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1.
BMJ Glob Health ; 6(11)2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34776411

RESUMO

INTRODUCTION: The Global Polio Eradication Initiative uses polio supplementary immunisation activities (SIAs) as a strategy to increase vaccine coverage and cease poliovirus transmission. Impact of polio SIAs on immunisation systems is frequently debated. We reviewed the impact of polio SIAs on routine immunisation and health systems during the modern era of polio eradication. METHODS: We searched nine databases for studies reporting on polio SIAs and immunisation coverage, financial investment, workforce and health services delivery. We conducted a narrative synthesis of evidence. Records prior to 1994, animal, modelling or case studies data were excluded. RESULTS: 20/1637 unique records were included. Data on vaccine coverage were included in 70% (14/20) studies, workforce in 65% (13/20) and health services delivery in 85% (17/20). SIAs positively contributed to vaccination uptake of non-polio vaccines in seven studies, neutral in three and negative in one. Some polio SIAs contributed to workforce strengthening through training and capacity building. Polio SIAs were accompanied with increased social mobilisation and community awareness building confidence in vaccination programmes. Included studies were programmatic in nature and contained variable data, thus could not be justly critically appraised. CONCLUSION: Polio SIAs are successful at increasing polio vaccine coverage, but the resources and infrastructures were not always utilised for delivery of non-polio vaccines and integration into routine service delivery. We found a gap in standardised tools to evaluate SIAs, which can then inform service integration. Our study provides data to inform SIAs evaluations, and provides important considerations for COVID-19 vaccine roll-out to strengthen health systems. PROSPERO REGISTRATION NUMBER: CRD42020152195.


Assuntos
COVID-19 , Poliomielite , Vacinas contra COVID-19 , Humanos , Imunização , Programas de Imunização , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , SARS-CoV-2 , Vacinação
3.
J Med Microbiol ; 70(10)2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34672918

RESUMO

Introduction. Global poliovirus eradication is a public health emergency of international concern. The acute flaccid paralysis (AFP) surveillance programme in South Africa has been instrumental in eliminating polioviruses and keeping the country poliovirus free.Gap statement. The sensitivity of surveillance for polioviruses by every African country is of global interest in the effort to ensure global health security from poliovirus re-emergence.Aim. To describe the epidemiology of polioviruses from AFP cases and environmental samples in South Africa and to report the performance of the AFP surveillance system for the years 2016-2019 against targets established by the World Health Organization (WHO).Methods. Stool specimens from AFP or suspected AFP cases were received and tested as per WHO guidelines. Environmental samples were gathered from sites across the Gauteng province using the grab collection method. Concentration was effected by the two-phase polyethylene glycol method approved by the WHO. Suspected polioviruses were isolated in RD and/or L20B cell cultures through identification of typical cytopathic effects. The presence of polioviruses was confirmed by intratypic differentiation PCR. All polioviruses were sequenced using the Sanger method, and their VP1 gene analysed for mutations.Results. Data from 4597 samples (2385 cases) were analysed from the years 2016-2019. Two cases of immunodeficiency-associated vaccine-derived poliovirus (iVDPV) type 3 were detected in 2017 and 2018. A further 24 Sabin type 1 or type 3 polioviruses were detected for the 4 years. The national surveillance programme detected an average of 3.1 cases of AFP/100 000 individuals under 15 years old (2.8/100 000-3.5/100 000). The stool adequacy of the samples received was 53.0 % (47.0-55.0%), well below the WHO target of 80 % adequacy. More than 90 % of results were released from the laboratory within the turnaround time (96.6 %) and non-polio enteroviruses were detected in 11.6 % of all samples. Environmental surveillance detected non-polio enterovirus in 87.5 % of sewage samples and Sabin polioviruses in 12.5 % of samples.Conclusion. The AFP surveillance programme in South Africa is sensitive to detect polioviruses in South Africa and provided no evidence of wild poliovirus or VDPV circulation in the country.


