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Song MY, Blake-Hepburn D, Karbasi A, Fadel SA, Allin S, Ataullahjan A, Ruggiero ED. Public health partnerships with faith-based organizations to support vaccination uptake among minoritized communities: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002765. [PMID: 38837963 DOI: 10.1371/journal.pgph.0002765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/22/2024] [Indexed: 06/07/2024]
Abstract
Faith-based vaccine initiatives are of growing interest to public health agencies who are looking to increase vaccine confidence among ethnoracially minoritized populations. Despite evidence that support faith-based organizations' (FBOs) partnerships with public health agencies (PHAs) to increase vaccine confidence, reviews on the scope and efforts to ensure equitable vaccination delivery for ethnoracially minoritized populations are scarce. We aimed to understand how public health agencies collaborate with FBOs or faith communities to improve vaccine confidence among minoritized communities in high-, low- and middle- income countries. We conducted a scoping review by searching OVID MEDLINE, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), SCOPUS, and PROQUEST from 2011 to 2023. We included case studies, news reports, observational studies, experimental, and quasi-experimental studies and multimedia content that describes PHA-FBO partnerships that created vaccine initiatives for marginalized and minoritized communities. The data was extracted, summarized, and results were described narratively. We included 167 initiatives reported in 160 publications; 83.8% of the included articles were published between 2019 to 2023. The interventions carried out by PHA-FBO partnerships attempted to increase vaccine uptake using any or all the following methods. First, the initiatives provided digital and in-person platforms for interfaith learning and established training programs to empower faith leaders to become vaccine ambassadors. Second, the initiatives designed and disseminated education and awareness materials that aimed to be sensitive to religious and gender norms. Third, PHA-FBO partnered to apply equity and faith-based frameworks and provided wrap-around support to enable equitable vaccine access. Majority of the initiatives reported that PHA-FBO partnerships improved vaccine confidence and uptake (71.3%). About 22.2% of the initiatives reported quantitative outcomes post-intervention. PHA-FBO initiatives over the past decade increased vaccine uptake and acceptance among diverse ethnoracially minoritized populations. Reporting of faith-based initiatives are subject to publication bias and can be strengthened by examining more evaluation studies and establishment of key outcome indicators to critically appraise intervention outcomes.
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Affiliation(s)
- Melodie Yunju Song
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | | | - Anna Karbasi
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Shaza A Fadel
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Clinical Public Health Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sara Allin
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Anushka Ataullahjan
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- School of Health Studies, Faculty of Health Sciences, Western University, London, Canada
| | - Erica Di Ruggiero
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Social and Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Robertson D, Heriot G, Jamrozik E. Herd immunity to endemic diseases: Historical concepts and implications for public health policy. J Eval Clin Pract 2024; 30:625-631. [PMID: 38562003 DOI: 10.1111/jep.13983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 12/28/2023] [Indexed: 04/04/2024]
Abstract
BACKGROUND "Herd immunity" became a contested term during the COVID-19 pandemic. Although the term "herd immunity" is often used to refer to thresholds at which some diseases can be eliminated (e.g., due to mass vaccination), the term has multiple referents. Different concepts of herd immunity have been relevant throughout the history of immunology and infectious disease epidemiology. For some diseases, herd immunity plays a role in the development of an endemic equilibrium, rather than elimination via threshold effects. METHODS We reviewed academic literature from 1920 to 2022, using historical and philosophical analysis to identify and develop relevant concepts of herd immunity. RESULTS This paper analyses the ambiguity surrounding the concept of herd immunity during the pandemic. We argue for the need to recapture a long-standing interpretation of this concept as one of the factors that leads to a dynamic endemic equilibrium between a host population and a mutating respiratory pathogen. CONCLUSIONS Informed by the history of infectious disease epidemiology, we argue that understanding the concept in this way will help us manage both SARS-CoV-2 and hundreds of other seasonal respiratory pathogens with which we live but which have been disrupted due to sustained public health measures/non-pharmaceutical interventions targeting SARS-CoV-2.
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Affiliation(s)
- David Robertson
- Swiss National Science Foundation; Faculty of History, Oxford Centre for the History of Science, Medicine, and Technology, University of Oxford, Oxford, UK
| | - George Heriot
- Department of Infectious Diseases, Melbourne Medical School, University of Melbourne, Melbourne, Australia
| | - Euzebiusz Jamrozik
- Nuffield Department of Population Health, The Ethox Centre & Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
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Ahmed N, Yousafzai MT, Naz Qamar F. The Enterics for Global Health (EFGH) Shigella Surveillance Study in Pakistan. Open Forum Infect Dis 2024; 11:S113-S120. [PMID: 38532950 PMCID: PMC10962754 DOI: 10.1093/ofid/ofad651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024] Open
Abstract
Background The Enterics for Global Health (EFGH) Shigella surveillance study is a longitudinal multicountry study that aims to estimate incidence rates and document consequences of Shigella diarrhea within 7 countries in Africa, Asia, and Latin America. In addition to a high incidence of childhood diarrhea, Pakistan is facing a problem of antimicrobial resistance in urban and peri-urban areas of Karachi. Methods In Pakistan, EFGH will be conducted in Karachi, which is one of the metropolitan cities bordering the Arabian Sea and has a diverse population of 1.6 million according to the 2017 population census. The study aims to enroll 1400 children aged 6-35 months over 2 years (2022-2024) from 6 health care facilities (Abbasi Shaheed Hospital, Khidmat-e-Alam Medical Centre, Sindh Government Hospital Korangi 5, Sindh Government Hospital Ibrahim Hyderi, Ali Akbar Shah VPT Center, and Bhains Colony VPT Center) situated in Nazimabad and Bin-Qasim town. Moreover, population enumeration and health care utilization surveys from a defined catchment area of health facilities will be conducted to estimate the Shigella diarrhea incidence rates. Conclusions The study will provide critical data to policy-makers about the burden of Shigella and antimicrobial resistance, which is essential for planning Shigella vaccine trials.
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Affiliation(s)
- Naveed Ahmed
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | | | - Farah Naz Qamar
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
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Abdelmagid N, Southgate RJ, Alhaffar M, Ahmed M, Bani H, Mounier-Jack S, Dahab M, Checchi F, Sabahelzain MM, Nor B, Rao B, Singh NS. The Governance of Childhood Vaccination Services in Crisis Settings: A Scoping Review. Vaccines (Basel) 2023; 11:1853. [PMID: 38140257 PMCID: PMC10747651 DOI: 10.3390/vaccines11121853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
The persistence of inadequate vaccination in crisis-affected settings raises concerns about decision making regarding vaccine selection, timing, location, and recipients. This review aims to describe the key features of childhood vaccination intervention design and planning in crisis-affected settings and investigate how the governance of childhood vaccination is defined, understood, and practised. We performed a scoping review of 193 peer-reviewed articles and grey literature on vaccination governance and service design and planning. We focused on 41 crises between 2010 and 2021. Following screening and data extraction, our analysis involved descriptive statistics and applying the governance analysis framework to code text excerpts, employing deductive and inductive approaches. Most documents related to active outbreaks in conflict-affected settings and to the mass delivery of polio, cholera, and measles vaccines. Information on vaccination modalities, target populations, vaccine sources, and funding was limited. We found various interpretations of governance, often implying hierarchical authority and regulation. Analysis of governance arrangements suggests a multi-actor yet fragmented governance structure, with inequitable actor participation, ineffective actor collaboration, and a lack of a shared strategic vision due to competing priorities and accountabilities. Better documentation of vaccination efforts during emergencies, including vaccination decision making, governance, and planning, is needed. We recommend empirical research within decision-making spaces.
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Affiliation(s)
- Nada Abdelmagid
- Department of Infectious Disease Epidemiology and International Health, Faculty of Epidemiology and Population Health, The London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
- Health in Humanitarian Crises Centre, The London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | | | - Mervat Alhaffar
- Department of Infectious Disease Epidemiology and International Health, Faculty of Epidemiology and Population Health, The London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
- Syria Research Group (SYRG), Co-Hosted by the London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK and Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
| | - Matab Ahmed
- School of Health Sciences, Ahfad University for Women (AUW), Omdurman P.O. Box 167, Sudan
| | - Hind Bani
- School of Health Sciences, Ahfad University for Women (AUW), Omdurman P.O. Box 167, Sudan
| | - Sandra Mounier-Jack
- Department of Global Health and Development, Faculty of Public Health and Policy, The London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
| | - Maysoon Dahab
- Department of Infectious Disease Epidemiology and International Health, Faculty of Epidemiology and Population Health, The London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
- Health in Humanitarian Crises Centre, The London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Francesco Checchi
- Department of Infectious Disease Epidemiology and International Health, Faculty of Epidemiology and Population Health, The London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
- Health in Humanitarian Crises Centre, The London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Majdi M. Sabahelzain
- School of Health Sciences, Ahfad University for Women (AUW), Omdurman P.O. Box 167, Sudan
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia
| | - Barni Nor
- Department of Women’s and Children’s Health, Uppsala University, 751 23 Uppsala, Sweden
| | - Bhargavi Rao
- Department of Global Health and Development, Faculty of Public Health and Policy, The London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
| | - Neha S. Singh
- Health in Humanitarian Crises Centre, The London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
- Department of Global Health and Development, Faculty of Public Health and Policy, The London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
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Wang Y, Ji W, Li D, Sun T, Zhu P, Li J, Zhang L, Zhang Y, Yang H, Chen S, Jin Y, Duan G. Active inoculation with an inactivated Coxsackievirus A2 vaccine induces neutralizing antibodies and protects mice against lethal infection. Vaccine 2023; 41:6470-6482. [PMID: 37718187 DOI: 10.1016/j.vaccine.2023.08.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 08/29/2023] [Accepted: 08/29/2023] [Indexed: 09/19/2023]
Abstract
Coxsackievirus A2 (CVA2) is one of the causative agents of hand-foot-and-mouth disease (HFMD), which poses a great challenge for global public health. However, presently, there are no available commercial vaccines or antivirals to prevent CVA2 infection. Here, we present an inactivated Vero cell-based whole CVA2 vaccine candidate and evaluate its safety and efficacy in this study. Neonatal BALB/c mice were vaccinated at 5 and 7 days old, respectively, and then challenged with either homologous or heterologous strain of CVA2 at a lethal dose at 10 days old. The inactivated whole CVA2 vaccine candidate showed a high protective efficacy. Additionally, our inactivated vaccine stimulated the production of CVA2-specific IgG1 and IgG2a antibodies in vivo and high titers of neutralization antibodies (NtAbs) in the serum of immunized mice. Maternal immunization with the inactivated CVA2 vaccine provided full protection to pups against lethal infection. Compared with mice inoculated with only alum, the viral loads were decreased, and pathological changes were relieved in tissue samples of immunized mice. Moreover, the transcription levels of some genes related to cytokines (IFN-γ and TNF-α, MCP-1, IL-6, CXCL-10 etc.) were significantly reduced. The number of immune cells and levels of cytokines in peripheral blood of mice inoculated with only alum were higher than that of immunized mice. It is noteworthy that this vaccine showed a good cross-immunity efficacy against Enterovirus A71 (EVA71) challenge. In conclusion, our findings suggest that this experimental inactivated CVA2 vaccine is a promising component of polyvalent vaccines related to HFMD in the near future.
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Affiliation(s)
- Yuexia Wang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China; Academy of Medical Science, Zhengzhou University, Zhengzhou 450001, Henan, China; Department of Infectious Disease Control and Prevention, Jiangshan Center for Disease Control and Prevention, Jiangshan 324100, Zhejiang, China
| | - Wangquan Ji
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China; Academy of Medical Science, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Dong Li
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China; Academy of Medical Science, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Tiantian Sun
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China; Academy of Medical Science, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Peiyu Zhu
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China; Academy of Medical Science, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Junwei Li
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China; Department of Infectious Disease Control and Prevention, Jiangshan Center for Disease Control and Prevention, Jiangshan 324100, Zhejiang, China
| | - Liang Zhang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China; Academy of Medical Science, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Yu Zhang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Haiyan Yang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Shuaiyin Chen
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Yuefei Jin
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China.
| | - Guangcai Duan
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China; Academy of Medical Science, Zhengzhou University, Zhengzhou 450001, Henan, China.
