Zubairu Iliyasu1, Eric Nwaze2, Harish Verma3, Asani O Mustapha4, Goitom Weldegebriel5, Alex Gasasira5, Kathleen A Wannemuehler6, Mark A Pallansch6, Auwalu U Gajida1, Muhammad Pate7, Roland W Sutter8. 1. Department of Community Medicine, Aminu Kano Teaching Hospital & Bayero University, Kano, Nigeria. 2. National Primary Health Care Development Agency, Abuja, Nigeria. 3. World Health Organization, Geneva, Switzerland. 4. Department of Pediatrics, Aminu Kano Teaching Hospital & Bayero University, Kano, Nigeria. 5. World Health Organization, Abuja, Nigeria. 6. Centers for Disease Control and Prevention, Atlanta, GA, United States. 7. National Primary Health Care Development Agency, Abuja, Nigeria; Duke Global Health Institute, Duke University, Durham, USA. 8. World Health Organization, Geneva, Switzerland. Electronic address: sutterr@who.int.
Abstract
INTRODUCTION: In 1988, the World Health Assembly resolved to eradicate poliomyelitis. Since then, much progress towards this goal has been made, but three countries including Nigeria remain polio-endemic as of end 2012. To assess the immunity level against poliomyelitis in young children in Northern Nigeria, we conducted a seroprevalence survey in the Kano Metropolitan Area (KMA) in May 2011. METHODS: Parents or guardians of infants aged 6-9months or children aged 36-47months presenting to the outpatient department of Murtala Mohammad Specialist Hospital were approached for participation, screened for eligibility and were asked to provide informed consent. After that, a questionnaire was administered and blood was collected for neutralization assay. RESULTS: A total of 327 subjects were enrolled. Of these, 313 (96%) met the study requirements and were analyzed (161 [51%] aged 6-9months and 152 [49%] aged 36-47months). Among subjects aged 6-9months, seroprevalence was 81% (95% confidence interval [CI] 75-87%) to poliovirus type 1, 76% (95% CI 68-81%) to poliovirus type 2, and 73% (95% CI 67-80%) to poliovirus type 3. Among subjects aged 36-47months, the seroprevalence was 91% (95% CI 86-95%) to poliovirus type 1, 87% (95% CI 82-92%) for poliovirus type 2, and 86% (95% CI 80-91%) to poliovirus type 3. Seroprevalence was associated with history of oral poliovirus vaccine (OPV) doses, maternal education and gender. CONCLUSIONS: Seroprevalence is lower than required levels for poliovirus interruption in the KMA. Persistence of immunity gaps in the 36-47months group is a big concern. Since higher number of vaccine doses is associated with higher seroprevalence, it implies that failure-to-vaccinate and not vaccine failure accounts for the suboptimal seroprevalence. Intensified efforts are necessary to administer polio vaccines to all target children and surpass the threshold levels for herd immunity. Published by Elsevier Ltd.
INTRODUCTION: In 1988, the World Health Assembly resolved to eradicate poliomyelitis. Since then, much progress towards this goal has been made, but three countries including Nigeria remain polio-endemic as of end 2012. To assess the immunity level against poliomyelitis in young children in Northern Nigeria, we conducted a seroprevalence survey in the Kano Metropolitan Area (KMA) in May 2011. METHODS: Parents or guardians of infants aged 6-9months or children aged 36-47months presenting to the outpatient department of Murtala Mohammad Specialist Hospital were approached for participation, screened for eligibility and were asked to provide informed consent. After that, a questionnaire was administered and blood was collected for neutralization assay. RESULTS: A total of 327 subjects were enrolled. Of these, 313 (96%) met the study requirements and were analyzed (161 [51%] aged 6-9months and 152 [49%] aged 36-47months). Among subjects aged 6-9months, seroprevalence was 81% (95% confidence interval [CI] 75-87%) to poliovirus type 1, 76% (95% CI 68-81%) to poliovirus type 2, and 73% (95% CI 67-80%) to poliovirus type 3. Among subjects aged 36-47months, the seroprevalence was 91% (95% CI 86-95%) to poliovirus type 1, 87% (95% CI 82-92%) for poliovirus type 2, and 86% (95% CI 80-91%) to poliovirus type 3. Seroprevalence was associated with history of oral poliovirus vaccine (OPV) doses, maternal education and gender. CONCLUSIONS: Seroprevalence is lower than required levels for poliovirus interruption in the KMA. Persistence of immunity gaps in the 36-47months group is a big concern. Since higher number of vaccine doses is associated with higher seroprevalence, it implies that failure-to-vaccinate and not vaccine failure accounts for the suboptimal seroprevalence. Intensified efforts are necessary to administer polio vaccines to all target children and surpass the threshold levels for herd immunity. Published by Elsevier Ltd.
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