Assuntos
Viroses do Sistema Nervoso Central/epidemiologia , Mielite/epidemiologia , Doenças Neuromusculares/epidemiologia , Poliomielite/epidemiologia , Poliovirus/isolamento & purificação , Adolescente , Viroses do Sistema Nervoso Central/prevenção & controle , Viroses do Sistema Nervoso Central/virologia , Criança , Pré-Escolar , Erradicação de Doenças/normas , Erradicação de Doenças/estatística & dados numéricos , Monitoramento Epidemiológico , Fezes/virologia , Humanos , Mielite/prevenção & controle , Mielite/virologia , Doenças Neuromusculares/prevenção & controle , Doenças Neuromusculares/virologia , Poliomielite/prevenção & controle , Poliomielite/virologia , Vacinas contra Poliovirus/isolamento & purificação , Esgotos/virologia , África do Sul/epidemiologia
4.
Crit Care Med ; 49(11): e1193-e1194, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34643594
5.
Ethiop J Health Sci ; 31(4): 897-902, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34703190

RESUMO

Background: Polio is a disabling and potentially deadly disease caused by a wild poliovirus and vaccine-derived poliovirus. The purpose of this review is to discuss the current situation of polio in Ethiopia. Method: Relevant scientific articles on Polio were searched from different data bases and websites. Results: The first wild poliovirus in Ethiopia was detected in 1999, followed by detection of few cases in 2000 and 2001. No wild poliovirus was detected in Ethiopia for the next 3 years (2001-2003). However, the disease resurged again in the country between 2004 and 2008 due to challenge to provide sufficient oral poliovirus vaccine coverage, migration and cross border economic activities and lack of good acute flaccid paralysis surveillance. After almost 5 years with no wild polio virus, Ethiopia again affected by polio outbreak importation in 2013. However, due to multiple supplementary immunization activities campaigns of improved quality and enhanced surveillance, the outbreak was eventually successfully interrupted within 6 months of confirmation. The most recent emergence of polio in Ethiopia has seen in this year (2020) six years after the country documented zero polio cases since 2014. The cause of the resurgence of the disease is circulating vaccine derived polio virus-2. Currently, Ethiopia has been conducting outbreak response by declaring Mop-up campaigns since September 2020. Conclusions: Therefore, it can be recommended that: - 1. The country has to completely shift from oral polio virus vaccine to inactivated polio vaccine so that the risk of vaccine derived polio will be diminished; 2. Ethiopia has to strengthen the mop up campaign that it has started in September 2020 following the reemergence of the disease in the country; 3. Ethiopia has to strengthen surveillance for acute flaccid paralysis in order to rapidly detect any new virus importation and to facilitate a rapid response.


Assuntos
Poliomielite , Poliovirus , Etiópia/epidemiologia , Humanos , Paralisia/epidemiologia , Paralisia/etiologia , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , Vacina Antipólio Oral/efeitos adversos
6.
NeuroRehabilitation ; 49(3): 491-499, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34542042

RESUMO

BACKGROUND: More than 7000 patients developed poliomyelitis during the main epidemic in the fifties in Israel. In recent years, there is a further deterioration in their condition due to accelerated aging process and post-polio syndrome. OBJECTIVE: To evaluate the risk factors for the progression of functional status in a cohort of patients with late effect of poliomyelitis over a period of ten years. METHODS: A cross-sectional cohort study including 82 individuals with late effect of poliomyelitis evaluated over ten years. Mean age was 67±8.5 years, 52.4%were men and 79.3%were Jewish. Functional status was evaluated by activities of daily living (ADL) questionnaire. Risk factors, including general comorbidities, history of poliomyelitis infection, use of assistive devices, employment, and physical activity statuses were evaluated using specific questionnaires. RESULTS: Independence in ADL functions deteriorated significantly over ten years. Older age, ethnicity, use of a wheelchair, and use of orthotic devices in childhood were risk factors for deterioration in ADL function. No correlation was found between the presence of other comorbidities or poliomyelitis parameters and worsening of ADL functions. CONCLUSIONS: Late effect of poliomyelitis was associated with deterioration in ADL functions probably due to the combined effect of the initial severity of the paralytic poliomyelitis symptoms and accelerated aging.