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Athikarisamy SE, Vinekar A, Patole S. Retinopathy of prematurity in India - what can we learn from the polio legacy? THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 14:100210. [PMID: 37492414 PMCID: PMC10363497 DOI: 10.1016/j.lansea.2023.100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/01/2023] [Accepted: 04/25/2023] [Indexed: 07/27/2023]
Abstract
Retinopathy of prematurity (ROP) is a vasoproliferative disease of the preterm retina that has the potential to cause vision impairment and blindness. Timely screening and treatment are hence critical for infants at risk for ROP. Screening for ROP is challenging in India owing to the limited resources, a vast at-risk population and lack of awareness among paediatricians and the public. Addressing ROP in India requires a comprehensive approach involving multiple sectors, considering the magnitude of the problem and the expected increase in need for ROP services due to the increased survival of preterm infants following improvements in neonatal care. The success of the Global Polio Eradication Initiative (GPEI) offers valuable lessons for improving ROP services in developing nations by applying its strategies. An approach for primary and secondary prevention of ROP is proposed, and the current challenges and a neonatal-led care model for ROP are discussed.
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Affiliation(s)
- Sam Ebenezer Athikarisamy
- Neonatal Directorate, Child Adolescent Health Service, Perth, Western Australia, Australia
- School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
| | - Anand Vinekar
- Director, KIDROP, Narayana Nethralaya Eye Institute, Bangalore, India
| | - Sanjay Patole
- Neonatal Directorate, Child Adolescent Health Service, Perth, Western Australia, Australia
- School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
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Soofi SB, Vadsaria K, Mannan S, Habib MA, Tabassum F, Hussain I, Muhammad S, Feroz K, Ahmed I, Islam M, Bhutta ZA. Factors Associated with Vaccine Refusal (Polio and Routine Immunization) in High-Risk Areas of Pakistan: A Matched Case-Control Study. Vaccines (Basel) 2023; 11:vaccines11050947. [PMID: 37243051 DOI: 10.3390/vaccines11050947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 04/19/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Pakistan has subpar childhood immunization rates and immunization activities have faced several challenges over the past years. We evaluated the social-behavioral and cultural barriers and risk factors for refusal of polio, Routine Immunization (RI), or both in high-risk areas of poliovirus circulation. METHODS A matched case-control study was conducted from April to July 2017 in eight super high-risk Union Councils of five towns in Karachi, Pakistan. A total of 3 groups, each with 250 cases, including refusals for the Oral Polio Vaccine (OPV) in campaigns (national immunization days and supplementary immunization activities), RI, and both, were matched with 500 controls and identified using surveillance records. Sociodemographic characteristics, household information, and immunization history were assessed. Study outcomes included social-behavioral and cultural barriers and reasons for vaccine refusal. Data were analyzed in STATA using conditional logistic regression. RESULTS RI refusal was associated with illiteracy and fear of the vaccine's adverse effects, while OPV refusals were linked to the mother's decision authority and the assumption that the OPV caused infertility. Conversely, higher socioeconomic status (SES) and knowledge of and willingness to vaccinate with Inactivated Polio Vaccine (IPV) were inversely associated with RI; and lower SES, walking to the vaccination point, knowledge of IPV, and an understanding of contracting polio were inversely associated with OPV refusals, with the latter two also inversely associated with complete vaccine refusal. CONCLUSION Education, knowledge and understanding of vaccines, and socioeconomic determinants influenced OPV and RI refusals among children. Effective interventions are needed to address knowledge gaps and misconceptions among parents.
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Affiliation(s)
- Sajid Bashir Soofi
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Khadija Vadsaria
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Sara Mannan
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Muhammad Atif Habib
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Farhana Tabassum
- Institute for Global Health and Development, Aga Khan University, Karachi 74800, Pakistan
| | - Imtiaz Hussain
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Sajid Muhammad
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Khalid Feroz
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Imran Ahmed
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Muhammad Islam
- Centre for Global Child Health, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada
| | - Zulfiqar A Bhutta
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
- Institute for Global Health and Development, Aga Khan University, Karachi 74800, Pakistan
- Centre for Global Child Health, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada
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Lohiniva AL, Nurzhynska A, Alhassan H, Shetye M, Ayiku P. Understanding Factors Influencing Polio Vaccine Uptake in Ghana-Developing Meaningful Community Mobilization and Engagement Strategies in Collaboration with Religious Leaders. Am J Trop Med Hyg 2022; 107:1345-1350. [PMID: 36315999 PMCID: PMC9768250 DOI: 10.4269/ajtmh.22-0271] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 09/05/2022] [Indexed: 12/30/2022] Open
Abstract
This qualitative study explores how religious leaders in Ghana view polio and polio vaccine-related knowledge and perceptions of the community members. It also examines the personal characteristics of those who are most likely to accept or reject the vaccine. On the basis of the findings, this study provides a set of evidence-based recommendations to support religious leaders' efforts to create polio vaccine demand in their communities. The study is based on focus group discussions conducted with religious leaders from various geographic locations across Ghana. The discussions were transcribed verbatim and analyzed thematically. Twenty religious leaders, including Christian, Muslim, and leaders of traditional African religions, participated in the study. The findings show that both religious leaders and community members lack knowledge and have multiple culturally and religiously influenced explanations for polio. In addition, the findings reveal that vaccine safety and efficacy are linked to emotional narratives, and receiving the polio vaccine is not a social norm in all communities. Educated mothers in urban settings were identified as those most receptive to the polio vaccine. To create polio vaccine demand, religious leaders need to combat misinformation and the negative perceptions about the vaccine. Recommendations include conveying high-quality information to community members, developing tactics to address culturally and religiously sensitive matters, using emotionally inspired personal accounts to enhance positive attitudes toward polio vaccines and act as catalysts for positive social norms towards the polio vaccine. Educated mothers from urban areas can be engaged as champions in vaccine demand creation.
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Affiliation(s)
- Anna-Leena Lohiniva
- UNICEF Ghana, Accra, Ghana;,Address correspondence to Anna-Leena Lohiniva, UNICEF Country Office, P.O. Box 5051, 4-8 Rangoon Close, Accra-North, Ghana. E-mail:
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Belshe WB, Alswang JM, Uplift-Brown AM, Chilenga L, Chipolombwe J, Seaman VY. Lessons learned from the Global Polio Eradication Initiative: A roadmap for the international COVID-19 vaccination campaign. Malawi Med J 2022; 34:294-298. [PMID: 38125783 PMCID: PMC10645833 DOI: 10.4314/mmj.v34i4.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
The COVID-19 vaccine is lauded by many as one of the greatest accomplishments in modern medicine, with the potential to definitively contain the deadliest pandemic of the last century. With the vaccine rollout now underway in the developing world, a robust, methodical, and swift global distribution effort is required to ensure that it will be done in an equitable manner. Taking into account the vast geographic, socioeconomic, cultural, and political diversity of countries around the world, global vaccination efforts have historically required multifaceted, time consuming, and labor-intensive approaches to be effective. However, with over 33 years of experience from the Global Polio Eradication Initiative - an international health initiative aimed at eradicating poliomyelitis - the COVID-19 vaccination campaign does not have to be approached blindly. Using lessons learned from the Global Polio Eradication Initiative, this paper aims to identify the supply- and demand-side barriers to the success of the international COVID-19 vaccination effort, and ways each can be overcome. Most notably, health systems shortcomings, political and cultural messaging, and civil unrest and violent conflict serve as daunting obstacles to the success of the COVID-19 vaccination campaign. The Global Polio Eradication Initiative has been able to overcome many of these same obstacles with innovative strategies such as context-specific microplanning, robust health surveillance systems, and community-centered education and advocacy programs. Ultimately, while the Global Polio Eradication Initiative is still fighting the battle of polio eradication, it has provided a roadmap for the COVID-19 vaccination campaign to be executed in a more swift and equitable manner.
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Xu Y, Liu Y, Wang J, Che X, Du J, Zhang X, Gu W, Zhang X, Jiang W. Cost-effectiveness of various immunization schedules with inactivated Sabin strain polio vaccine in Hangzhou, China. Front Public Health 2022; 10:990042. [PMID: 36211670 PMCID: PMC9545176 DOI: 10.3389/fpubh.2022.990042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 08/24/2022] [Indexed: 01/26/2023] Open
Abstract
Background It is necessary to select suitable inactivated poliovirus vaccine(IPV) and live, attenuated oral poliovirus vaccine (OPV) sequential immunization programs and configure the corresponding health resources. An economic evaluation was conducted on the sequential procedures of Sabin strain-based IPV (sIPV) and bivalent OPV (bOPV) with different doses to verify whether a cost-effectiveness target can be achieved. This study aimed to evaluate the cost-effectiveness of different sIPV immunization schedules, which would provide convincing evidence to further change the poliovirus vaccine (PV) immunization strategies in China. Methods Five strategies were included in this analysis. Based on Strategy 0(S0), the incremental cost (IC), incremental effect (IE), and incremental cost-effectiveness ratio (ICER) of the four different strategies (S1/S2/S3/S4) were calculated based on the perspective of the society. Seven cost items were included in this study. Results of field investigations and expert consultations were used to calculate these costs. Results The ICs of S1/S2/S3/S4 was Chinese Yuan (CNY) 30.77, 68.58, 103.82, and 219.82 million, respectively. The IE of vaccine-associated paralytic poliomyelitis (IEVAPP) cases of S1/S2/S3/S4 were 0.22, 0.22, 0.22, and 0.11, respectively, while the IE of disability-adjusted life-years (IEDALY) of S1/S2/S3/S4 were 8.98, 8.98, 8.98, and 4.49, respectively. The ICERVAPP of S1/S2/S3/S4 gradually increased to CNY 13.99, 31.17, 47.19, and 199.83 million/VAPP, respectively. The ICERDALY of S1/S2/S3/S4 also gradually increased to CNY 0.34, 0.76, 1.16, and 4.90 million/DALY, respectively. Conclusion ICERVAPP and ICERDALY were substantially higher for S3 (four-sIPV) and S4 (replacement of self-funded sIPV based on one-sIPV-three-bOPV). Two-sIPV-two-bOPV had a cost-effectiveness advantage, whereas S2/S3/S4 had no cost-effectiveness advantage.
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Khaliq A, Elahi AA, Zahid A, Lassi ZS. A Survey Exploring Reasons behind Immunization Refusal among the Parents and Caregivers of Children under Two Years Living in Urban Slums of Karachi, Pakistan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11631. [PMID: 36141905 PMCID: PMC9516974 DOI: 10.3390/ijerph191811631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/05/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
This study assesses the experiences of parents/caregivers regarding the refusal to childhood immunization. A cross-sectional study was conducted among the parents/caregivers of children under two years old from January 2019 to June 2019 who were residents of either Pathan Colony or Orangi Town, Karachi. In this study, the data collectors targeted parents/caregivers of 440 households who showed a refusal mark "R" in the Expanded Program of Immunization (EPI) H-chalking system. These households were approached using a 30 × 7 multistage-stratified-cluster random sampling technique and were interviewed using a structured questionnaire. The study sample produced two different types of refusals: true refusal (absence) and potential refusal (presence), based on the absence and presence of a vaccination card at the time of the survey. Multivariate logistic regression was used to analyze the data using Jamovi (V-1.6.13). A total of 230 households consented to participate in this study, of which 141 (61.3%) represented true refusals, while 89 (38.7%) represented potential refusals. More than half of the participants from both groups complained about fever and pain at the injection site following immunization. The use of alternative medicines and a history of adverse events following immunization (AEFI) were associated with increasing the odds of immunization refusals by four-to-five fold. However, advanced paternal age, a long distance to the clinic, a lack of trust in government, and the influence of community/religious leaders were associated with lower immunization refusal odds. Thus, an unawareness about self-limiting vaccine-related adverse events, the use of alternative medicines, and an increased concern about the safety and efficacy of vaccines were found to be barriers to immunization, which can be improved by increasing public awareness through media campaigns and policy reform.
