Country Office. We also reviewed the reports of surveillance activities conducted in these security-challenged states, to identify strategies that were implemented to improve polio surveillance. RESULTS: Environmental surveillance was implemented in Borno in 2013 and in Yobe in 2014. All disease surveillance and notification officers in the 3 security-challenged states now receive annual training, and the number of community informants in these states has dramatically increased. Media-based messaging (via radio and television) is now used to sensitize the public to the importance of surveillance, and contact samples have been regularly collected in both states since 2014. CONCLUSIONS: The strategies implemented in the security-challenged states improved the quality of polio surveillance during the review period.


Asunto(s)
Poliomielitis/epidemiología , Vigilancia de la Población , Mejoramiento de la Calidad , Historia del Siglo XXI , Humanos , Nigeria/epidemiología , Poliomielitis/historia , Vigilancia de la Población/métodos , Estudios Retrospectivos
16.
J Infect Dis ; 213 Suppl 3: S116-23, 2016 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-26912379

RESUMEN

BACKGROUND: Following the 65th World Health Assembly (WHA) resolution on intensification of the Global Poliomyelitis Eradication Initiative (GPEI), the Nigerian government, with support from the World Health Organization (WHO) and other partners, implemented a number of innovative strategies to curb the transmission of wild poliovirus (WPV) in the country. One of the innovations successfully implemented since mid 2012 is the WHO's engagement of surge capacity personnel. METHODS: The WHO reorganized its functional structure, adopted a transparent recruitment and deployment process, provided focused technical and management training, and applied systematic accountability framework to successfully manage the surge capacity project in close collaboration with the national counterparts and partners. The deployment of the surge capacity personnel was guided by operational and technical requirement analysis. RESULTS: Over 2200 personnel were engaged, of whom 92% were strategically deployed in 11 states classified as high risk on the basis of epidemiological risk analysis and compromised security. These additional personnel were directly engaged in efforts aimed at improving the performance of polio surveillance, vaccination campaigns, increased routine immunization outreach sessions, and strengthening partnership with key stakeholders at the operational level, including community-based organizations. DISCUSSION: Programmatic interventions were sustained in states in which security was compromised and the risk of polio was high, partly owing to the presence of the surge capacity personnel, who are engaged from the local community. Since mid-2012, significant programmatic progress was registered in the areas of polio supplementary immunization activities, acute flaccid paralysis surveillance, and routine immunization with the support of the surge capacity personnel. As of 19 June 2015, the last case of WPV was reported on 24 July 2014. The surge infrastructure has also been instrumental in building local capacity; supporting other public health emergencies, such as the Ebola outbreak response and measles and meningitis outbreaks; and strengthening the integrated disease surveillance and response. Due to weak health systems in the country, it is vital to maintain a reasonable level of the surge capacity for successful implementation of the 2013-2018 global polio endgame strategy and beyond.


Asunto(s)
Erradicación de la Enfermedad , Programas de Inmunización , Poliomielitis/prevención & control , Capacidad de Reacción , Implementación de Plan de Salud , Historia del Siglo XXI , Humanos , Nigeria/epidemiología , Poliomielitis/epidemiología , Poliomielitis/historia , Vigilancia de la Población , Estudios Retrospectivos , Vacunación , Organización Mundial de la Salud
17.
J Infect Dis ; 213 Suppl 3: S101-7, 2016 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-26912380

RESUMEN

BACKGROUND: Since the World Health Assembly (WHA) resolved in 1988 to eradicate poliovirus, several rounds of immunization campaigns have been conducted by member states. By 2000, with the support of the Global Polio Eradication Initiative (GPEI) partners, the number of polio cases decreased by 99%. Eradicating the remaining 1% proved to be more challenging. Although the GPEI, being the largest public health project, required >$9 billion between 1988 and 2012, economic analysis showed the estimated incremental net benefits of $40 billion-$50 billion between 1988 and 2035. In 2012, the WHA declared that the completion of poliovirus eradication is a programmatic emergency for global public health. Nigeria, as one of 3 remaining polio-endemic countries, developed an emergency plan to interrupt the transmission of poliovirus. The plan included the introduction or scale-up of various new innovations and strategies, which had substantial financial implication. METHODS: This is a retrospective study to document the intensified resource mobilization efforts made by the World Health Organization (WHO) in Nigeria to meet the increased financial requirements and bridge the remaining gap in funding. In addition to the established coordination platforms, the WHO Nigeria Country Office team directly engaged with national authorities, donors, and partners throughout the process of resource requirement analysis, project appraisals, proposal development, and implementation of activities, joint monitoring, and evaluation exercises. The office strengthened its capacity for direct funds disbursement and systematic implementation of a rigorous accountability framework. RESULTS: Between 2008 and May 2015, $538 million was mobilized locally, of which 82% was mobilized since 2012. The percentage of the total funding requirements that were locally mobilized averaged 31% between 2008 and 2011 and increased to 70% between 2012 and May 2015. During the same period, the WHO Nigeria Country Office team produced and submitted 102 grant reports and facilitated >20 joint project assessment exercises. DISCUSSION: The polio program in Nigeria has achieved unprecedented gains, despite prevailing security and operational challenges, with no case of wild poliovirus infection since July 2014. Through rigorous, transparent, and accountable funds management practice, the WHO country office in Nigeria gained donors' confidence. The locally mobilized funds have made a remarkable contribution to the successful implementation of the strategies set out in the polio emergency plan. We face the challenges of a narrow donor-base, donor fatigue, and competition among other emerging agencies joining the polio eradication initiative efforts over the last few years. We actively engage the national authorities and partners for effective coordination of the polio eradication initiative program and harmonization of resources, using the existing platforms at national, state, and local levels. We recommend strengthening the local resource mobilization machinery and broadening the donor base, to support the polio endgame strategy. Such efforts should also be adopted to support routine immunization, introduction of new vaccines, and strengthening of health systems in the country as part of polio legacy planning.