Assuntos
Atividades Cotidianas , Poliomielite , Idoso , Estudos de Coortes , Estudos Transversais , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Poliomielite/complicações , Poliomielite/epidemiologia , Fatores de Risco
7.
MMWR Morb Mortal Wkly Rep ; 70(39): 1359-1364, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34591827

RESUMO

When the Global Polio Eradication Initiative began in 1988, wild poliovirus (WPV) transmission was occurring in 125 countries; currently, only WPV type 1 (WPV1) transmission continues, and as of August 2021, WPV1 transmission persists in only two countries (1,2). This report describes Pakistan's progress toward polio eradication during January 2020-July 2021 and updates previous reports (3,4). In 2020, Pakistan reported 84 WPV1 cases, a 43% reduction from 2019; as of August 25, 2021, Pakistan has reported one WPV1 case in 2021. Circulating vaccine-derived poliovirus (cVDPV) emerges as a result of attenuated oral poliovirus vaccine (OPV) virus regaining neurovirulence after prolonged circulation in underimmunized populations and can lead to paralysis. In 2019, 22 cases of cVDPV type 2 (cVDPV2) were reported in Pakistan, 135 cases were reported in 2020, and eight cases have been reported as of August 25, 2021. Because of the COVID-19 pandemic, planned supplementary immunization activities (SIAs)* were suspended during mid-March-June 2020 (3,5). Seven SIAs were implemented during July 2020-July 2021 without substantial decreases in SIA quality. Improving the quality of polio SIAs, vaccinating immigrants from Afghanistan, and implementing changes to enhance program accountability and performance would help the Pakistan polio program achieve its goal of interrupting WPV1 transmission by the end of 2022.


Assuntos
Erradicação de Doenças , Poliomielite/prevenção & controle , Vigilância da População , Adolescente , Criança , Pré-Escolar , Humanos , Programas de Imunização , Esquemas de Imunização , Lactente , Paquistão/epidemiologia , Poliomielite/epidemiologia , Poliovirus/isolamento & purificação , Vacina Antipólio Oral/administração & dosagem , Vacinação/estatística & dados numéricos
9.
Vaccine ; 39(42): 6250-6255, 2021 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-34538696

RESUMO

BACKGROUND: Afghanistan is one of two countries with endemic wild poliovirus type 1 (WPV1). The oral poliovirus vaccine (OPV) is the predominant vaccine used for polio eradication. Although OPV has been administered in routine childhood immunization and during frequent supplementary immunization activities, WPV1 continues to circulate in Afghanistan and case incidence has been increasing since 2017. We estimated the effectiveness of OPV in Afghanistan during 2010-2020. METHODS: We conducted a matched case-control analysis using acute flaccid paralysis (AFP) surveillance data from 29,370 children < 15 years with AFP onset between January 1, 2010 and December 31, 2020. We matched children with confirmed WPV1 (cases) with children with non-polio AFP (controls) by age at onset of paralysis (+/- 3 months), date of onset of paralysis (+/- 3 months), and province of residence, and compared their reported OPV vaccination history to estimate the effectiveness of OPV in preventing paralysis by WPV1 using conditional logistic regression. To account for changes in OPV formulations provided over the analysis period, we stratified the analysis based on dates of the global switch from trivalent OPV (tOPV) to bivalent OPV (bOPV) in April 2016. RESULTS: Between January 1, 2010 and December 31, 2020, there were 329 WPV1 cases in Afghanistan. The per-dose estimated effectiveness of OPV against WPV1 was 19% (95% CI: 15%-22%) and of ≥ 7 doses was 94% (95% CI: 90%-97%). Before the global switch from tOPV to bOPV, the per-dose estimated effectiveness of OPV was 14% (95% CI: 11%-18%) and of ≥ 7 doses was 92% (95% CI: 85%-96%). After the switch, the per-dose estimated effectiveness of OPV against WPV1 was 32% (24%-39%) and of ≥ 7 doses was 96% (95% CI: 90%-99%). DISCUSSION: OPV is highly effective in preventing paralysis by WPV1; these results indicate that continued WPV1 transmission in Afghanistan is due to failure to vaccinate, not failure of the vaccine. Although difficult to implement in parts of country, improving the administration of OPV in routine immunization and supplementary immunization activities will be critical for achieving polio eradication in Afghanistan.