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Affiliation(s)
- Asif Khaliq
- Department of Health & Hospital Management, Institute of Business Management, Karachi 75190, Pakistan
- School of Public Health & Social Work, Queensland University of Technology, Brisbane, QLD 4059, Australia
| | - Alfaraz Ashraf Elahi
- Department of Health & Hospital Management, Institute of Business Management, Karachi 75190, Pakistan
| | - Asima Zahid
- Department of Health & Hospital Management, Institute of Business Management, Karachi 75190, Pakistan
| | - Zohra S. Lassi
- Robinson Research Institute, The University of Adelaide, Adelaide, SA 5005, Australia
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Elimination of human rabies in Goa, India through an integrated One Health approach. Nat Commun 2022; 13:2788. [PMID: 35589709 PMCID: PMC9120018 DOI: 10.1038/s41467-022-30371-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 04/27/2022] [Indexed: 01/13/2023] Open
Abstract
Dog-mediated rabies kills tens of thousands of people each year in India, representing one third of the estimated global rabies burden. Whilst the World Health Organization (WHO), World Organization for Animal Health (OIE) and the Food and Agriculture Organization of the United Nations (FAO) have set a target for global dog-mediated human rabies elimination by 2030, examples of large-scale dog vaccination programs demonstrating elimination remain limited in Africa and Asia. We describe the development of a data-driven rabies elimination program from 2013 to 2019 in Goa State, India, culminating in human rabies elimination and a 92% reduction in monthly canine rabies cases. Smartphone technology enabled systematic spatial direction of remote teams to vaccinate over 95,000 dogs at 70% vaccination coverage, and rabies education teams to reach 150,000 children annually. An estimated 2249 disability-adjusted life years (DALYs) were averted over the program period at 526 USD per DALY, making the intervention 'very cost-effective' by WHO definitions. This One Health program demonstrates that human rabies elimination is achievable at the state level in India.
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SteelFisher GK, Caporello H, McIntosh R, Muhammad Safdar R, Desomer L, Chimenya D, Abdelwahab J, Ratna J, Rutter P, O'Reilly D, Gilani BI, Williams MR, Ben-Porath EN, Blendon RJ. Preventing erosion of oral polio vaccine acceptance: A role for vaccinator visits and social norms. Vaccine 2022; 40:3752-3760. [PMID: 35599038 PMCID: PMC9119726 DOI: 10.1016/j.vaccine.2022.04.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 03/02/2022] [Accepted: 04/29/2022] [Indexed: 10/28/2022]
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Ezezika O, Mengistu M, Opoku E, Farheen A, Chauhan A, Barrett K. What are the barriers and facilitators to polio vaccination and eradication programs? A systematic review. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001283. [PMID: 36962654 PMCID: PMC10022167 DOI: 10.1371/journal.pgph.0001283] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 10/21/2022] [Indexed: 11/17/2022]
Abstract
Global efforts to eradicate polio by the Global Polio Eradication Initiative agency partners and country-level stakeholders have led to the implementation of global polio vaccination programs. This study presents the findings of existing studies regarding the barriers and facilitators that countries face when implementing polio interventions. A comprehensive search was conducted in OVID Medline, OVID Embase, EBSCO CINAHL Plus, and Web of Science. Eligible studies underwent quality assessment. A qualitative evidence synthesis approach was conducted and aligned to the Consolidated Framework for Implementation Research (CFIR). The search identified 4147 citations, and following the removal of duplicates and screening according to our inclusion/exclusion criteria, 20 articles were eligible for inclusion in the review. Twelve countries were represented in this review, with India, Nigeria, Pakistan, Ethiopia, and Afghanistan having the most representation of available studies. We identified 36 barriers and 16 facilitators. Seven themes emerged from these barriers and facilitators: fear, community trust, infrastructure, beliefs about the intervention, influential opinions, intervention design, and geo-politics. The most frequently cited CFIR constructs for the facilitators and barriers were knowledge and beliefs about the intervention, followed by available resources. This study identified a wide range of barriers and facilitators to polio vaccination implementation across the globe, adding to the scarce body of literature on these barriers and facilitators from an implementation perspective and using a determinant framework. The diversity of factors among different groups of people or countries highlights the relevance of contexts. Implementers should be conversant with the contexts within which polio eradication programs boost intervention coverage and capacity. This study provides policymakers, practitioners, and researchers with a tool for planning and designing polio immunization programs. Trial registration: A protocol for this systematic review was developed and uploaded onto the PROSPERO international prospective register of systematic reviews database (Registration number: CRD42020222115).
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Affiliation(s)
- Obidimma Ezezika
- School of Health Studies, Faculty of Health Sciences, University of Western Ontario, London, Canada
- Department of Health and Society, University of Toronto Scarborough, Toronto, Canada
- African Centre for Innovation and Leadership Development, Abuja, Nigeria
| | - Meron Mengistu
- Department of Health and Society, University of Toronto Scarborough, Toronto, Canada
- London School of Hygiene & Tropical Medicine, Keppel St, London, United Kingdom
| | - Eric Opoku
- Department of Health and Society, University of Toronto Scarborough, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Aiman Farheen
- Department of Health and Society, University of Toronto Scarborough, Toronto, Canada
| | - Anuradha Chauhan
- Department of Health and Society, University of Toronto Scarborough, Toronto, Canada
| | - Kathryn Barrett
- School of Health Studies, Faculty of Health Sciences, University of Western Ontario, London, Canada
- University of Toronto Scarborough Library, Toronto, Canada
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Dizbay İE, Öztürkoğlu Ö. Factors affecting recommended childhood vaccine demand. JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2021. [DOI: 10.3233/jifs-219184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Reaching a high vaccination coverage level is of vital essence when preventing epidemic diseases. For mandatory vaccines, the demand can be forecasted using some demographics such as birth rates or populations between certain ages. However, it has been difficult to forecast non-mandatory vaccine demands because of vaccine hesitation, alongside other factors such as social norms, literacy rate, or healthcare infrastructure. Consequently, the purpose of this study is to explore the predominant factors that affect the non-mandatory vaccine demand, focusing on the recommended childhood vaccines, which are usually excluded from national immunization programs. For this study, fifty-nine factors were determined and categorized as system-oriented and human-oriented factors. After a focus group study conducted with ten experts, seven system-oriented and eight human-oriented factors were determined. To reveal the cause and effect relationship between factors, one of the multi-criteria decision-making methods called Fuzzy-DEMATEL was implemented. The results of the analysis showed that “Immunization-related beliefs”, “Media/social media contents/messaging”, and “Social, cultural, religious norms” have a strong influence on non-mandatory childhood vaccine demand. Furthermore, whereas “Availability and access to health care facilities” and “Political/ financial support to health systems” are identified as cause group factors, “Quality of vaccine and service delivery management” is considered an effect group factor. Lastly, a guide was generated for decision-makers to help their forecasting process of non-mandatory vaccine demands to avoid vaccine waste or shortage.
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Affiliation(s)
- İkbal Ece Dizbay
- Department of Management & Organization, Yasar University, İzmir, Turkey
| | - Ömer Öztürkoğlu
- Department of Business Administration, Yasar University, İzmir, Turkey
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Eslava-Schmalbach J, Rosero EB, Garzón-Orjuela N. Global control of COVID-19: good vaccines may not suffice. Rev Panam Salud Publica 2021; 45:e148. [PMID: 34908811 PMCID: PMC8663111 DOI: 10.26633/rpsp.2021.148] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 05/27/2021] [Indexed: 12/17/2022] Open
Abstract
The COVID-19 pandemic has unveiled health and socioeconomic inequities around the globe. Effective epidemic control requires the achievement of herd immunity, where susceptible individuals are conferred indirect protection by being surrounded by immunized individuals. The proportion of people that need to be vaccinated to obtain herd immunity is determined through the herd immunity threshold. However, the number of susceptible individuals and the opportunities for contact between infectious and susceptible individuals influence the progress of an epidemic. Thus, in addition to vaccination, control of a pandemic may be difficult or impossible to achieve without other public health measures, including wearing face masks and social distancing. This article discusses the factors that may contribute to herd immunity and control of COVID-19 through the availability of effective vaccines and describes how vaccine effectiveness in the community may be lower than that expected. It also discusses how pandemic control in some countries and populations may face vaccine accessibility barriers if market forces strongly regulate the new technologies available, according to the inverse care law.
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Affiliation(s)
- Javier Eslava-Schmalbach
- Universidad Nacional de Colombia Bogotá Colombia Universidad Nacional de Colombia, Bogotá, Colombia
| | - Eric B Rosero
- University of Texas Southwestern Medical Center DallasTexas United States of America University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Nathaly Garzón-Orjuela
- Universidad Nacional de Colombia Bogotá Colombia Universidad Nacional de Colombia, Bogotá, Colombia
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The Influence of War and Conflict on Infectious Disease: A Rapid Review of Historical Lessons We Have Yet to Learn. SUSTAINABILITY 2021. [DOI: 10.3390/su131910783] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Armed conflicts degrade established healthcare systems, which typically manifests as a resurgence of preventable infectious diseases. While 70% of deaths globally are now from non-communicable disease; in low-income countries, respiratory infections, diarrheal illness, malaria, tuberculosis, and HIV/AIDs are all in the top 10 causes of death. The burden of these infectious diseases is exacerbated by armed conflict, translating into even more dramatic long-term consequences. This rapid evidence review searched electronic databases in PubMed, Scopus, and Web of Science. Of 381 identified publications, 73 were included in this review. Several authors indicate that the impact of infectious diseases increases in wars and armed conflicts due to disruption to surveillance and response systems that were often poorly developed to begin with. Although the true impact of conflict on infectious disease spread is not known and requires further research, the link between them is indisputable. Current decision-making management systems are insufficient and only pass the baton to the next unwary generation.
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Divyaveer S, Jha V. COVID-19 and care for patients with chronic kidney disease: Challenges and lessons. FASEB Bioadv 2021; 3:569-576. [PMID: 34230909 PMCID: PMC8250957 DOI: 10.1096/fba.2021-00002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/05/2021] [Accepted: 03/17/2021] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 pandemic has blurred the traditional distinction between communicable diseases (CD) and noncommunicable diseases (NCDs). The manifestations of COVID-19 range from an asymptomatic carrier state to fatal multiorgan failure. While initial reports did not report significant effects on the kidneys, it is now well established that kidney involvement (acute kidney injury, urinary abnormalities, tubular function defects) in COVID-19 is common and it is also associated with poorer outcomes. At the same time, care for patients with existing chronic kidney disease (CKD) has suffered during this pandemic and those with CKD are considered to have higher risk for severity of COVID-19 symptoms. Widespread lockdowns have affected the delivery of health care to patients with CKD, including those on dialysis or on transplant wait-lists. The pandemic has reinforced the need for accessible home-based therapies and highlighted the value of teleconsultation and remote monitoring technologies. COVID-19 has revealed the poor emergency preparedness by health systems around the world. It has underscored glaring inequities in availability of diagnostic tests and essential medications, including that for dialysis. In response, there has been increasing recognition of the necessity of universal health coverage and in prioritizing vaccine distribution to serve the most vulnerable, including those with kidney failure. The COVID-19 pandemic has also reaffirmed the role of the environment and eco-systems contributing to both CDs and NCDs. Attention to universal health coverage through a One Health approach is needed to prevent global health crises and prevent further kidney dysfunction and failure.
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Affiliation(s)
- Smita Divyaveer
- Department of NephrologyPostgraduate Institute of Medical Education and ResearchChandigarhIndia
| | - Vivekanand Jha
- George Institute for Global Health, UNSWNew DelhiIndia
- School of Public Health, Faculty of MedicineImperial CollegeLondonUK
- Prasanna School of Public HealthManipal Academy of Higher EducationManipalIndia
- International Society of NephrologyBrusselsBelgium
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Ozawa S, Yemeke TT, Mitgang E, Wedlock PT, Higgins C, Chen HH, Pallas SW, Abimbola T, Wallace A, Bartsch SM, Lee BY. Systematic review of the costs for vaccinators to reach vaccination sites: Incremental costs of reaching hard-to-reach populations. Vaccine 2021; 39:4598-4610. [PMID: 34238610 PMCID: PMC10680154 DOI: 10.1016/j.vaccine.2021.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 04/07/2021] [Accepted: 05/06/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Economic evidence on how much it may cost for vaccinators to reach populations is important to plan vaccination programs. Moreover, knowing the incremental costs to reach populations that have traditionally been undervaccinated, especially those hard-to-reach who are facing supply-side barriers to vaccination, is essential to expanding immunization coverage to these populations. METHODS We conducted a systematic review to identify estimates of costs associated with getting vaccinators to all vaccination sites. We searched PubMed and the Immunization Delivery Cost Catalogue (IDCC) in 2019 for the following costs to vaccinators: (1) training costs; (2) labor costs, per diems, and incentives; (3) identification of vaccine beneficiary location; and (4) travel costs. We assessed if any of these costs were specific to populations that are hard-to-reach for vaccination, based on a framework for examining supply-side barriers to vaccination. RESULTS We found 19 studies describing average vaccinator training costs at $0.67/person vaccinated or targeted (SD $0.94) and $0.10/dose delivered (SD $0.07). The average cost for vaccinator labor and incentive costs across 29 studies was $2.15/dose (SD $2.08). We identified 13 studies describing intervention costs for a vaccinator to know the location of a beneficiary, with an average cost of $19.69/person (SD $26.65), and six studies describing vaccinator travel costs, with an average cost of $0.07/dose (SD $0.03). Only eight of these studies described hard-to-reach populations for vaccination; two studies examined incremental costs per dose to reach hard-to-reach populations, which were 1.3-2 times higher than the regular costs. The incremental cost to train vaccinators was $0.02/dose, and incremental labor costs for targeting hard-to-reach populations were $0.16-$1.17/dose. CONCLUSION Additional comparative costing studies are needed to understand the potential differential costs for vaccinators reaching the vaccination sites that serve hard-to-reach populations. This will help immunization program planners and decision-makers better allocate resources to extend vaccination programs.
