Christopher H Hsu1, Kathleen A Wannemuehler2, Sajid Soofi3, Mohd Mashal4, Imtiaz Hussain3, Zulfiqar A Bhutta3, Larin McDuffie5, William Weldon6, Noha H Farag7. 1. Polio Eradication Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: ydh2@cdc.gov. 2. Polio Eradication Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA. 3. Woman and Child Health Division, Aga Khan University, Karachi, Pakistan. 4. World Health Organization, Amman, Jordan. 5. IHRC Inc., Atlanta, GA, USA(1). 6. Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. 7. Polio Eradication Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: iym0@cdc.gov.
Abstract
BACKGROUND: Afghanistan remains among the three countries with endemic wild poliovirus transmission, and high population immunity levels are required to interrupt transmission and prevent outbreaks. Surveillance and vaccination of children in Afghanistan have been challenging due to security issues limiting accessibility in certain areas. METHODS: A serosurvey was conducted in 2013 within accessible enumeration areas (EAs) among children aged <5 years using samples collected for a national micronutrient assessment survey to assess poliovirus immunity in Afghanistan. Of 21194 total EAs in Afghanistan, 107 were inaccessible and therefore were excluded from the sampling frame. RESULTS: Population immunity was high overall but varied for the poliovirus serotypes, and was lowest for type 3 (95% [95% CI: 93%, 96%]) compared to type 1 (99% [95% CI:97%, 99%]) and type 2 (98% [95% CI:96%, 99%]). The proportion of the population immune to all three types was 93% (95% CI: 91%, 95%), and the proportion seronegative for all three types was 0.5% (95% CI: 0.2%, 1.7%). CONCLUSION: Except for regional differences in immunity to type 3 virus, there were no other apparent differences in seroprevalence by region or by any of the demographic or nutritional characteristics assessed in this study. The study was not powered to provide provincial level seroprevalence estimates, but Paktika Province, in the South region, had the largest proportion of seronegative specimens for type 1 (4 seronegative of 17 serum specimens compared to 14 seronegative of 673 for the remainder of the areas). Among accessible children in Afghanistan, seroprevalence of antibodies to poliovirus was high, with most seroprevalence reported at 95% or greater. Despite high seroprevalence in areas assessed in this study, the continued detection of poliovirus cases in the South and East regions indicate that overall regional vaccination coverage and performance is not sufficient to stop polio transmission. Published by Elsevier Ltd.
BACKGROUND: Afghanistan remains among the three countries with endemic wild poliovirus transmission, and high population immunity levels are required to interrupt transmission and prevent outbreaks. Surveillance and vaccination of children in Afghanistan have been challenging due to security issues limiting accessibility in certain areas. METHODS: A serosurvey was conducted in 2013 within accessible enumeration areas (EAs) among children aged <5 years using samples collected for a national micronutrient assessment survey to assess poliovirus immunity in Afghanistan. Of 21194 total EAs in Afghanistan, 107 were inaccessible and therefore were excluded from the sampling frame. RESULTS: Population immunity was high overall but varied for the poliovirus serotypes, and was lowest for type 3 (95% [95% CI: 93%, 96%]) compared to type 1 (99% [95% CI:97%, 99%]) and type 2 (98% [95% CI:96%, 99%]). The proportion of the population immune to all three types was 93% (95% CI: 91%, 95%), and the proportion seronegative for all three types was 0.5% (95% CI: 0.2%, 1.7%). CONCLUSION: Except for regional differences in immunity to type 3 virus, there were no other apparent differences in seroprevalence by region or by any of the demographic or nutritional characteristics assessed in this study. The study was not powered to provide provincial level seroprevalence estimates, but Paktika Province, in the South region, had the largest proportion of seronegative specimens for type 1 (4 seronegative of 17 serum specimens compared to 14 seronegative of 673 for the remainder of the areas). Among accessible children in Afghanistan, seroprevalence of antibodies to poliovirus was high, with most seroprevalence reported at 95% or greater. Despite high seroprevalence in areas assessed in this study, the continued detection of poliovirus cases in the South and East regions indicate that overall regional vaccination coverage and performance is not sufficient to stop polio transmission. Published by Elsevier Ltd.
Authors: Helen E Jenkins; R Bruce Aylward; Alex Gasasira; Christl A Donnelly; Michael Mwanza; Jukka Corander; Sandra Garnier; Claire Chauvin; Emmanuel Abanida; Muhammad Ali Pate; Festus Adu; Marycelin Baba; Nicholas C Grassly Journal: N Engl J Med Date: 2010-06-24 Impact factor: 91.245
Authors: Kathleen M O'Reilly; Elias Durry; Obaid ul Islam; Arshad Quddus; Ni'ma Abid; Tahir P Mir; Rudi H Tangermann; R Bruce Aylward; Nicholas C Grassly Journal: Lancet Date: 2012-07-04 Impact factor: 79.321
Authors: Steven Wassilak; Muhammad Ali Pate; Kathleen Wannemuehler; Julie Jenks; Cara Burns; Paul Chenoweth; Emmanuel Ade Abanida; Festus Adu; Marycelin Baba; Alex Gasasira; Jane Iber; Pascal Mkanda; A J Williams; Jing Shaw; Mark Pallansch; Olen Kew Journal: J Infect Dis Date: 2011-04-01 Impact factor: 5.226