Assuntos
Poliomielite , Poliovirus , Afeganistão/epidemiologia , Criança , Erradicação de Doenças , Humanos , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , Vacina Antipólio de Vírus Inativado , Vacina Antipólio Oral
10.
BMJ Glob Health ; 6(8)2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34344665

RESUMO

INTRODUCTION: The debate over the impact of vertical programmes, including mass vaccination, on health systems is long-standing and often polarised. Studies have assessed the effects of a given vertical health programme on a health system separately from the goals of the vertical programme itself. Further, these health system effects are often categorised as either positive or negative. Yet health systems are in fact complex, dynamic and tightly linked. Relationships between elements of the system determine programme and system-level outcomes over time. METHODS: We constructed a causal loop diagram of the interactions between mass polio vaccination campaigns and government health systems in Ethiopia, India and Nigeria, working inductively from two qualitative datasets. The first dataset was 175 interviews conducted with policymakers, officials and frontline staff in these countries in 2011-2012. The second was 101 interviews conducted with similar groups in 2019, focusing on lessons learnt from polio eradication. RESULTS: Pursuing high coverage in polio campaigns, without considering the dynamic impacts of campaigns on health systems, cost campaign coverage gains over time in weaker health systems with many campaigns. Over time, the systems effects of frequent campaigns, delivered through parallel structures, led to a loss of frontline worker motivation, and an increase in vaccine hesitancy in recipient populations. Co-delivery of interventions helped to mitigate these negative effects. In stronger health systems with fewer campaigns, these issues did not arise. CONCLUSION: It benefits vertical programmes to reduce the construction of parallel systems and pursue co-delivery of interventions where possible, and to consider the workflow of frontline staff. Ultimately, for health campaign designs to be effective, they must make sense for those delivering and receiving campaign interventions, and must take into account the complex, adaptive nature of the health systems in which they operate. .


Assuntos
Poliomielite , Vacinas , Etiópia/epidemiologia , Humanos , Índia/epidemiologia , Motivação , Nigéria , Poliomielite/epidemiologia , Poliomielite/prevenção & controle
12.
BMJ Open ; 11(8): e048694, 2021 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-34373306

RESUMO

OBJECTIVE: This study employed the Consolidated Framework for Implementation Research (CFIR) to assess factors that enhanced or impeded the implementation of community engagement strategies using the Nigerian polio programme as a point of reference. DESIGN: This study was a part of a larger descriptive cross-sectional survey. The CFIR was used to design the instrument which was administered through face-to-face and phone interviews as well as a web-based data collection platform, Qualtrics. SETTING: The study took place in at least one State from each of the six geopolitical zones in Nigeria (Nasarawa, Borno, Kano, Sokoto, Anambra, Bayelsa, Lagos, Ondo and Oyo States as well as the Federal Capital Territory). PARTICIPANTS: The respondents included programme managers, policy-makers, researchers and frontline field implementers affiliated with the Global Polio Eradication Initiative (PEI) core partner organisations, the three tiers of the government health parastatals (local, state and federal levels) and academic/research institutions. RESULTS: Data for this study were obtained from 364 respondents who reported participation in community engagement activities in Nigeria's PEI. Majority (68.4%) had less than 10 years' experience in PEI, 57.4% were involved at the local government level and 46.9% were team supervisors. Almost half (45.0%) of the participants identified the process of conducting the PEI program and social environment (56.0%) as the most important internal and external contributor to implementing community engagement activities in the community, respectively. The economic environment (35.7%) was the most frequently reported challenge among the external challenges to implementing community engagement activities. CONCLUSION: Community engagement strategies were largely affected by the factors relating to the process of conducting the polio programme, the economic environment and the social context. Therefore, community engagement implementers should focus on these key areas and channel resources to reduce obstacles to achieve community engagement goals.