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Affiliation(s)
- Sachiko Ozawa
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA; Department of Maternal and Child Health, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Tatenda T Yemeke
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - Elizabeth Mitgang
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
| | - Patrick T Wedlock
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
| | - Colleen Higgins
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - Hui-Han Chen
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - Sarah W Pallas
- Global Immunization Division, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Taiwo Abimbola
- Global Immunization Division, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Aaron Wallace
- Global Immunization Division, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Sarah M Bartsch
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
| | - Bruce Y Lee
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY, USA
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20
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Yan D, Wang D, Zhang Y, Li X, Tang H, Guan J, Song Y, Zhu S, Xu W. Implication of a High Risk for Type 2 Vaccine-Derived Poliovirus Emergence and Transmission After the Switch From Trivalent to Bivalent Oral Poliovirus Vaccine. J Infect Dis 2021; 223:113-118. [PMID: 32621746 DOI: 10.1093/infdis/jiaa386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 07/03/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND China implemented the globally synchronized switch from trivalent oral poliovirus vaccine (tOPV) to bivalent OPV (bOPV) and introduced 1 dose of inactivated poliovirus vaccine on 1 May 2016. We assessed the impact of the switch on the immunity level against poliovirus, especially type 2. METHODS Children born between 2014 and 2017, who were brought to the hospitals in Urumqi city, Xinjiang Province in 2017, were enrolled and blood samples were collected to test for antibody titers against poliovirus. A comparison of seroprevalence between the children born before (preswitch group) and after the switch (postswitch group) was performed to assess the impact of the switch on the immunity level against polio. RESULTS A total of 172 subjects were enrolled. The overall seroprevalences were 98.8%, 79.1%, and 98.3% for types 1, 2, and 3, respectively. Seroprevalence for type 2 significantly decreased from 91.6% in the preswitch group to 67.4% in the postswitch group, but no statistically significant change was observed for both types 1 and 3. CONCLUSIONS The switch from tOPV to bOPV can provide high-level immunity against types 1 and 3 but not against type 2, indicating a high risk of type 2 vaccine-derived poliovirus emergence and transmission.
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Affiliation(s)
- Dongmei Yan
- World Health Organization Western Pacific Regional Office Regional Reference Poliomyelitis Laboratory and NHC Key Laboratory of Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dongyan Wang
- World Health Organization Western Pacific Regional Office Regional Reference Poliomyelitis Laboratory and NHC Key Laboratory of Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yong Zhang
- World Health Organization Western Pacific Regional Office Regional Reference Poliomyelitis Laboratory and NHC Key Laboratory of Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaolei Li
- World Health Organization Western Pacific Regional Office Regional Reference Poliomyelitis Laboratory and NHC Key Laboratory of Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haishu Tang
- Xinjiang Uyghur Autonomous Region Center for Disease Control and Prevention, Urumqi, China
| | - Jing Guan
- Xinjiang Uyghur Autonomous Region Center for Disease Control and Prevention, Urumqi, China
| | - Yang Song
- World Health Organization Western Pacific Regional Office Regional Reference Poliomyelitis Laboratory and NHC Key Laboratory of Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shuangli Zhu
- World Health Organization Western Pacific Regional Office Regional Reference Poliomyelitis Laboratory and NHC Key Laboratory of Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wenbo Xu
- World Health Organization Western Pacific Regional Office Regional Reference Poliomyelitis Laboratory and NHC Key Laboratory of Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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González-Silva M, Rabinovich NR. Some lessons for malaria from the Global Polio Eradication Initiative. Malar J 2021; 20:210. [PMID: 33933088 PMCID: PMC8087877 DOI: 10.1186/s12936-021-03690-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/06/2021] [Indexed: 11/10/2022] Open
Abstract
The Global Polio Eradication Initiative (GPEI) was launched in 1988 with the aim of completely clearing wild polio viruses by 2000. More than three decades later, the goal has not been achieved, although spectacular advances have been made, with wild polio virus reported in only 2 countries in 2019. In spite of such progress, novel challenges have been added to the equation, most importantly outbreaks of vaccine-derived polio cases resulting from reversion to neurovirulence of attenuated vaccine virus, and insufficient coverage of vaccination. In the context of the latest discussions on malaria eradication, the GPEI experience provides more than a few lessons to the malaria field when considering a coordinated eradication campaign. The WHO Strategic Advisory Committee on Malaria Eradication (SAGme) stated in 2020 that in the context of more than 200 million malaria cases reported, eradication was far from reach in the near future and, therefore, efforts should remain focused on getting back on track to achieve the objectives set by the Global Technical Strategy against Malaria (2016-2030). Acknowledging the deep differences between both diseases and the stages they are in their path towards eradication, this paper draws from the history of GPEI and highlights relevant insights into what it takes to eradicate a pathogen in fields as varied as priority setting, global governance, strategy, community engagement, surveillance systems, and research. Above all, it shows the critical need for openness to change and adaptation as the biological, social and political contexts vary throughout the time an eradication campaign is ongoing.
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Affiliation(s)
| | - N. Regina Rabinovich
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Harvard TH Chan School of Public Health, Boston, MA USA
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22
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Buchy P, Chen J, Zhang XH, Benninghoff B, Lee C, Bibera GL. A review of rotavirus vaccine use in Asia and the Pacific regions: challenges and future prospects. Expert Rev Vaccines 2021; 20:1499-1514. [PMID: 33275065 DOI: 10.1080/14760584.2020.1853532] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Introduction: Rotavirus infection causes a significant proportion of diarrhea disease burden in children <5 years of age in Asia and the Pacific regions. The World Health Organization recommends that rotavirus vaccination should be included in national immunization programs to prevent rotavirus gastroenteritis (RVGE).Areas covered: A literature review was performed to identify and summarize published evidence on RVGE epidemiology and status of rotavirus vaccine use, including the impact and cost-effectiveness of rotavirus vaccination programs in Asia and the Pacific regions (49 countries) during the period 2000-2018.Expert opinion: Rotavirus vaccination programs have successfully reduced the burden of RVGE in many countries. However, such programs still do not exist in most Asia-Pacific countries, and therefore the burden of RVGE remains high in children <5 years of age. Challenges to vaccine implementation include a lack of surveillance data; safety concerns around intussusception; a general lack of awareness about RVGE disease epidemiology and vaccines among physicians, policy-makers, and parents; insufficient cost-effectiveness analyses; and potential issues with vaccine affordability including vaccination costs and lack of political will. Recommendations to overcome these challenges include developing cost-effectiveness analyses for more diverse national and regional settings, providing non-governmental support for low-income countries, and improving advocacy efforts.Plain language summaryWhat is the context?• Rotavirus (RV) infection causes acute gastroenteritis (GE) in children under 5 years of age.• Rotavirus vaccination (RVV) implementation has been slow in Asia and the Pacific (AP) regions, which could be responsible for the region falling behind in their fight against RVGE.What is new?• RVV via national immunization programs (NIPs) is available in 8/49 countries and through the private market or non-governmental support in other countries. Coverage rates vary between countries, possibly driven by the mechanism through which RVV is available.• A substantial positive impact of RVV on RVGE disease burden with a very low risk of intestinal intussusception for up to 7 days after RVV has been documented in the AP regions.• Economic evaluation studies, mainly cost-effectiveness analyses, predict a significant reduction in treatment costs related to RVGE and its complications showing that RVV is good value for money.What is the impact?• The prospect of continued safe and effective use of RVV in the AP regions is promising.• Challenges to RVV implementation include establishing evidence of burden of disease, poor awareness of rotavirus vaccines, limited evidence from cost-effectiveness analyses from several countries, issues of affordability of the vaccine and a lack of political will.• Recommendations for RVV implementation into the NIPs include conducting clinical and cost-effectiveness studies in countries where these are not available, establishing reliable surveillance mechanisms, providing non-governmental support for low-income countries and improving advocacy efforts.• Maintenance of high vaccination coverage is needed in countries that have implemented national RVV programs.Graphical abstract[Formula: see text].
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Yan D, Wang D, Zhu S, Zhang Y, Li X, Tang H, Guan J, Xu W. Immunogenicity of Oral Polio Vaccine and Salk Inactive Polio Vaccine Against Xinjiang Imported Type 1 Wild Poliovirus. Clin Infect Dis 2021; 70:1980-1984. [PMID: 31240315 DOI: 10.1093/cid/ciz549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 06/20/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND An outbreak of an imported Type 1 wild poliovirus from Pakistan occurred in the Xinjiang Uygur Autonomous Region of China in 2011, although the local immunity status of the oral polio vaccine (OPV) was relatively satisfied. METHODS Neutralizing antibody titers against the Xinjiang strain and Sabin 1 strain were measured in 237 sera from 3 groups of fully OPV-vaccinated persons and 1 group of infants fully vaccinated with the inactive polio vaccine (IPV). Additionally, 17 sera collected from 1 Xinjiang poliomyelitis case and his 16 contacts were also tested. Genomic sequencing was conducted the Xinjiang strain. RESULTS The antibody titers against the Xinjiang strain in each of 237 sera were significantly lower than those against the Sabin 1 strain. Notably, 40.0% of children in Group 1 were seronegative against the Xinjiang strain, which indicated that they might play an important role in wild poliovirus transmission, although their antibody titers against the Sabin 1 strain varied between 1:8 and 1:512. Meanwhile, serological results of the Xinjiang poliomyelitis case and his contacts also provided evidence that a proportion of OPV-vaccinated children had indeed been involved in the transmission chain of the Xinjiang outbreak. Genomic sequencing indicated that the Xinjiang strain was greatly distinguishable from the Sabin 1 strain in neutralizing antigenic sites. CONCLUSION The lack of neutralizing antibodies against the Xinjiang strain in persons vaccinated by OPV may be associated with the transmission of Type 1 wild poliovirus in Xinjiang. Using Salk IPV along with OPV might be considered in a wild poliovirus outbreak response, especially in the countries which continued to have persistent wild poliovirus circulation.
