Characteristics of wild polio virus outbreak investigation and response in Ethiopia in 2013-2014: implications for prevention of outbreaks due to importations.

Autor: Tegegne AA; World Health Organization Country Office, P. O. Box 3069, Addis Abba, Ethiopia. aysheshema@who.int., Braka F; World Health Organization Country Office, P. O. Box 3069, Addis Abba, Ethiopia., Shebeshi ME; Inter-Country Support Team eastern and Southern Africa, IST, Harare, Zimbabwe., Aregay AK; World Health Organization Country Office, P. O. Box 3069, Addis Abba, Ethiopia., Beyene B; Ethiopian Public Health Institute, Addis Ababa, Ethiopia., Mersha AM; World Health Organization Country Office, P. O. Box 3069, Addis Abba, Ethiopia., Ademe M; World Health Organization Technical Support Team, Jijiga, Somali Region, Ethiopia., Muhyadin A; World Health Organization Technical Support Team, Jijiga, Somali Region, Ethiopia., Jima D; Ethiopian Public Health Institute, Addis Ababa, Ethiopia., Wyessa AB; Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2018 Jan 05; Vol. 18 (1), pp. 9. Date of Electronic Publication: 2018 Jan 05.
DOI: 10.1186/s12879-017-2904-9
Abstrakt: Background: Ethiopia joined the Global Polio Eradication Initiative (GPEI) in 1996, and by the end of December 2001 circulation of indigenous Wild Polio Virus (WPV) had been interrupted. Nonetheless, the country experienced multiple importations during 2004-2008, and in 2013. We characterize the 2013 outbreak investigations and response activities, and document lessons learned.
Method: The data were pulled from different field investigation reports and from the national surveillance database for Acute Flaccid Paralysis (AFP).
Results: In 2013, a WPV1 outbreak was confirmed following importation in Dollo zone of the Somali region, which affected three Woredas (Warder, Geladi and Bokh). Between July 10, 2013, and January 5, 2014, there were 10 children paralyzed due to WPV1 infection. The majorities (7 of 10) were male and below 5 years of age, and 7 of 10 cases was not vaccinated, and 72% (92/129) of < 5 years of old children living in close proximity with WPV cases had zero doses of oral polio vaccine (OPV). The travel history of the cases showed that seven of the 10 cases had contact with someone who had traveled or had a travel history prior to the onset of paralysis. Underserved and inaccessibility of routine immunization service, suboptimal surveillance sensitivity, poor quality and inadequate supplemental immunization were the most crucial gaps identified during the outbreak investigations.
Conclusion: Prior to the 2013 outbreak, Ethiopia experienced multiple imported polio outbreaks following the interruption of indigenous WPV in December 2001. The 2013 outbreak erupted due to massive population movement and was fueled by low population immunity as a result of low routine immunization and supplemental Immunization coverage and quality. In order to avert future outbreaks, it is critical that surveillance sensitivity be improved by establishing community-based surveillance systems and by assigning surveillance focal points at all level particularly in border areas. In addition, it is vital to set up in hard to reach areas a functional immunization service delivery system using the "Reaching Every Child" approach, including periodic routine immunization intensification and supplemental immunization activities.
Databáze: MEDLINE
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