Assuntos
Erradicação de Doenças , Poliomielite , Participação da Comunidade , Estudos Transversais , Humanos , Nigéria , Poliomielite/epidemiologia , Poliomielite/prevenção & controle
14.
Bol Med Hosp Infant Mex ; 78(4): 326-330, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34351886

RESUMO

Se describe cómo se articuló la lucha contra la poliomielitis y las secuelas que dejaba la enfermedad en el Hospital Infantil de México Federico Gómez. Se narra cómo dicha lucha exigió que algunos ortopedistas, como Alfonso Tohen Zamudio, Alejandro Velasco Zimbrón, Juan Farill y Luis Sierra Rojas, aplicaran técnicas quirúrgicas ideadas por ellos y se diera la invención de aparatos ortopédicos que ocuparon un lugar fundamental en la estrategia terapéutica de la poliomielitis al preservar la marcha segura, prevenir o disminuir deformidades y reducir la fatiga. El hospital no tardó en convertirse en el centro de concentración obligado y único para los niños enfermos de poliomielitis procedentes de todo el país, al crear una sala para atender los casos agudos.This article studies how the fight against poliomyelitis and the sequelae left by the disease was articulated in the Hospital Infantil de México Federico Gómez and shows how this fight required some orthopedists, such as Alfonso Tohen Zamudio, Alejandro Velasco Zimbrón, Juan Farill, and Luis Sierra Rojas, to apply surgical techniques devised by them, as well as the invention of orthopedic devices that occupied a fundamental place in the therapeutic strategy of poliomyelitis by preserving a safe gait, avoiding falls, preventing or reducing deformities, and reducing fatigue. The hospital soon became the obligatory and only concentration center for children with polio from all over the country by creating a ward to attend to acute cases.


Assuntos
Pandemias , Poliomielite , Criança , Hospitais , Humanos , Masculino , México/epidemiologia , Poliomielite/epidemiologia , Poliomielite/prevenção & controle
15.
Vaccine ; 39(40): 5982-5990, 2021 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-34419305

RESUMO

Assessing the cost of vaccine preventable diseases (VPD) surveillance is becoming more important in the context of the Global Polio Eradication Initiative (GPEI) funding transition, since GPEI support to polio surveillance helped the incremental building of VPD surveillance systems in many countries, including low income countries such as Nepal. However, there is limited knowledge on the cost of conducting VPD surveillance, especially the national cost for surveillance of multiple vaccine-preventable diseases. The current study sought to calculate the economic and financial costs of Nepal's comprehensive VPD surveillance systems from July 2016 to July 2017. At thecentral level, all surveillance units were included in the sample. At sub-national level, a purposive sampling strategy was used to select a representative sample from locations involved in conducting surveillance. The sub-national sample costs were extrapolated to the nationwide VPD surveillance system. Nepal's total annual economic cost of VPD surveillance was USD 4.81 million or USD 0.18 per capita, while the total financial cost was USD 4.38 million or USD 0.16 per capita. Government expenditures accounted for 56% of the total economic cost, and World Health Organization accounting for 44%. The biggest cost driver was personnel accounting for 51% of the total economic cost. WHO supported trained surveillance personnel through donor funding, mainly from Global Polio Eradication Initiative. As a polio transition priority country, Nepal will need to make strategic choices to fully self-finance or seek full donor support or a mixed-financing model as polio program funding diminishes.