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Affiliation(s)
- Dongmei Yan
- Regional Reference Poliomyelitis Laboratory, World Health Organization Western Pacific Regional Office, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing.,National Health Commission Key Laboratory of Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing
| | - Dongyan Wang
- Regional Reference Poliomyelitis Laboratory, World Health Organization Western Pacific Regional Office, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing
| | - Shuangli Zhu
- Regional Reference Poliomyelitis Laboratory, World Health Organization Western Pacific Regional Office, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing
| | - Yong Zhang
- Regional Reference Poliomyelitis Laboratory, World Health Organization Western Pacific Regional Office, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing.,Xinjiang Uyghur Autonomous Region Center for Disease Control and Prevention, Urumqi, People's Republic of China
| | - Xiaolei Li
- Regional Reference Poliomyelitis Laboratory, World Health Organization Western Pacific Regional Office, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing
| | - Haishu Tang
- Xinjiang Uyghur Autonomous Region Center for Disease Control and Prevention, Urumqi, People's Republic of China
| | - Jing Guan
- National Health Commission Key Laboratory of Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing
| | - Wenbo Xu
- Regional Reference Poliomyelitis Laboratory, World Health Organization Western Pacific Regional Office, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing.,National Health Commission Key Laboratory of Medical Virology, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing
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Schleiff M, Olateju A, Decker E, Neel AH, Oke R, Peters MA, Rao A, Alonge O. A multi-pronged scoping review approach to understanding the evolving implementation of the Smallpox and Polio eradication programs: what can other Global Health initiatives learn? BMC Public Health 2020; 20:1698. [PMID: 33339517 PMCID: PMC7747000 DOI: 10.1186/s12889-020-09439-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 08/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous initiatives have aimed to document the history and legacy of the Smallpox Eradication Program (SEP) and the Global Polio Eradication Initiative (GPEI). In this multi-pronged scoping review, we explored the evolution and learning from SEP and GPEI implementation over time at global and country levels to inform other global health programs. METHODS Three related reviews of literature were conducted; we searched for documents on 1) the SEP and 2) GPEI via online database searches and also conducted global and national-level grey literature searches for documents related to the GPEI in seven purposively selected countries under the Synthesis and Translation of Research and Innovations from Polio Eradication (STRIPE) project. We included documents relevant to GPEI implementation. We conducted full text data analysis and captured data on Expert Recommendations for Implementing Change (ERIC) implementation strategies and principles, tools, outcomes, target audiences, and relevance to global health knowledge areas. RESULTS 200 articles were included in the SEP scoping review, 1885 articles in the GPEI scoping review, and 963 documents in the grey literature review. M&E and engagement strategies were consistently translated from the SEP to GPEI; these evolved into newer approaches under the GPEI. Management strategies including setting up robust record systems also carried forward from SEP to GPEI; however, lessons around the need for operational flexibility in applying these strategies at national and sub-national levels did not. Similarly, strategies and lessons around conducting health systems readiness assessments prior to implementation were not carried forward from SEP to GPEI. Differences in the planning and communication strategies between the two programs included fidelity to implementation blueprints appeared to be higher under SEP, and independent monitoring boards and communication and media strategies were more prominent under GPEI. CONCLUSIONS Linear learning did not always occur between SEP and GPEI; several lessons were lost and had to be re-learned. Implementation and adaptation of strategies in global health programs should be well codified, including information on the contextual, time and stakeholders' issues that elicit adaptations. Such description can improve the systematic translation of knowledge, and gains in efficiency and effectiveness of future global health programs.
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Affiliation(s)
- Meike Schleiff
- International Health Department, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA.
| | - Adetoun Olateju
- International Health Department, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | - Ellie Decker
- International Health Department, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | - Abigail H Neel
- International Health Department, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | - Rasheedat Oke
- International Health Department, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | - Michael A Peters
- International Health Department, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | - Aditi Rao
- International Health Department, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | - Olakunle Alonge
- International Health Department, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
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Din M, Ali H, Khan M, Waris A, Ullah S, Kashif M, Rahman S, Ali M. Impact of COVID-19 on polio vaccination in Pakistan: a concise overview. Rev Med Virol 2020; 31:e2190. [PMID: 33176028 DOI: 10.1002/rmv.2190] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 11/07/2022]
Abstract
The pandemic of coronavirus disease 2019 (COVID-19) has disrupted immunization programs around the globe, potentially increasing life-threatening vaccine-preventable diseases. Pakistan and Afghanistan are the only countries, which are still struggling to eradicate wild poliovirus. All vaccination campaigns in Pakistan were suspended in April due to the COVID-19 outbreak, leading 40 million children to miss out on polio vaccination. Like the climate crisis, the COVID-19 pandemic could be regarded as a child-rights crisis because it could have life-threatening impact over children, who need immunization, now and in the long-term. Delays in polio vaccination programs might not have immediate impact but, in the long-term, the increase in polio cases in Pakistan could result in the global export of infections. Therefore, healthcare authorities must intensify their efforts to track and vaccinate unvaccinated children in countries like Pakistan and Afghanistan. Polio vaccination campaigns need to resume immediately, so we suggest applying social distancing measures along with standard operating procedure to flatten the transmission curve of COVID-19. Furthermore, the concurrent emergence of cVDPV2 means that tOPV should temporarily be used for primary immunization. In the current review, we have discussed delays in polio vaccination, surveillance of polio viruses, reported cases in Pakistan along with recommendations to overcome interrupted immunization.
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Affiliation(s)
- Misbahud Din
- Department of Biotechnology, Quaid-i-Azam University Islamabad, Islamabad, Pakistan
| | - Hammad Ali
- Department of Biotechnology, Quaid-i-Azam University Islamabad, Islamabad, Pakistan
| | - Mudassir Khan
- Department of Healthcare Biotechnology, Atta-Ur-Rahman School of Applied Biosciences (ASAB), National University of Science and Technology (NUST), Islamabad, Pakistan
| | - Abdul Waris
- Department of Biotechnology, Quaid-i-Azam University Islamabad, Islamabad, Pakistan
| | - Sana Ullah
- Department of Biotechnology, Quaid-i-Azam University Islamabad, Islamabad, Pakistan
| | - Muhammad Kashif
- Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Sidra Rahman
- Department of Biotechnology, Quaid-i-Azam University Islamabad, Islamabad, Pakistan
| | - Muhammad Ali
- Department of Biotechnology, Quaid-i-Azam University Islamabad, Islamabad, Pakistan
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26
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Orel I, Graf H, Riou P. Decontamination efficacy of sodium hypochlorite solutions for poliovirus. Biologicals 2020; 67:75-80. [PMID: 32807609 DOI: 10.1016/j.biologicals.2020.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/24/2020] [Accepted: 07/26/2020] [Indexed: 12/01/2022] Open
Abstract
Effective decontamination procedures are critical to the successful manufacture and control of poliovirus vaccines to minimize the risk to personnel and the environment. Polio viruses have been reported to be more resistant to disinfectants than many other viruses. We assessed the efficacy of sodium hypochlorite-containing disinfectants for decontamination for three poliovirus serotypes to implement decontamination procedures that are fully compliant with the WHO GAP III and Health authorities' requirements. A 10.4 log reduction was observed with a 0.63% sodium hypochlorite solution in a suspension with high protein and high poliovirus concentrations diluted 10-fold compared with a 6 log reduction in an undiluted sample. Treatment efficacy increased with sodium hypochlorite content and decreased with sample protein content. The surface tests showed that two 1-min treatments, 5-min apart, with a 0.63% Chl sodium hypochlorite solution effectively reduced the concentration of all poliovirus serotypes by 10 log10, irrespective of the protein and virus concentration in the sample. Sodium hypochlorite solutions lower than 0.52% were less effective for complete inactivation of poliovirus. In conclusion, we demonstrated that a high level of virus reduction (>10 log10) can be achieved with sodium hypochlorite solutions with poliovirus in suspension and dried on surfaces.
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Affiliation(s)
- Isabelle Orel
- Sanofi Pasteur, 1541 Avenue Marcel Mérieux, 69280, Marcy l'Étoile, France.
| | - Hugues Graf
- Sanofi Pasteur, 1541 Avenue Marcel Mérieux, 69280, Marcy l'Étoile, France.
| | - Patrice Riou
- Sanofi Pasteur, 1541 Avenue Marcel Mérieux, 69280, Marcy l'Étoile, France.
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27
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Wells CR, Huppert A, Fitzpatrick MC, Pandey A, Velan B, Singer BH, Bauch CT, Galvani AP. Prosocial polio vaccination in Israel. Proc Natl Acad Sci U S A 2020; 117:13138-13144. [PMID: 32457142 PMCID: PMC7293608 DOI: 10.1073/pnas.1922746117] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Regions with insufficient vaccination have hindered worldwide poliomyelitis eradication, as they are vulnerable to sporadic outbreaks through reintroduction of the disease. Despite Israel's having been declared polio-free in 1988, a routine sewage surveillance program detected polio in 2013. To curtail transmission, the Israel Ministry of Health launched a vaccine campaign to vaccinate children-who had only received the inactivated polio vaccine-with the oral polio vaccine (OPV). Determining the degree of prosocial motivation in vaccination behavior is challenging because vaccination typically provides direct benefits to the individual as well as indirect benefits to the community by curtailing transmission. However, the Israel OPV campaign provides a unique and excellent opportunity to quantify and model prosocial vaccination as its primary objective was to avert transmission. Using primary survey data and a game-theoretical model, we examine and quantify prosocial behavior during the OPV campaign. We found that the observed vaccination behavior in the Israeli OPV campaign is attributable to prosocial behavior and heterogeneous perceived risk of paralysis based on the individual's comprehension of the prosocial nature of the campaign. We also found that the benefit of increasing comprehension of the prosocial nature of the campaign would be limited if even 24% of the population acts primarily from self-interest, as greater vaccination coverage provides no personal utility to them. Our results suggest that to improve coverage, communication efforts should also focus on alleviating perceived fears surrounding the vaccine.
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Affiliation(s)
- Chad R Wells
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT 06520
| | - Amit Huppert
- The Biostatistics & Biomathematics Unit, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, 52621 Ramat Gan, Israel
- School of Public Health, The Sackler Faculty of Medicine, Tel-Aviv University, 69978 Tel Aviv, Israel
| | - Meagan C Fitzpatrick
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT 06520
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD 21201
| | - Abhishek Pandey
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT 06520
| | - Baruch Velan
- The Biostatistics & Biomathematics Unit, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, 52621 Ramat Gan, Israel
| | - Burton H Singer
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610;
| | - Chris T Bauch
- Department of Applied Mathematics, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Alison P Galvani
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT 06520
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Chaudhry A, Javed N, Muhsan Wattoo M. Assessment of risk factors associated with oral polio vaccine refusal in Rahim Yar Khan District, Pakistan (2017). JOURNAL OF BIOSAFETY AND BIOSECURITY 2020. [DOI: 10.1016/j.jobb.2020.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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29
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New PW. A Narrative Review of Pediatric Nontraumatic Spinal Cord Dysfunction. Top Spinal Cord Inj Rehabil 2019; 25:112-120. [PMID: 31068743 DOI: 10.1310/sci2502-112] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This article provides a narrative review of seven key issues relevant to pediatric onset of spinal cord damage not due to trauma, or spinal cord dysfunction (SCDys). The first topic discussed is terminology issues. There is no internationally accepted term for spinal cord damage not due to trauma. The implications of this terminology issue and an approach to addressing this are discussed. Second, a brief history of SCDys is presented, focusing on conditions relevant to pediatrics. Third, the classification of SCDys is outlined, based on the International Spinal Cord Injury Data Sets for Non-Traumatic Spinal Cord Injury. Following this, a summary is given of the epidemiology of pediatric SCDys, primarily focused on the incidence, prevalence, and etiology, with a comparison to traumatic spinal cord injury. Next, important clinical rehabilitation principles unique to children with SCDys are highlighted. Then important prevention opportunities for SCDys in children are discussed. Finally, trends, challenges, and opportunities regarding research in SCDys are mentioned.
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Affiliation(s)
- Peter Wayne New
- Spinal Rehabilitation Service, Department of Rehabilitation, Caulfield Hospital, Alfred Health, Victoria, Australia.,Epworth-Monash Rehabilitation Medicine Unit, Monash University, Melbourne, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Victoria, Australia
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30
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Portnoy A, Campos NG, Sy S, Burger EA, Cohen J, Regan C, Kim JJ. Impact and Cost-Effectiveness of Human Papillomavirus Vaccination Campaigns. Cancer Epidemiol Biomarkers Prev 2019; 29:22-30. [DOI: 10.1158/1055-9965.epi-19-0767] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/13/2019] [Accepted: 10/23/2019] [Indexed: 11/16/2022] Open
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Awale J, Choudhary M, Solomon R, Chaturvedi A. Effective Partnership Mechanisms: A Legacy of the Polio Eradication Initiative in India and Their Potential for Addressing Other Public Health Priorities. Am J Trop Med Hyg 2019; 101:21-32. [PMID: 31760982 PMCID: PMC6776101 DOI: 10.4269/ajtmh.18-0938] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 06/25/2019] [Indexed: 11/18/2022] Open
Abstract
While many factors contributed to the successful elimination of polio from India, partnership and coordination mechanisms at multiple levels that have evolved over the years have been an important element. The lessons learned from these partnership and coordination mechanisms among various stakeholders involved in service delivery, surveillance, community mobilization, and governance deserve documentation as a legacy of the program. This article discusses the various processes and techniques adopted to build strong partnerships and coordination mechanisms among stakeholders by optimizing their strengths and using opportunities that lead toward the eradication of polio from India. Secondary data and literature review of relevant reports, papers and documents were adopted as the methodology for developing this research article. The article provides a model conceptual framework for partnerships and applies that framework to the CORE Group Polio Project (CGPP) partnerships in India and the partnerships among stakeholders for polio eradication in India. The learnings and expertise of the CGPP in developing, managing, and nurturing partnerships can be adapted and replicated for elimination or controlling other diseases (especially those that are vaccine-preventable as well as tuberculosis and vector-borne diseases) and for ending preventable child and maternal deaths.