Asunto(s)
Erradicación de la Enfermedad , Recursos en Salud , Programas de Inmunización , Poliomielitis/epidemiología , Poliomielitis/prevención & control , Organización Mundial de la Salud , Financiación del Capital , Organización de la Financiación , Historia del Siglo XXI , Humanos , Nigeria/epidemiología , Evaluación de Resultado en la Atención de Salud , Poliomielitis/historia , Vigilancia de la Población , Estudios Retrospectivos
18.
J Infect Dis ; 213 Suppl 3: S147-50, 2016 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-26917576

RESUMEN

BACKGROUND: Following the 2012 declaration by World Health Organization (WHO) Regional Director for Africa and the WHO Executive Board to ramp up routine immunization (RI) activities, began to intensify activities to strengthen RI. This study assessed how the intensification of RI helped strengthen service delivery in local government areas (LGAs) of northern Nigeria at high risk for polio transmission. METHODS: A retrospective study was performed by analyzing RI administrative data and findings from supportive supervisory visits in 107 high-risk LGAs. RESULTS: Our study revealed that administrative coverage with 3rd dose of diphtheria-pertussis-tetanus vaccine in the 107 high-risk LGAs improved from a maximum average coverage of 33% during the preintensification period of 2009-2011 to 74% during the postintensification period of 2012-2014. CONCLUSIONS: Routine immunization could be strengthened in areas where coverage is low, and RI has been identified to be weak when certain key routine activities are intensified.


Asunto(s)
Inmunización , Poliomielitis/epidemiología , Poliomielitis/prevención & control , Vacunas contra Poliovirus , Erradicación de la Enfermedad , Historia del Siglo XXI , Humanos , Programas de Inmunización , Nigeria/epidemiología , Poliomielitis/historia , Poliomielitis/transmisión , Vacunas contra Poliovirus/administración & dosificación , Vigilancia de la Población , Organización Mundial de la Salud
19.
J Infect Dis ; 213 Suppl 3: S86-90, 2016 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-26721745

RESUMEN

BACKGROUND: The polio eradication initiative had major setbacks in 2003 and 2007 due to media campaigns in which renowned scholars and Islamic clerics criticized polio vaccines. The World Health Organization (WHO) partnered with journalists in 2007 to form the Journalists Initiatives on Immunisation Against Polio (JAP), to develop communication initiatives aimed at highlighting polio eradication activities and the importance of immunization in northern Nigeria. METHODS: We evaluated the impact of JAP activities in Kaduna State by determining the total number of media materials produced and the number of newspaper clips and bulletins published in support of polio eradication. We also determined the number of households in noncompliant communities that became compliant with vaccination during 2015 supplementary immunization activities (SIAs) after JAP interventions and compared caregivers' sources of information about SIAs in 2007 before and after the JAP was formed. RESULTS: Since creation of the JAP, >500 reports have been published and aired, with most portraying polio vaccine positively. During June 2015 SIAs in high-risk wards of Kaduna STATE, JAP interventions resulted in vaccination of 5122 of 5991 children (85.5%) from noncompliant households. During early 2007, the number of caregivers who had heard about SIA rounds from the media increased from 26% in January, before the JAP was formed, to 33% in March, after the initiation of JAP activities. CONCLUSIONS: The formation of the JAP resulted in measurable improvement in the acceptance of polio vaccine in northern Nigeria.


Asunto(s)
Programas de Inmunización , Medios de Comunicación de Masas , Poliomielitis/epidemiología , Poliomielitis/prevención & control , Vacunas contra Poliovirus/inmunología , Vacunación , Historia del Siglo XXI , Humanos , Nigeria/epidemiología , Poliomielitis/historia , Vacunas contra Poliovirus/administración & dosificación
20.
J Infect Dis ; 213 Suppl 3: S91-5, 2016 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-26609003

RESUMEN

INTRODUCTION: One of the major challenges being faced in the Global Polio Eradication Initiative program is persistent refusal of oral polio vaccine (OPV) and harassment of vaccination team members by youths. The objective of the study was to describe the strategy of collaborating with recognized youth groups to reduce team harassment during vaccination campaigns and improve vaccination coverage in noncompliant communities. METHODS: We assessed data from polio vaccination activities in OPV-refusing communities in the Igabi and Zaria local government areas (LGAs) of Kaduna State in Nigeria. We evaluated the following factors to determine trends: enhanced independent monitoring data on the proportion of children missed by vaccination activities (hereafter, "missed children"), lot quality assurance surveys, and vaccination team harassment. RESULTS: The proportion of missed children decreased in both LGAs after the intervention. In Igabi LGA and Zaria LGA, the lowest proportions of missed children before and after the intervention decreased from 7% to 2% and from 5% to 1%, respectively. Lot quality assurance survey trends showed an improvement in immunization coverage 1 year after youth groups' engagement in both LGAs. CONCLUSIONS: Systematic engagement of youth groups has a great future in polio interruption as we approach the endgame strategy for polio eradication. It promises to be a veritable innovation in reaching chronically missed children in OPV-refusing communities.


Asunto(s)
Cumplimiento de la Medicación , Poliomielitis/epidemiología , Poliomielitis/prevención & control , Vacuna Antipolio Oral , Vacunación , Factores de Edad , Erradicación de la Enfermedad , Historia del Siglo XXI , Humanos , Muestreo para la Garantía de la Calidad de Lotes , Nigeria/epidemiología , Poliomielitis/historia , Vacuna Antipolio Oral/administración & dosificación
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