Friday, 13 February 2015

Polio Vaccine : How far we have come

In the continent of Africa, Northern Nigeria is the main polio hub, such that if we can achieve zero cases in Nigeria, it's almost a unanimous victory for the rest of Africa and the world at large.

Since the expanded program on immunization began in 1974, the polio virus plus five others were the main targets. Significant progress has been made to reduce the occurrence of epidemics by increasing the percentage of the under five population that are vaccinated.
The polio vaccine is lagging behind due to some logistic issues, although some progress has been made.
Statistics from the Global polio eradication  initiative shows that the last case of the wild polio virus (WPV) was reported in Somalia in August 2014 and prior to that the case in Cameroun in July 2014. Only six cases of the wild polio virus was reported in Nigeria in 2014, whilst 30 cases of the vaccine derived polio virus were recorded. Somalia and Equatorial Guinea had five cases each of the WPV in 2014 while Cameroon had two and Ethiopia a single case.
South Sudan also reported two cases of the cVDPV the last of which was in September 2014.
There has been no case of the wild polio virus reported in Africa in the last six months and especially in Nigeria. This progress is significant, because it is believed by experts that if the virus exists anywhere, then every child globally is at risk.

This new upward turn in the curve of progress was noticed between 2013 and 2014,when a 92 percent drop in the number of cases was recorded.

What changed would we then ask?

Over 90 percent of children in Nigeria were recorded to have had more than three doses of the oral polio vaccine. This is a great leap!

Political instability and terrorism have contributed immensely to the slow progress of immunization in Northern Nigeria.

Displaced people fleeing for dear lives across the borders also contributed to the spread of the virus, as children missed their immunization schedules due to socio political unrest. In fact, it is suspected that the case of wild polio virus that was reported in Cameroon in July 2014 may have been due to the influx of people from Northern Nigeria into Cameroon.

Repeated attacks against health workers who were assigned to the  region to vaccinate children was also discouraging.

Difficult to access areas also raised the percentage of unvaccinated children, as children in these areas had little or no access to immunization.

Resistance by parents and care givers due to distrust was also a clog in the wheel of progress.
A good number of the indigenes prevented their children from being immunized for several reasons.
Some thought it was harmful to the children, others declined vaccination for political reasons while some simply refused as a reaction to the lack of provision of basic amenities by the government.

The national program for polio eradication together with the Global polio eradication initiative have worked relentlessly to get to this point.
Specially designed outreach programs for hard to reach areas have helped to increase the percentage of vaccinated children in those regions. Also increased efforts were focused on internally displaced people. This also has reduced the number of missed children.
An increase in the quality of campaigns and more organized out reaches have also helped.

The last case of the vaccine derived polio virus (cVDPV) was reported at Bade Local Government in Yobe State Nigeria in November 2014. This is a rare type of the polio virus that is mutated from the strains contained in vaccines.
Cases of  cVDPV can occur in populations that are inadequately vaccinated and have a poor level of personal hygiene and sanitation. Phasing out of the oral polo vaccines  is being proposed for 2016 so as to eliminate the vaccine derived polio viruses which could serve as a threat to the elimination of Polio globally.

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