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32
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Abdelnabi R, Geraets JA, Ma Y, Mirabelli C, Flatt JW, Domanska A, Delang L, Jochmans D, Kumar TA, Jayaprakash V, Sinha BN, Leyssen P, Butcher SJ, Neyts J. A novel druggable interprotomer pocket in the capsid of rhino- and enteroviruses. PLoS Biol 2019; 17:e3000281. [PMID: 31185007 PMCID: PMC6559632 DOI: 10.1371/journal.pbio.3000281] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 05/08/2019] [Indexed: 12/22/2022] Open
Abstract
Rhino- and enteroviruses are important human pathogens, against which no antivirals are available. The best-studied inhibitors are "capsid binders" that fit in a hydrophobic pocket of the viral capsid. Employing a new class of entero-/rhinovirus inhibitors and by means of cryo-electron microscopy (EM), followed by resistance selection and reverse genetics, we discovered a hitherto unknown druggable pocket that is formed by viral proteins VP1 and VP3 and that is conserved across entero-/rhinovirus species. We propose that these inhibitors stabilize a key region of the virion, thereby preventing the conformational expansion needed for viral RNA release. A medicinal chemistry effort resulted in the identification of analogues targeting this pocket with broad-spectrum activity against Coxsackieviruses B (CVBs) and compounds with activity against enteroviruses (EV) of groups C and D, and even rhinoviruses (RV). Our findings provide novel insights in the biology of the entry of entero-/rhinoviruses and open new avenues for the design of broad-spectrum antivirals against these pathogens.
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Affiliation(s)
- Rana Abdelnabi
- Department of Microbiology and Immunology, Rega Institute for Medical Research, Laboratory of Virology and Chemotherapy, KU Leuven, Leuven, Belgium
| | - James A. Geraets
- Faculty of Biological and Environmental Sciences, Molecular and Integrative Bioscience Research Programme, University of Helsinki, Helsinki, Finland
- Helsinki Institute of Life Sciences, Institute of Biotechnology, University of Helsinki, Helsinki, Finland
| | - Yipeng Ma
- Department of Microbiology and Immunology, Rega Institute for Medical Research, Laboratory of Virology and Chemotherapy, KU Leuven, Leuven, Belgium
| | - Carmen Mirabelli
- Department of Microbiology and Immunology, Rega Institute for Medical Research, Laboratory of Virology and Chemotherapy, KU Leuven, Leuven, Belgium
| | - Justin W. Flatt
- Faculty of Biological and Environmental Sciences, Molecular and Integrative Bioscience Research Programme, University of Helsinki, Helsinki, Finland
- Helsinki Institute of Life Sciences, Institute of Biotechnology, University of Helsinki, Helsinki, Finland
| | - Aušra Domanska
- Faculty of Biological and Environmental Sciences, Molecular and Integrative Bioscience Research Programme, University of Helsinki, Helsinki, Finland
- Helsinki Institute of Life Sciences, Institute of Biotechnology, University of Helsinki, Helsinki, Finland
| | - Leen Delang
- Department of Microbiology and Immunology, Rega Institute for Medical Research, Laboratory of Virology and Chemotherapy, KU Leuven, Leuven, Belgium
| | - Dirk Jochmans
- Department of Microbiology and Immunology, Rega Institute for Medical Research, Laboratory of Virology and Chemotherapy, KU Leuven, Leuven, Belgium
| | - Timiri Ajay Kumar
- Department of Pharmaceutical Sciences & Technology, Birla Institute of Technology, Mesra, Ranchi, Jharkhand, India
| | - Venkatesan Jayaprakash
- Department of Pharmaceutical Sciences & Technology, Birla Institute of Technology, Mesra, Ranchi, Jharkhand, India
| | - Barij Nayan Sinha
- Department of Pharmaceutical Sciences & Technology, Birla Institute of Technology, Mesra, Ranchi, Jharkhand, India
| | - Pieter Leyssen
- Department of Microbiology and Immunology, Rega Institute for Medical Research, Laboratory of Virology and Chemotherapy, KU Leuven, Leuven, Belgium
| | - Sarah J. Butcher
- Faculty of Biological and Environmental Sciences, Molecular and Integrative Bioscience Research Programme, University of Helsinki, Helsinki, Finland
- Helsinki Institute of Life Sciences, Institute of Biotechnology, University of Helsinki, Helsinki, Finland
- * E-mail: (JN); (SJB)
| | - Johan Neyts
- Department of Microbiology and Immunology, Rega Institute for Medical Research, Laboratory of Virology and Chemotherapy, KU Leuven, Leuven, Belgium
- * E-mail: (JN); (SJB)
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Polio endgame: Lessons for the global rotavirus vaccination program. Vaccine 2019; 37:3040-3049. [DOI: 10.1016/j.vaccine.2019.04.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 04/02/2019] [Accepted: 04/08/2019] [Indexed: 12/19/2022]
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34
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After polio: Imagining, planning, and delivering a world beyond eradication. Health Place 2018; 54:29-36. [DOI: 10.1016/j.healthplace.2018.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 08/29/2018] [Accepted: 09/10/2018] [Indexed: 11/21/2022]
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35
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McKay VR, Morshed AB, Brownson RC, Proctor EK, Prusaczyk B. Letting Go: Conceptualizing Intervention De-implementation in Public Health and Social Service Settings. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2018; 62:189-202. [PMID: 29971792 PMCID: PMC6175194 DOI: 10.1002/ajcp.12258] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The discontinuation of interventions that should be stopped, or de-implementation, has emerged as a novel line of inquiry within dissemination and implementation science. As this area grows in human services research, like public health and social work, theory is needed to help guide scientific endeavors. Given the infancy of de-implementation, this conceptual narrative provides a definition and criteria for determining if an intervention should be de-implemented. We identify three criteria for identifying interventions appropriate for de-implementation: (a) interventions that are not effective or harmful, (b) interventions that are not the most effective or efficient to provide, and (c) interventions that are no longer necessary. Detailed, well-documented examples illustrate each of the criteria. We describe de-implementation frameworks, but also demonstrate how other existing implementation frameworks might be applied to de-implementation research as a supplement. Finally, we conclude with a discussion of de-implementation in the context of other stages of implementation, like sustainability and adoption; next steps for de-implementation research, especially identifying interventions appropriate for de-implementation in a systematic manner; and highlight special ethical considerations to advance the field of de-implementation research.
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Affiliation(s)
- Virginia R. McKay
- Center for Public Health Systems ScienceBrown SchoolWashington University in St. LouisSt. LouisMOUSA
- Institute of Clinical and Translational ScienceWashington University School of Medicine in St. LouisSt. LouisMOUSA
| | - Alexandra B. Morshed
- Prevention Research Center in St. LouisBrown SchoolWashington University in St. LouisSt. LouisMOUSA
| | - Ross C. Brownson
- Prevention Research Center in St. LouisBrown SchoolWashington University in St. LouisSt. LouisMOUSA
- Department of Surgery (Division of Public Health Sciences) and Alvin J. Siteman Cancer CenterWashington University School of MedicineWashington University in St. LouisSt. LouisMOUSA
| | - Enola K. Proctor
- Institute of Clinical and Translational ScienceWashington University School of Medicine in St. LouisSt. LouisMOUSA
- Center for Mental Health Services ResearchGeorge Warren Brown School of Social WorkWashington University in St. LouisSt. LouisMOUSA
- Institute for Public HealthWashington University in St. LouisSt. LouisMOUSA
| | - Beth Prusaczyk
- Department of MedicineVanderbilt University Medical CenterNashvilleTNUSA
- Center for Clinical Quality and Implementation ResearchVanderbilt University Medical CenterNashvilleTNUSA
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Mbaeyi C, Mohamed A, Owino BO, Mengistu KF, Ehrhardt D, Elsayed EA. Strengthening Acute Flaccid Paralysis Surveillance Through the Village Polio Volunteers Program in Somalia. Clin Infect Dis 2018; 67:941-946. [PMID: 29509835 DOI: 10.1093/cid/ciy180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 03/01/2018] [Indexed: 11/14/2022] Open
Abstract
Background Surveillance for cases of acute flaccid paralysis (AFP) is a key strategy adopted for the eradication of polio. Detection of poliovirus circulation is often predicated on the ability to identify AFP cases and test their stool specimens for poliovirus infection in a timely manner. The Village Polio Volunteers (VPV) program was established in 2013 in a bid to strengthen polio eradication activities in Somalia, including AFP surveillance, given the country's vulnerability to polio outbreaks. Methods To assess the impact of the VPV program on AFP surveillance, we determined case counts, case-reporting sources, and nonpolio AFP rates in the years before and after program introduction (ie, 2011-2016). We also compared the stool specimen adequacy rates and timeliness of cases reported by VPVs to those reported by other sources. Results In the years after program introduction, VPVs accounted for a high proportion of AFP cases reported in Somalia. AFP case counts rose from 148 cases in 2012, the year before program introduction, to 279 cases in 2015, when VPVs accounted for 40% of reported cases. Further, from 2012 to 2015, the nonpolio AFP rate improved from 2.8 to 4.8 cases per 100000 persons aged <15 years. Stool specimen adequacy rates have been consistently high, and AFP cases have been detected in a timelier manner since the program was introduced. Conclusions Given the impact of the VPV program on improving AFP surveillance indicators in Somalia, similar community-based programs could play a crucial role in enhancing surveillance activities in countries with limited healthcare infrastructure.
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Affiliation(s)
- Chukwuma Mbaeyi
- US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Abdinoor Mohamed
- World Health Organization Liaison Office for Somalia, Nairobi, Kenya
| | - Brian Ogola Owino
- World Health Organization Liaison Office for Somalia, Nairobi, Kenya
| | | | - Derek Ehrhardt
- US Centers for Disease Control and Prevention, Atlanta, Georgia
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Liang F, Guan P, Wu W, Liu J, Zhang N, Zhou BS, Huang DS. A review of documents prepared by international organizations about influenza pandemics, including the 2009 pandemic: a bibliometric analysis. BMC Infect Dis 2018; 18:383. [PMID: 30089459 PMCID: PMC6083574 DOI: 10.1186/s12879-018-3286-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 07/31/2018] [Indexed: 11/19/2022] Open
Abstract
Background World Health Organization (WHO), the World Bank, UN System Influenza Coordination (UNSIC) and other international organizations released a series of documents to fight against the influenza pandemic. Those documents have great significance on guiding influenza pandemic preparedness and responses and providing a multilevel, multi-directional influenza pandemic prevention and control network for their member countries. This study focuses on the above-mentioned influenza pandemic preparedness guidelines with the aim of exploring the roles of the society, defining the relationship of different interventions and evaluating the planning on influenza pandemic preparedness. Methods Documents about pandemic influenza preparedness were retrieved from the official websites of the following three international organizations, World Health Organization (WHO), the World Bank, UN System Influenza Coordination (UNSIC) with the key words ‘pandemic’, ‘influenza’ and the Boolean combinations of these words as the retrieval strategy. Guidelines, research study and meeting reports were included in the study. The categories of the ministries/departments involved and their roles/responsibilities in pandemic influenza preparedness were summarized. Word frequency of selected vocabularies about pandemic influenza preventive measures were collected from the documents and the correlations between the word frequency of these measures were analyzed. Ochiai coefficient was employed to show the correlation between the word vocabularies. Results A total of 38 records on the topic of pandemic influenza preparedness were included. The responsibilities of the whole-of-society mentioned in the international organizations’ documents varied across the 2009 influenza pandemic period. Meanwhile, it had been emphasized that a comprehensive influenza prevention and control plan in every sector should be developed and evaluated. Because various measures were emphasized in the guidelines after 2009 pandemic influenza, the correlations between the word frequencies of the various influenza preventive measures became stronger after the pandemic influenza. Conclusions Responsibilities of ministries of education, ministries of energy, ministries of agriculture and animal health, ministries of communication and the business sector in the pandemic influenza preparedness were described more comprehensively in the international organizations’ documents in 2017. Better understanding the variations of the guidelines delivered by international organizations would be useful for the member countries to strengthen their influenza control network. Electronic supplementary material The online version of this article (10.1186/s12879-018-3286-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Feng Liang
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Peng Guan
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Wei Wu
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Jing Liu
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Ning Zhang
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Bao-Sen Zhou
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, 110122, China
| | - De-Sheng Huang
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, 110122, China. .,Department of Mathematics, School of Fundamental Sciences, China Medical University, Shenyang, 110122, China.
