1
|
Surveillance optimisation to detect poliovirus in the pre-eradication era: a modelling study of England and Wales. Epidemiol Infect 2020; 148:e157. [PMID: 32398193 PMCID: PMC7379320 DOI: 10.1017/s0950268820001004] [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] [Indexed: 01/25/2023] Open
Abstract
Surveillance for acute flaccid paralysis (AFP) cases are essential for polio eradication. However, as most poliovirus infections are asymptomatic and some regions of the world are inaccessible, additional surveillance tools require development. Within England and Wales, we demonstrate how inclusion of environmental sampling (ENV) improves the sensitivity of detecting both wild and vaccine-derived polioviruses (VDPVs) when compared to current surveillance. Statistical modelling was used to estimate the spatial risk of wild and VDPV importation and circulation in England and Wales. We estimate the sensitivity of each surveillance mode to detect poliovirus and the probability of being free from poliovirus, defined as being below a pre-specified prevalence of infection. Poliovirus risk was higher within local authorities in Manchester, Birmingham, Bradford and London. The sensitivity of detecting wild poliovirus within a given month using AFP and enterovirus surveillance was estimated to be 0.096 (95% CI 0.055–0.134). Inclusion of ENV in the three highest risk local authorities and a site in London increased surveillance sensitivity to 0.192 (95% CI 0.191–0.193). The sensitivity of ENV strategies can be compared using the framework by varying sites and the frequency of sampling. The probability of being free from poliovirus slowly increased from the date of the last case in 1993. ENV within areas thought to have the highest risk improves detection of poliovirus, and has the potential to improve confidence in the polio-free status of England and Wales and detect VDPVs.
Collapse
|
2
|
Ticha JM, Matthew KO, Hamisu AW, Fiona B, Mkanda P, Nsubuga P, Tesfaye E, Craig K, Andrew E, Emelife O, Shuaib F, Folasade A, Adeniji J, Adamu U, Dallatu M, Oyeyinka G, Brown H, Nnamah N, Okwori J, Chinedu C, Anibijuwon I, Olubusuyi A, Emmanuel D, Bagana M, Baba M, Nicksy G, Banda R, Tegegne SG, Oyetunji A, Diop O, Tomori O, Vaz RG. Towards an effective poliovirus laboratory containment strategy in Nigeria. BMC Public Health 2018; 18:1304. [PMID: 30541484 PMCID: PMC6291910 DOI: 10.1186/s12889-018-6181-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Global Commission for the Certification of the Eradication of Poliomyelitis will declare the world free of wild poliovirus transmission when no wild virus has been found in at least 3 consecutive years, and all laboratories possessing wild poliovirus materials have adopted appropriate measures of containment. Nigeria has made progress towards poliomyelitis eradication with the latest reported WPV type 1 on 21 Aug 2016 after 2 years without any case. This milestone achievement was followed by an inventory of biomedical laboratories completed in November 2015 with the destruction of all identified infectious materials. This paper seeks to describe the poliovirus laboratory containment process in Nigeria on which an effective containment system has been built to minimize the risk of virus re-introduction into the population from the laboratories. METHODS A national survey of all biomedical facilities, as well as an inventory of laboratories from various sectors, was conducted from June-November 2015. National Task Force (NTF) members and staff working on polio administered an on-site questionnaire in each facility. Laboratory personnel were sensitized with all un-needed materials destroyed by autoclaving and incineration. All stakeholders were also sensitized to continue the destruction of such materials as a requirement for phase one activities. RESULTS A total of 20,638 biomedical facilities were surveyed with 9575 having laboratories. Thirty laboratories were found to contain poliovirus or potentially infectious materials. The 30 laboratories belonged to the ministries of health, education, defence and private organizations. CONCLUSIONS This article is amongst the first in Africa that relates poliovirus laboratory containment in the context of the tOPV-bOPV switch in alignment with the Global Action Plan III. All identified infectious materials were destroyed and personnel trained to continue to destroy subsequent materials, a process that needs meticulous monitoring to mitigate the risk of poliovirus re-introduction to the population.
