Endgame for polio eradication? Options for overcoming social and political factors in the progress to eradicating polio

Ganapathiraju, Pavan V.; Morssink, Christiaan B.; Plumb, James

doi:10.1080/17441692.2014.994655

Cited by 8 publications

(5 citation statements)

References 14 publications

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“…When the number of inaccessible children was included as a covariate, insecurity had no independent association with vaccination rates. Insecurity may interfere with vaccination efforts in many ways, but limiting vaccinator access has been described as potentially the most important (19). Our findings support this theory and are consistent with results from surveys in which caregivers in insecure zones were more likely to report that vaccinators did not visit their homes (45% versus 7% in more secure zones) (10).…”

Section: Discussionsupporting

confidence: 88%

“…Studies in Afghanistan, Sierra Leone, and Angola identified an association between insecurity and reduced vaccination or polio incidence (14)(15)(16)(17), but they are limited in drawing a causal linkage because insecure areas were designated using expert opinion rather than objective data, vaccination rates and polio incidence were not studied together, vaccinator access was not examined, and/or temporal changes in exposure to insecurity were not captured. Numerous articles have commented on the relationship between insecurity and poliovirus transmission (6,12,(18)(19)(20), but none of these provide empirical evidence to support their anecdotal observations.…”

Section: Discussionmentioning

confidence: 99%

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Insecurity, polio vaccination rates, and polio incidence in northwest Pakistan

Verma

Jiménez

Tangermann

et al. 2018

Proc. Natl. Acad. Sci. U.S.A.

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Pakistan is one of three countries in which endemic transmission of poliovirus has never been stopped. Insecurity is often cited but poorly studied as a barrier to eradicating polio. We analyzed routinely collected health data from 32 districts of northwest Pakistan and constructed an index of insecurity based on journalistic reports of the monthly number of deaths and injuries resulting from conflict-related security incidents. The primary outcomes were the monthly incidence of paralytic polio cases within each district between 2007 and 2014 and the polio vaccination percentage from 666 district-level vaccination campaigns between 2007 and 2009, targeting ∼5.7 million children. Multilevel Poisson regression controlling for time and district fixed effects was used to model the association between insecurity, vaccinator access, vaccination rates, and polio incidence. The number of children inaccessible to vaccinators was 19.7% greater (95% CI: 19.2-20.2%), and vaccination rates were 5.3% lower (95% CI: 5.2-5.3%) in "high-insecurity" campaigns compared with "secure" campaigns. The unadjusted mean vaccination rate was 96.3% (SD = 8.6) in secure campaigns and 88.3% (SD = 19.2) in high-insecurity campaigns. Polio incidence was 73.0% greater (95% CI: 30-131%) during high-insecurity months (unadjusted mean = 0.13 cases per million people, SD = 0.71) compared with secure months (unadjusted mean = 1.23 cases per million people, SD = 4.28). Thus, insecurity was associated with reduced vaccinator access, reduced polio vaccination, and increased polio incidence in northwest Pakistan. These findings demonstrate that insecurity is an important obstacle to global polio eradication.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Insecurity, polio vaccination rates, and polio incidence in northwest Pakistan

Verma

Jiménez

Tangermann

et al. 2018

Proc. Natl. Acad. Sci. U.S.A.

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“…For instance, the challenges of administering vaccines in war zones have contributed to a large outbreak of polio in Syria as recently as 2015 [380]. At the same time in Pakistan, violence against WHO vaccinators has stymied efforts to combat polio [381]. Despite this, global polio eradication is coming closer [382].…”

Section: Rationale For Studying Behavior-disease Dynamicsmentioning

confidence: 99%

Statistical physics of vaccination

et al. 2016

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Historically, infectious diseases caused considerable damage to human societies, and they continue to do so today. To help reduce their impact, mathematical models of disease transmission have been studied to help understand disease dynamics and inform prevention strategies. Vaccination-one of the most important preventive measures of modern times-is of great interest both theoretically and empirically. And in contrast to traditional approaches, recent research increasingly explores the pivotal implications of individual behavior and heterogeneous contact patterns in populations. Our report reviews the developmental arc of theoretical epidemiology with emphasis on vaccination, as it led from classical models assuming homogeneously mixing (mean-field) populations and ignoring human behavior, to recent models that account for behavioral feedback and/or population spatial/social structure. Many of the methods used originated in statistical physics, such as lattice and network models, and their associated analytical frameworks. Similarly, the feedback loop between vaccinating behavior and disease propagation forms a coupled nonlinear system with analogs in physics. We also review the new paradigm of digital epidemiology, wherein sources of digital data such as online social media are mined for high-resolution information on epidemiologically relevant individual behavior. Armed with the tools and concepts of statistical physics, and further assisted by new sources of digital data, models that capture nonlinear interactions between behavior and disease dynamics offer a novel way of modeling real-world phenomena, and can help improve health outcomes. We conclude the review by discussing open problems in the field and promising directions for future research.

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“…If the strategic plan is implemented well as planned, then polio eradication will become a reality. However, political and social barriers, including religious resistance to vaccination are threats to the success of the endgame strategy [11]. …”

Section: Introductionmentioning

confidence: 99%

Did the call for boycott by the Catholic bishops affect the polio vaccination coverage in Kenya in 2015 ? A cross-sectional study

Njeru¹,

Ajack²,

Muitherero³

et al. 2016

Pan Afr Med J

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IntroductionPolio eradication is now feasible after removal of Nigeria from the list of endemic countries and global reduction of cases of wild polio virus in 2015 by more than 80%. However, all countries must remain focused to achieve eradication. In August 2015, the Catholic bishops in Kenya called for boycott of a polio vaccination campaign citing safety concerns with the polio vaccine. We conducted a survey to establish if the coverage was affected by the boycott.MethodsA cross sectional survey was conducted in all the 32 counties that participated in the campaign. A total of 90,157 children and 37,732 parents/guardians were sampled to determine the vaccination coverage and reasons for missed vaccination.ResultsThe national vaccination coverage was 93% compared to 94% in the November 2014 campaign. The proportion of parents/guardians that belonged to Catholic Church was 31% compared to 7% of the children who were missed. Reasons for missed vaccination included house not being visited (44%), children not being at home at time of visit (38%), refusal by parents (12%), children being as leep (1%), and various other reasons (5%). Compared to the November 2014 campaign, the proportion of children who were not vaccinated due to parent's refusal significantly increased from 6% to 12% in August 2015.ConclusionThe call for boycott did not affect the campaign significantly. However, if the call for boycott is repeated in future it could have some significant negative implication to polio eradication. It is therefore important to ensure that any vaccine safety issues are addressed accordingly.

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Endgame for polio eradication? Options for overcoming social and political factors in the progress to eradicating polio

Cited by 8 publications

References 14 publications

Insecurity, polio vaccination rates, and polio incidence in northwest Pakistan

Insecurity, polio vaccination rates, and polio incidence in northwest Pakistan

Statistical physics of vaccination

Did the call for boycott by the Catholic bishops affect the polio vaccination coverage in Kenya in 2015 ? A cross-sectional study

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