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Tao Y, Shea K, Ferrari M. Logistical constraints lead to an intermediate optimum in outbreak response vaccination. PLoS Comput Biol 2018; 14:e1006161. [PMID: 29791432 PMCID: PMC5988332 DOI: 10.1371/journal.pcbi.1006161] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 06/05/2018] [Accepted: 04/30/2018] [Indexed: 11/18/2022] Open
Abstract
Dynamic models in disease ecology have historically evaluated vaccination strategies under the assumption that they are implemented homogeneously in space and time. However, this approach fails to formally account for operational and logistical constraints inherent in the distribution of vaccination to the population at risk. Thus, feedback between the dynamic processes of vaccine distribution and transmission might be overlooked. Here, we present a spatially explicit, stochastic Susceptible-Infected-Recovered-Vaccinated model that highlights the density-dependence and spatial constraints of various diffusive strategies of vaccination during an outbreak. The model integrates an agent-based process of disease spread with a partial differential process of vaccination deployment. We characterize the vaccination response in terms of a diffusion rate that describes the distribution of vaccination to the population at risk from a central location. This generates an explicit trade-off between slow diffusion, which concentrates effort near the central location, and fast diffusion, which spreads a fixed vaccination effort thinly over a large area. We use stochastic simulation to identify the optimum vaccination diffusion rate as a function of population density, interaction scale, transmissibility, and vaccine intensity. Our results show that, conditional on a timely response, the optimal strategy for minimizing outbreak size is to distribute vaccination resource at an intermediate rate: fast enough to outpace the epidemic, but slow enough to achieve local herd immunity. If the response is delayed, however, the optimal strategy for minimizing outbreak size changes to a rapidly diffusive distribution of vaccination effort. The latter may also result in significantly larger outbreaks, thus suggesting a benefit of allocating resources to timely outbreak detection and response. It has long been recognized that an epidemic of infectious disease can be prevented if a sufficient proportion of the susceptible population is vaccinated in advance. This logic also holds for vaccine-based outbreak response to stop an outbreak of a novel, or re-emerging pathogen, but with an important caveat. If vaccination is used in response to an outbreak, then it will necessarily take time to achieve the required level of vaccination coverage, during which time the outbreak may continue to spread. Thus, one must consider the logistical and operational constraints of vaccine distribution to assess the ability of outbreak response vaccination to slow or stop an advancing epidemic. We develop a simple mathematical framework for representing vaccine distribution in response to an epidemic and solve for the optimal distribution strategy under realistic constraints of total vaccination effort. Focused deployment near the outbreak epicenter concentrates resources in the area most in need, but may allow the outbreak to spread outside of the response zone. Broad deployment over the whole population may spread vaccination resources too thin, creating shortages and delays at the local scale that fail to prevent the advancing epidemic. Thus we found that, in general, the best strategy is an intermediate optimum that deploys vaccine neither too slow to prevent escape from the outbreak epicenter, nor too fast to spread resources too thin. The specific optimum rate for any given outbreak depends on the infectiousness of the pathogen, the population density, the range of contacts amongst individuals, the timeliness of the response, and the vaccine intensity. This insight only emerges from linking an epidemic model with a realistic model of outbreak response and highlights the need for further work to merge operations research with epidemic models to develop operationally relevant response strategies.
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Affiliation(s)
- Yun Tao
- Department of Biology and The Center for Infectious Disease Dynamics, The Pennsylvania State University, University Park, Pennsylvania, United States of America
- * E-mail:
| | - Katriona Shea
- Department of Biology and The Center for Infectious Disease Dynamics, The Pennsylvania State University, University Park, Pennsylvania, United States of America
| | - Matthew Ferrari
- Department of Biology and The Center for Infectious Disease Dynamics, The Pennsylvania State University, University Park, Pennsylvania, United States of America
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Goodson JL, Alexander JP, Linkins RW, Orenstein WA. Measles and rubella elimination: learning from polio eradication and moving forward with a diagonal approach. Expert Rev Vaccines 2017; 16:1203-1216. [PMID: 29037086 PMCID: PMC6477920 DOI: 10.1080/14760584.2017.1393337] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION In 1988, an estimated 350,000 children were paralyzed by polio and 125 countries reported polio cases, the World Health Assembly passed a resolution to achieve polio eradication by 2000, and the Global Polio Eradication Initiative (GPEI) was established as a partnership focused on eradication. Today, following eradication efforts, polio cases have decreased >99% and eradication of all three types of wild polioviruses is approaching. However, since polio resources substantially support disease surveillance and other health programs, losing polio assets could reverse progress toward achieving Global Vaccine Action Plan goals. Areas covered: As the end of polio approaches and GPEI funds and capacity decrease, we document knowledge, experience, and lessons learned from 30 years of polio eradication. Expert commentary: Transitioning polio assets to measles and rubella (MR) elimination efforts would accelerate progress toward global vaccination coverage and equity. MR elimination feasibility and benefits have long been established. Focusing efforts on MR elimination after achieving polio eradication would make a permanent impact on reducing child mortality but should be done through a 'diagonal approach' of using measles disease transmission to identify areas possibly susceptible to other vaccine-preventable diseases and to strengthen the overall immunization and health systems to achieve disease-specific goals.
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Affiliation(s)
- James L. Goodson
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - James P. Alexander
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Robert W. Linkins
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Walter A. Orenstein
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
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SteelFisher GK, Blendon RJ, Guirguis S, Lodge W, Caporello H, Petit V, Coleman M, Williams MR, Parwiz SM, Corkum M, Gardner S, Ben-Porath EN. Understanding threats to polio vaccine commitment among caregivers in high-priority areas of Afghanistan: a polling study. THE LANCET. INFECTIOUS DISEASES 2017; 17:1172-1179. [DOI: 10.1016/s1473-3099(17)30397-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 05/25/2017] [Accepted: 06/15/2017] [Indexed: 11/29/2022]
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Ozawa S, Wonodi C, Babalola O, Ismail T, Bridges J. Using best-worst scaling to rank factors affecting vaccination demand in northern Nigeria. Vaccine 2017; 35:6429-6437. [PMID: 29037575 DOI: 10.1016/j.vaccine.2017.09.079] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 08/25/2017] [Accepted: 09/26/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Understanding and ranking the reasons for low vaccination uptake among parents in northern Nigeria is critical to implement effective policies to save lives and prevent illnesses. This study applies best-worst scaling (BWS) to rank various factors affecting parents' demand for routine childhood immunization. METHODS We conducted a household survey in Nahuche, Zamfara State in northern Nigeria. Nearly two hundred parents with children under age five were asked about their views on 16 factors using a BWS technique. These factors focused on known attributes that influence the demand for childhood immunization, which were identified from a literature review and reviewed by a local advisory board. The survey systematically presented parents with subsets of six factors and asked them to choose which they think are the most and least important in decisions to vaccinate children. We used a sequential best-worst analysis with conditional logistic regression to rank factors. RESULTS The perception that vaccinating a child makes one a good parent was the most important motivation for parents in northern Nigeria to vaccinate children. Statements related to trust and social norms were ranked higher in importance compared to those that highlighted perceived benefits and risks, healthcare service, vaccine information, or opportunity costs. Fathers ranked trust in the media and views of their leaders to be of greatest importance, whereas mothers placed greater importance on social perceptions and norms. Parents of children without routine immunization ranked their trust in local leaders about vaccines higher in considerations, and the media's views lower, compared to parents with children who received routine immunization. CONCLUSIONS Framing immunization messages in the context of good parenting and hearing these messages from trusted information sources may motivate parental uptake of childhood vaccines. These results are useful to policymakers to prioritize resources in order to increase awareness and demand for childhood immunization.
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Affiliation(s)
- Sachiko Ozawa
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Maternal and Child Health, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Chizoba Wonodi
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Olufemi Babalola
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Tukur Ismail
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - John Bridges
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Nnadi C, Etsano A, Uba B, Ohuabunwo C, Melton M, Wa Nganda G, Esapa L, Bolu O, Mahoney F, Vertefeuille J, Wiesen E, Durry E. Approaches to Vaccination Among Populations in Areas of Conflict. J Infect Dis 2017; 216:S368-S372. [PMID: 28838202 PMCID: PMC5754212 DOI: 10.1093/infdis/jix175] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Vaccination is an important and cost-effective disease prevention and control strategy. Despite progress in vaccine development and immunization delivery systems worldwide, populations in areas of conflict (hereafter, “conflict settings”) often have limited or no access to lifesaving vaccines, leaving them at increased risk for morbidity and mortality related to vaccine-preventable disease. Without developing and refining approaches to reach and vaccinate children and other vulnerable populations in conflict settings, outbreaks of vaccine-preventable disease in these settings may persist and spread across subnational and international borders. Understanding and refining current approaches to vaccinating populations in conflict and humanitarian emergency settings may save lives. Despite major setbacks, the Global Polio Eradication Initiative has made substantial progress in vaccinating millions of children worldwide, including those living in communities affected by conflicts and other humanitarian emergencies. In this article, we examine key strategic and operational tactics that have led to increased polio vaccination coverage among populations living in diverse conflict settings, including Nigeria, Somalia, and Pakistan, and how these could be applied to reach and vaccinate populations in other settings across the world.
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Affiliation(s)
- Chimeremma Nnadi
- Global Immunization Division, Centers for Disease Prevention and Control, Atlanta, Georgia
| | - Andrew Etsano
- Nigeria Polio Emergency Operations Center, National Primary Health Care Development Agency
| | - Belinda Uba
- National Stop Transmission of Polio Program, Africa Field Epidemiology and Training Network Nigeria Country Office, Abuja, Nigeria
| | - Chima Ohuabunwo
- Global Immunization Division, Centers for Disease Prevention and Control, Atlanta, Georgia
| | - Musa Melton
- National Stop Transmission of Polio Program, Africa Field Epidemiology and Training Network Nigeria Country Office, Abuja, Nigeria
| | - Gatei Wa Nganda
- Global Immunization Division, Centers for Disease Prevention and Control, Atlanta, Georgia
| | - Lisa Esapa
- Global Immunization Division, Centers for Disease Prevention and Control, Atlanta, Georgia
| | - Omotayo Bolu
- Global Immunization Division, Centers for Disease Prevention and Control, Atlanta, Georgia
| | - Frank Mahoney
- Global Immunization Division, Centers for Disease Prevention and Control, Atlanta, Georgia
| | - John Vertefeuille
- Global Immunization Division, Centers for Disease Prevention and Control, Atlanta, Georgia
| | - Eric Wiesen
- Global Immunization Division, Centers for Disease Prevention and Control, Atlanta, Georgia
| | - Elias Durry
- Global Immunization Division, Centers for Disease Prevention and Control, Atlanta, Georgia
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Garon J, Patel M. The polio endgame: rationale behind the change in immunisation. Arch Dis Child 2017; 102:362-365. [PMID: 28096107 DOI: 10.1136/archdischild-2016-311171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 12/21/2016] [Accepted: 12/26/2016] [Indexed: 11/03/2022]
Abstract
The decades long effort to eradicate polio is nearing the final stages and oral polio vaccine (OPV) is much to thank for this success. As cases of wild poliovirus continue to dwindle, cases of paralysis associated with OPV itself have become a concern. As type-2 poliovirus (one of three) has been certified eradicated and a large proportion of OPV-related paralysis is caused by the type-2 component of OPV, the World Health Assembly endorsed the phased withdrawal of OPV and the introduction of inactivated polio vaccine (IPV) into routine immunisation schedules as a crucial step in the polio endgame plan. The rapid pace of IPV scale-up and uptake required adequate supply, planning, advocacy, training and operational readiness. Similarly, the synchronised switch from trivalent OPV (all three types) to bivalent OPV (types 1 and 3) involved an unprecedented level of global coordination and country commitment. The important shift in vaccination policy seen through global IPV introduction and OPV withdrawal represents an historical milestone reached in the polio eradication effort.
