Conference abstract

Outbreak of poliomyelitis in a previously Polio-Free State in Nigeria, 2013

Pan African Medical Journal - Conference Proceedings. 2018:8(48).05 Dec 2018.
doi: 10.11604/pamj-cp.2018.8.48.630

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Keywords: Polio, Free-state, Nigeria
Opening ceremony

Outbreak of poliomyelitis in a previously Polio-Free State in Nigeria, 2013

Musa Abdullahi1,&, Kabir Sabitu2, Gabriella Poggensee1, Patrick Nguku1, Muhammad Balogun1, Ndadilnasiya Waziri3, Saheed Gidado3

1Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria, 2Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria, 3African Field Epidemiology Network, Nigeria

&Corresponding author
Musa Abdullahi, Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria

Abstract

Introduction: globally, Nigeria is one of the three polio endemic countries. Taraba State reported two confirmed wild polio virus type 1 (WPV 1) cases between April - May 2013. The cases were in settlements 2 - 3 kilometers apart. The state last reported WPV 1 in 2008. We conducted an outbreak investigation of Poliomyelitis to determine the factor(s) that contributed to the re-emergence of WPV 1 and to assess the extent of spread of the cases.

Methods: we defined a paralytic polio case as any case of Acute Flaccid Paralysis (AFP) with wild polio isolation in stool from April - May 2013. We reviewed medical records in health-facilities to obtain information on reported AFP cases. We interviewed household heads of cases to obtain information on socio-demographics and immunization status of cases. We also conducted an immunization coverage survey in 30 households in each affected settlement.

Results: a total of two AFP cases were identified in the affected Local Government Area (LGA) and all 2 (100%) were positive for WPV 1. All cases were males with a mean age of 15 months; both never received Oral Polio Vaccine (OPV). Seventy-four children were sampled during the survey, 33 (45%) males and 41 (55%) females with a mean age of 24 months. 53 (71%) never received OPV through Routine Immunization (RI) and attributed it to health-facility being inaccessible due to distance. Forty-one (55%) never received OPV (Zero-dose) during Supplemental Immunization Activities (SIA) and attributed it to SIA teams not visited the house. Affected settlements are contiguous farming settlements, with underserved Fulani settlements in the surroundings. Seventy-seven children in 15 surrounding settlements were vaccinated during mop-up vaccination. Settlements were not in ward micro-plans and missed during polio immunizations.

Conclusion: sub-optimal immunization coverage and gaps in surveillance are plausible factors for re- emergence of poliomyelitis. We carried out a rapid mop-up vaccination in the affected and contiguous settlements, conducted a large-scale mop-up immunization in the state and recruited key informants in the communities for AFP surveillance. We included affected settlements in the micro-plans and recommended conduct of outreach sessions by health facilities offering Routine Immunization to the affected and contiguous settlements.