Collapse
Affiliation(s)
| | | | | | - Braka Fiona
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Pascal Mkanda
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | | | - Eberto Tesfaye
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Kehinde Craig
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Etsano Andrew
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Obi Emelife
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Faisal Shuaib
- National Task Force on Polio Containment, Abuja, Nigeria
| | | | | | - Usman Adamu
- National Task Force on Polio Containment, Abuja, Nigeria
| | | | | | - Holly Brown
- National Task Force on Polio Containment, Abuja, Nigeria
| | | | - Joseph Okwori
- National Task Force on Polio Containment, Abuja, Nigeria
| | | | | | | | | | - Murtala Bagana
- National Task Force on Polio Containment, Abuja, Nigeria
| | - Marycelin Baba
- University Teaching Hospital Polio Laboratory, Maiduguri, Nigeria
| | - Gumede Nicksy
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Richard Banda
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Sisay G. Tegegne
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Ajiboye Oyetunji
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Ousmane Diop
- World Health Organization, Headquarters, Geneva, Switzerland
| | - O. Tomori
- Expert Review Committee on Polio and Routine Immunization, Abuja, Nigeria
| | - Rui G. Vaz
- World Health Organization, Country Representative Office, Abuja, Nigeria
| |
Collapse
|
3
|
Bassey BE, Braka F, Shuaib F, Banda R, Tegegne SG, Ticha JM, Abdullalhi WH, Kolawole OM, Kabir Y. Distribution pattern of poliovirus potentially infectious materials in the phase 1b medical laboratories containment in conformity with the global action plan III. BMC Public Health 2018; 18:1319. [PMID: 30541511 PMCID: PMC6291917 DOI: 10.1186/s12889-018-6183-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background The containment of poliovirus infectious/potentially infectious materials in all biomedical facilities in Nigeria remain crucial to maintaining gains recorded towards polio eradication. Activities involved in the Nigerian Poliovirus type 2-laboratory containment survey in line with the 3rd Global Action Plan III (GAP III) for poliovirus containment are documented in this study. Through these activities, the overall preparedness for poliovirus eradication in Nigeria is assessed. Method A cross-sectional survey was conducted from 19th September-31st October 2016 using structured Laboratory survey and inventory (LSI) questionnaires uploaded onto the SPSS software package in 560 biomedical facilities classified either as high risk or medium risk facilities across the 6 zones in Nigeria. Results In total, 560 biomedical facilities were surveyed in Nigeria in conformity with the GAP III. In total, 86% of the facilities surveyed were with laboratories while 14% were without laboratories. Twelve laboratories with poliovirus potentially infectious materials were identified in this exercise. In total, 50% of the 12 laboratories were under the ministry of education for research purposes. While 33% were among those laboratories surveyed in the phase 1a exercise without any recorded inventory, but have acquired some since the phase 1a survey. A total of 13,484 poliovirus infectious materials were found in the 12 laboratories. Only 8% of the materials were immediately destroyed while the remaining materials (62%) were found in Oyo and Borno states scheduled for destruction within 3–4 months according to WHO protocol for destruction of poliovirus infectious materials. Conclusion This study has revealed the successful containment of all poliovirus infectious materials in the laboratories surveyed. It has also revealed some surveillance gaps. We recommend that the surveillance system be improved to maintain the gains from the containment exercise and avoid reintroduction of infectious materials into biomedical facilities. This reduces the chances of viral reintroduction to the population in general.
Collapse
Affiliation(s)
- Bassey Enya Bassey
- , World Health organization (WHO) Nigeria Country office, UN House, plot 617/618, Diplomatic Drive, Central Business District, PMB 2861, Garki, Abuja, Nigeria.
| | - Fiona Braka
- , World Health organization (WHO) Nigeria Country office, UN House, plot 617/618, Diplomatic Drive, Central Business District, PMB 2861, Garki, Abuja, Nigeria
| | - Faisal Shuaib
- National Primary Health care Development Agency, Abuja, Nigeria
| | - Richard Banda
- , World Health organization (WHO) Nigeria Country office, UN House, plot 617/618, Diplomatic Drive, Central Business District, PMB 2861, Garki, Abuja, Nigeria
| | - Sisay Gashu Tegegne
- , World Health organization (WHO) Nigeria Country office, UN House, plot 617/618, Diplomatic Drive, Central Business District, PMB 2861, Garki, Abuja, Nigeria
| | - Johnson Muluh Ticha
- , World Health organization (WHO) Nigeria Country office, UN House, plot 617/618, Diplomatic Drive, Central Business District, PMB 2861, Garki, Abuja, Nigeria
| | - Walla Hamisu Abdullalhi
- , World Health organization (WHO) Nigeria Country office, UN House, plot 617/618, Diplomatic Drive, Central Business District, PMB 2861, Garki, Abuja, Nigeria
| | - Olatunji Mathew Kolawole
- Department of Microbiology, Faculty of Life Sciences, University of Ilorin, Ilorin, Kwara State, Nigeria
| | - Yusuf Kabir
- National Primary Health care Development Agency, Abuja, Nigeria
| |
Collapse
|