Assuntos
Poliomielite , Doenças Preveníveis por Vacina , Gastos em Saúde , Humanos , Nepal/epidemiologia , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , Organização Mundial da Saúde
16.
MMWR Morb Mortal Wkly Rep ; 70(34): 1129-1135, 2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34437527

RESUMO

In 1988, when the Global Polio Eradication Initiative (GPEI) began, polio paralyzed >350,000 children across 125 countries. Today, only one of three wild poliovirus serotypes, type 1 (WPV1), remains in circulation in only two countries, Afghanistan and Pakistan. This report summarizes progress toward global polio eradication during January 1, 2019-June 30, 2021 and updates previous reports (1,2). In 2020, 140 cases of WPV1 were reported, including 56 in Afghanistan (a 93% increase from 29 cases in 2019) and 84 in Pakistan (a 43% decrease from 147 cases in 2019). As GPEI focuses on the last endemic WPV reservoirs, poliomyelitis outbreaks caused by circulating vaccine-derived poliovirus (cVDPV) have emerged as a result of attenuated oral poliovirus vaccine (OPV) virus regaining neurovirulence after prolonged circulation in underimmunized populations (3). In 2020, 32 countries reported cVDPV outbreaks (four type 1 [cVDPV1], 26 type 2 [cVDPV2] and two with outbreaks of both); 13 of these countries reported new outbreaks. The updated GPEI Polio Eradication Strategy 2022-2026 (4) includes expanded use of the type 2 novel oral poliovirus vaccine (nOPV2) to avoid new emergences of cVDPV2 during outbreak responses (3). The new strategy deploys other tactics, such as increased national accountability, and focused investments for overcoming the remaining barriers to eradication, including program disruptions and setbacks caused by the COVID-19 pandemic.


Assuntos
Erradicação de Doenças , Saúde Global/estatística & dados numéricos , Poliomielite/prevenção & controle , Vigilância da População , Surtos de Doenças/estatística & dados numéricos , Doenças Endêmicas/estatística & dados numéricos , Humanos , Programas de Imunização , Poliomielite/epidemiologia , Vacinas contra Poliovirus/administração & dosagem
17.
BMC Public Health ; 21(1): 1371, 2021 07 10.
Artigo em Inglês | MEDLINE | ID: mdl-34246239

RESUMO

BACKGROUND: A social mobilization (SM) initiative contributed to India's success in polio elimination. This was the CORE Group Polio Project (CGPP) India, a partner of the Uttar Pradesh (UP) SM Network and which continued its SM activities, even during the polio-free period through a network of multi-level social mobilizers. This paper assesses the effects of this community-level SM (CLSM) intervention on the extent of community engagement and performance of polio Supplementary Immunization Activity campaigns (SIAs) during the post-polio-endemic period (i.e., from March 2012 to September 2017). METHODS: This study followed a quasi-experimental design. We used secondary, cluster-level data from CGPP India's Management Information System, including 52 SIAs held from January 2008 to September 2017, covering 56 blocks from 12 districts of UP. We computed various indicators and performed Generalized Estimating Equations based analysis to assess the statistical significance of differences between the outcomes of intervention and non-intervention areas. We then estimated the effects of the SM intervention using Interrupted time-series, Difference-in-Differences and Synthetic Control Methods. Finally, we estimated the population influenced by the intervention. RESULTS: The performance of polio SIAs changed over time, with the intervention areas having better outcomes than non-intervention areas. The absence of CLSM intervention during the post-polio-endemic period would have negatively impacted the outcomes of polio SIAs. The percentage of children vaccinated at polio SIA booths, percentage of 'X' houses (i.e., households with unvaccinated children or households with out-of-home/out-of-village children or locked households) converted to 'P' (i.e., households with all vaccinated children or households without children eligible for vaccination), and percentage of resistant houses converted to polio acceptors would have gone down by 14.1 (Range: 12.7 to 15.5), 6.3 (Range: 5.2 to 7.3) and 7.4 percentage points, respectively. Community engagement would have reduced by 7.2 (Range: 6.6 to 7.7) percentage points. CONCLUSIONS: The absence of CLSM intervention would have significantly decreased the level of community engagement and negatively impacted the performance of polio SIAs of the post-polio-endemic period. The study provides evidence of an added value of deploying additional human resource dedicated to social mobilization to achieve desired vaccination outcomes in hard-to-reach or programmatically challenging areas.