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Affiliation(s)
- Julie Garon
- Department of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Manish Patel
- Center for Vaccine Equity, Task Force for Global Health, Decatur, Georgia, USA
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Basharat S, Shaikh BT. Polio immunization in Pakistan: ethical issues and challenges. Public Health Rev 2017; 38:6. [PMID: 29450078 PMCID: PMC5809887 DOI: 10.1186/s40985-017-0049-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 01/18/2017] [Indexed: 11/10/2022] Open
Abstract
Background Immunization should be considered a basic human right to health and well-being. It is everybody's business, and it is everybody's responsibility: the individual, the community, the health system and the state. This paper attempts to review some of the literature that highlights the ethical and religious concerns surrounding polio vaccination and what approaches may be used to counter the problems faced in Pakistan. Methods This paper is developed through a literature review on public health and polio in Pakistan, consulting local, regional and globally published peer reviewed articles focussing on religion, culture, ethics and public health. Discussion Human behaviour, including the utilization and acceptability of healthcare services, is greatly influenced by religious beliefs and dogmas. Immunization, specifically for the purpose of polio eradication, has been a topic under focus and in the news in Pakistan. The government is doing its best through a variety of interventions to increase access, inform the public and increase vaccination rates. Nevertheless, the country still faces a huge challenge from certain stern pockets of uncompromising populations who resist and refuse vaccination. Beliefs, practices and cultural norms overshadow public health priorities and ethics. Understanding of the context, therefore, is critical to determine the social hindrances in polio eradication and strategize thereon. Conclusion Having programmatic, system-wide, socio-cultural and of course ethical dimensions, the policy makers and the programme managers in Pakistan must attempt to address the multitude of challenges to polio vaccination, whereby the plan of action developed within the ethical norms could potentially lead to an ultimate success.
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Affiliation(s)
- Sarah Basharat
- Health Systems and Policy Department, Health Services Academy, Chak Shahzad, Park Road, Islamabad, 44000 Pakistan
| | - Babar Tasneem Shaikh
- Health Systems and Policy Department, Health Services Academy, Chak Shahzad, Park Road, Islamabad, 44000 Pakistan
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New PW, Biering-Sørensen F. Review of the History of Non-traumatic Spinal Cord Dysfunction. Top Spinal Cord Inj Rehabil 2017; 23:285-298. [PMID: 29339905 PMCID: PMC5667426 DOI: 10.1310/sci2304-285] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background: The incidence of non-traumatic spinal cord dysfunction (SCDys) is reported to be higher than traumatic spinal cord injury (SCI) in many countries. No formal review of the history of SCDys has been published. Objective: This article aims to identify key highlights in the history of SCDys. Method: An electronic literature search was conducted (January 2017) using MEDLINE (1946-2016) and Embase (1974-2016) databases for publications regarding the history of SCDys. Publications on the history of SCI and a selection of neurology textbooks and books on the history of neurology were reviewed for potentially relevant references. The focus of the literature search was on identifying publications that detail key highlights regarding the history of the diagnosis and management of the most common SCDys conditions, as well as those of historical significance. Results: The electronic search of MEDLINE and Embase identified 11 relevant publications. The majority of publications included were identified from the authors' libraries and a selection of books on neurology and the history of neurology. Conclusions: This review outlines the history of SCDys, taking a broader historical perspective and covering the increasing awareness of the role of the spinal cord and knowledge of neuroanatomy. Key milestones in the history of the diagnosis and management of the most common SCDys conditions are presented. An appreciation of the history of SCDys increases our understanding of the large number of people who contributed to our current knowledge of these conditions and in some situations helps guide efforts regarding prevention of SCDys.
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Affiliation(s)
- Peter Wayne New
- Spinal Rehabilitation Service, Department of Rehabilitation, Caulfield Hospital, Alfred Health, Caulfield, Victoria, Australia
- Epworth-Monash Rehabilitation Medicine Unit, Southern Medical School, Monash University, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, Monash University, Victoria, Australia
| | - Fin Biering-Sørensen
- Clinic for Spinal Cord Injuries, Neuroscience Center, Rigshospitalet, University of Copenhagen, Denmark
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Hussain SF, Boyle P, Patel P, Sullivan R. Eradicating polio in Pakistan: an analysis of the challenges and solutions to this security and health issue. Global Health 2016; 12:63. [PMID: 27729081 PMCID: PMC5059991 DOI: 10.1186/s12992-016-0195-3] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 09/08/2016] [Indexed: 11/23/2022] Open
Abstract
Since the launch of the Global Polio Eradication Initiative (GPEI) in 1988 the global incidence of poliomyelitis has fallen by nearly 99 %. From a situation where wild type poliovirus was endemic in 125 countries across five continents, transmission is now limited to regions of just three countries – Pakistan, Afghanistan and Nigeria. A sharp increase in Pakistan’s poliomyelitis cases in 2014 prompted the International Health Regulations Emergency Committee to declare the situation a ‘public health emergency of international concern’. Global polio eradication hinges on Pakistan’s ability to address the religious, political and socioeconomic barriers to immunisation; including discrepancies in vaccine coverage, a poor health infrastructure, and conflict in polio-endemic regions of the country. This analysis provides an overview of the GPEI, focusing on the historical and contemporary challenges facing Pakistan’s polio eradication programme and the impact of conflict and insecurity, and sheds light on strategies to combat vaccine hesitancy, engage local communities and build on recent progress towards polio eradication in Pakistan.
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Affiliation(s)
- Shoaib Fahad Hussain
- Conflict and Health Research Group, King's Centre for Global Health, King's College London, Suite 2.13 Weston Education Centre, Cutcombe Road, London, SE5 9RJ, UK.
| | - Peter Boyle
- International Prevention Research Institute, Lyon, France.,University of Strathclyde Institute of Global Public Health @iPRI, Lyon, France
| | - Preeti Patel
- Department of War Studies and Conflict and Health Research Group, King's College London, London, UK
| | - Richard Sullivan
- Conflict and Health Research Group, King's Centre for Global Health, King's College London, Suite 2.13 Weston Education Centre, Cutcombe Road, London, SE5 9RJ, UK
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Elimination of visceral leishmaniasis on the Indian subcontinent. THE LANCET. INFECTIOUS DISEASES 2016; 16:e304-e309. [PMID: 27692643 DOI: 10.1016/s1473-3099(16)30140-2] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 04/26/2016] [Accepted: 05/25/2016] [Indexed: 01/08/2023]
Abstract
Visceral leishmaniasis is a serious public health problem on the Indian subcontinent, causing high morbidity and mortality. The governments in the region launched a visceral leishmaniasis elimination initiative in 2005. We review knowledge gaps and research priorities. Key challenges include low coverage of health services for those most at risk, drug resistance, the absence of a vaccine, and the complex biology of the sandfly-human host transmission cycle. Vector control is an essential component, but innovation in this field is insufficient. Substantial progress has been made in the area of diagnostic, therapeutic, and vaccine development, but there are still many hurdles to overcome. For visceral leishmaniasis elimination to become a reality, effective deployment of these existing and new tools is essential. A strong commitment at community level is imperative, and appropriate diagnostic and treatment services as well as effective epidemiological surveillance need to be ensured.
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Wen AM, Steinmetz NF. Design of virus-based nanomaterials for medicine, biotechnology, and energy. Chem Soc Rev 2016; 45:4074-126. [PMID: 27152673 PMCID: PMC5068136 DOI: 10.1039/c5cs00287g] [Citation(s) in RCA: 246] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This review provides an overview of recent developments in "chemical virology." Viruses, as materials, provide unique nanoscale scaffolds that have relevance in chemical biology and nanotechnology, with diverse areas of applications. Some fundamental advantages of viruses, compared to synthetically programmed materials, include the highly precise spatial arrangement of their subunits into a diverse array of shapes and sizes and many available avenues for easy and reproducible modification. Here, we will first survey the broad distribution of viruses and various methods for producing virus-based nanoparticles, as well as engineering principles used to impart new functionalities. We will then examine the broad range of applications and implications of virus-based materials, focusing on the medical, biotechnology, and energy sectors. We anticipate that this field will continue to evolve and grow, with exciting new possibilities stemming from advancements in the rational design of virus-based nanomaterials.
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Affiliation(s)
- Amy M Wen
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA.
| | - Nicole F Steinmetz
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA. and Department of Radiology, Case Western Reserve University, Cleveland, OH 44106, USA and Department of Materials Science and Engineering, Case Western Reserve University, Cleveland, OH 44106, USA and Department of Macromolecular Science and Engineering, Case Western Reserve University, Cleveland, OH 44106, USA and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
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Mwengee W, Okeibunor J, Poy A, Shaba K, Mbulu Kinuani L, Minkoulou E, Yahaya A, Gaturuku P, Landoh DE, Nsubuga P, Salla M, Mihigo R, Mkanda P. Polio Eradication Initiative: Contribution to improved communicable diseases surveillance in WHO African region. Vaccine 2016; 34:5170-5174. [PMID: 27389170 DOI: 10.1016/j.vaccine.2016.05.060] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 05/03/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Since the launch of the Global Polio Eradication Initiative (GPEI) in 1988, there has been a tremendous progress in the reduction of cases of poliomyelitis. The world is on the verge of achieving global polio eradication and in May 2013, the 66th World Health Assembly endorsed the Polio Eradication and Endgame Strategic Plan (PEESP) 2013-2018. The plan provides a timeline for the completion of the GPEI by eliminating all paralytic polio due to both wild and vaccine-related polioviruses. METHODS We reviewed how GPEI supported communicable disease surveillance in seven of the eight countries that were documented as part of World Health Organization African Region best practices documentation. Data from WHO African region was also reviewed to analyze the performance of measles cases based surveillance. RESULTS All 7 countries (100%) which responded had integrated communicable diseases surveillance core functions with AFP surveillance. The difference is on the number of diseases included based on epidemiology of diseases in a particular country. The results showed that the polio eradication infrastructure has supported and improved the implementation of surveillance of other priority communicable diseases under integrated diseases surveillance and response strategy. CONCLUSION As we approach polio eradication, polio-eradication initiative staff, financial resources, and infrastructure can be used as one strategy to build IDSR in Africa. As we are now focusing on measles and rubella elimination by the year 2020, other disease-specific programs having similar goals of eradicating and eliminating diseases like malaria, might consider investing in general infectious disease surveillance following the polio example.
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Affiliation(s)
- William Mwengee
- World Health Organization, Country Representative Office, Dar Es Salaam, Tanzania
| | - Joseph Okeibunor
- World Health Organization, Regional Office for Africa, Brazzaville, Congo.
| | - Alain Poy
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Keith Shaba
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Leon Mbulu Kinuani
- World Health Organization, Country Representative Office, Kinshasa, Democratic Republic of Congo
| | - Etienne Minkoulou
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Ali Yahaya
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Peter Gaturuku
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | | | | | - Mbaye Salla
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Richard Mihigo
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Pascal Mkanda
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
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Poy A, Minkoulou E, Shaba K, Yahaya A, Gaturuku P, Dadja L, Okeibunor J, Mihigo R, Mkanda P. Polio Eradication Initiative contribution in strengthening immunization and integrated disease surveillance data management in WHO African region, 2014. Vaccine 2016; 34:5181-5186. [PMID: 27389171 DOI: 10.1016/j.vaccine.2016.05.057] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 05/11/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The PEI Programme in the WHO African region invested in recruitment of qualified staff in data management, developing data management system and standards operating systems since the revamp of the Polio Eradication Initiative in 1997 to cater for data management support needs in the Region. This support went beyond polio and was expanded to routine immunization and integrated surveillance of priority diseases. But the impact of the polio data management support to other programmes such as routine immunization and disease surveillance has not yet been fully documented. This is what this article seeks to demonstrate. METHODS We reviewed how Polio data management area of work evolved progressively along with the expansion of the data management team capacity and the evolution of the data management systems from initiation of the AFP case-based to routine immunization, other case based disease surveillance and Supplementary immunization activities. RESULTS IDSR has improved the data availability with support from IST Polio funded data managers who were collecting them from countries. The data management system developed by the polio team was used by countries to record information related to not only polio SIAs but also for other interventions. From the time when routine immunization data started to be part of polio data management team responsibility, the number of reports received went from around 4000 the first year (2005) to >30,000 the second year and to >47,000 in 2014. CONCLUSION Polio data management has helped to improve the overall VPD, IDSR and routine data management as well as emergency response in the Region. As we approach the polio end game, the African Region would benefit in using the already set infrastructure for other public health initiative in the Region.
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Affiliation(s)
- Alain Poy
- World Health Organization, Regional Office for Africa, Brazzaville, Congo.
| | - Etienne Minkoulou
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Keith Shaba
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Ali Yahaya
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Peter Gaturuku
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Landoh Dadja
- World Health Organization, Country Representative Office, Lome, Togo
| | - Joseph Okeibunor
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Richard Mihigo
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Pascal Mkanda
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
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