Assuntos
Poliomielite , Criança , Humanos , Imunização , Programas de Imunização , Índia/epidemiologia , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , Vacinação
18.
BMJ Open ; 11(7): e045904, 2021 07 28.
Artigo em Inglês | MEDLINE | ID: mdl-34321293

RESUMO

INTRODUCTION: Children with primary immunodeficiency disorders (PID) are more susceptible to developing viral infections and are at a substantially increased risk of developing paralytic poliomyelitis. Such children, if given oral polio vaccines tend to excrete poliovirus chronically that may lead to the propagation of highly divergent vaccine-derived poliovirus (VDPV). Consequently, they may act as a reservoir for the community by introducing an altered virus potentially imposing a risk to global polio eradication. However, the risks of chronic and prolonged excretion are not well characterised in the study context. This study seeks to establish a pilot surveillance system for successful identification and monitoring of VDPV excretion among children with PID. It will assess whether the Jeffrey Modell warning signs of PID can be used as an appropriate screening tool for PID in Pakistan. METHODS AND ANALYSIS: In this pilot surveillance, recruitment of PID cases is currently done at participating hospitals in Pakistan. Potential children are screened and tested against the Jeffrey Modell Foundation (JMF) warning signs for immunodeficiency and their stool is collected to test for poliovirus excretion. Cases excreting poliovirus are followed until the two consecutive negative stool samples are obtained over a period of 6 months. The data will be analysed to calculate hospital-based proportions of total Immunodeficiency-related vaccine-derived poliovirus (iVDPV) cases over a 2-year period and to determine the sensitivity and specificity of the JMF signs. ETHICS AND DISSEMINATION: This protocol was reviewed and approved by the WHO (WHO Reference-2018/811124-0), Aga Khan University (AKU ERC-2018-0380-1029) and National Bioethics Committee (Ref No. 4-87 NBC-308-Y2). The results will be published in an open access peer-reviewed scientific journal and presented to the iVDPV Working Group members, policy-makers, paediatric consultants and fellow researchers with the same domain interest. It may be presented in scientific conferences and seminars in the form of oral or poster presentations.


Assuntos
Poliomielite , Poliovirus , Doenças da Imunodeficiência Primária , Criança , Humanos , Paquistão/epidemiologia , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , Vacina Antipólio Oral/efeitos adversos
19.
J Prim Care Community Health ; 12: 21501327211029800, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34218701

RESUMO

BACKGROUND: Polio Supplementary Immunization Activities (SIAs) were carried out in the State of Sabah in response to the Vaccine Derived Poliovirus outbreak declared in December 2019. Prior to this, Malaysia had been polio-free over the past 27 years. This paper reported on the successful implementation of SIAs in the district of Penampang, Sabah, adapting (vaccine administration) to the COVID-19 pandemic. METHODS: A series of meticulous planning, healthcare staff training, advocacy, and community engagement activities were conducted by the Penampang District Health Office. Bivalent Oral Polio Vaccine (bOPV) and monovalent Oral Polio Vaccine were administered over the period of 1 year via these methods: house to house, drive-through, static, and mobile posts. The targeted group was 22 096 children aged 13 years and below. RESULTS: Polio SIAs in Penampang managed to achieve more than 90% coverage for both bOPV and mOPV. The overall vaccine wastage was reported to be 1.63%. No major adverse reaction was reported. CONCLUSION: High vaccine uptake during Polio SIAs in Penampang was attributed to good inter-agency collaboration, community engagement, intensified health promotion activities, and drive-through vaccination campaign.


Assuntos
COVID-19 , Poliomielite , Criança , Humanos , Imunização , Malásia/epidemiologia , Pandemias , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , SARS-CoV-2
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