Modeling Undetected Live Poliovirus Circulation After Apparent Interruption of Transmission: Borno and Yobe in Northeast Nigeria

Kalkowska, Dominika A.; Thompson, Kimberly M.

doi:10.1111/risa.13486

Cited by 8 publications

(12 citation statements)

References 14 publications

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“…Although not captured in the review, modeling of one of the last known reservoirs of WPV3 transmission (i.e. Borno and Yobe, Nigeria) published in 2020 [ 233 , 234 ] also supported the 2019 decision by the Global Certification Commission to certify the global eradication of indigenous WPV3 [ 235 ].…”

Section: Themesmentioning

confidence: 99%

Review of poliovirus modeling performed from 2000 to 2019 to support global polio eradication

Thompson¹,

Kalkowska²

2020

Expert Review of Vaccines

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Introduction: Over the last 20 years (2000-2019) the partners of the Global Polio Eradication Initiative (GPEI) invested in the development and application of mathematical models of poliovirus transmission as well as economics, policy, and risk analyses of polio endgame risk management options, including policies related to poliovirus vaccine use during the polio endgame. Areas covered: This review provides a historical record of the polio studies published by the three modeling groups that primarily performed the bulk of this work. This review also systematically evaluates the polio transmission and health economic modeling papers published in English in peerreviewed journals from 2000 to 2019, highlights differences in approaches and methods, shows the geographic coverage of the transmission modeling performed, identified common themes, and discusses instances of similar or conflicting insights or recommendations. Expert opinion: Polio modeling performed during the last 20 years substantially impacted polio vaccine choices, immunization policies, and the polio eradication pathway. As the polio endgame continues, national preferences for polio vaccine formulations and immunization strategies will likely continue to change. Future modeling will likely provide important insights about their costeffectiveness and their relative benefits with respect to controlling polio and potentially achieving and maintaining eradication.

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Section: Themesmentioning

confidence: 99%

Review of poliovirus modeling performed from 2000 to 2019 to support global polio eradication

Thompson¹,

Kalkowska²

2020

Expert Review of Vaccines

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“…The Global Commission for the Certification of Poliomyelitis Eradication (GCC) emphasized in October 2018 (World Health Organization, 2018) that the absence of detection of serotype 3 wild poliovirus (WPV3) cases since late 2012 (World Health Organization, 2013) creates the opportunity to certify the world as free of WPV3, and it initiated the WPV3 certification process. Confidence about the absence about no circulation of WPV3 continues to increase, with now over seven years since the last reported case in the last reservoirs (Duintjer Tebbens, Kalkowska, & Thompson, 2019) (Kalkowska, Duintjer Tebbens, Pallansch, & Thompson, 2019; Kalkowska & Thompson, 2020). In October 2019, the GCC certified the eradication of WPV3 (World Health Organization, 2019), which will likely lead to discussions about the appropriate and optimal timing of cessation of OPV3.…”

Section: Introductionmentioning

confidence: 95%

Expected Implications of Globally Coordinated Cessation of Serotype 3 Oral Poliovirus Vaccine (OPV) Before Serotype 1 OPV

Kalkowska¹,

Thompson²

2020

Risk Analysis

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Globally coordinated cessation of all three serotypes of oral poliovirus vaccine (OPV) represents a critical part of a successful polio endgame, which the Global Polio Eradication Initiative (GPEI) plans to conduct in phases, with serotype 2 OPV cessation completed in mid 2016. Although in 2016 the GPEI expected to globally coordinate cessation of the remaining OPV serotypes (1 and 3) by 2021, continuing transmission of serotype 1 wild polioviruses to date makes those plans obsolete. With increasing time since the last reported polio case caused by serotype 3 wild poliovirus (in November 2012) leading to high confidence about its successful global eradication, the Global Commission for the Certification of Poliomyelitis Eradication recently certified its eradication. Questions now arise about the optimal timing of serotype 3 OPV (OPV3) cessation. Using an integrated global model that characterizes the risks, costs, and benefits of global polio policy and risk management options, we explored the implications of different options for coordinated cessation of OPV3 prior to COVID‐19. Globally coordinating cessation of OPV3 as soon as possible offers the opportunity to reduce cases of vaccine‐associated paralytic polio globally. In addition, earlier cessation of OPV3 should reduce the risks of creating serotype 3 circulating vaccine‐derived polioviruses after OPV3 cessation, which represents a significant threat to the polio endgame given current GPEI plans to reduce preventive OPV supplemental immunization activities starting in 2019.

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“…Despite its limitations, deterministic modeling can help to support the development of assumptions for use in stochastic models that explore the confidence of no circulation (Kalkowska et al., 2015, 2019). A separate analysis explores the confidence about no undetected circulation as a function of time since the last detected events using a stochastic model (Kalkowska & Thompson, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…The deterministic DEB model including small (almost completely) isolated subpopulations comes with some limitations, but modeling the bounds of potential transmission provide some confidence about die out. Estimating the confidence about no undetected circulation requires further stochastic modeling, as discussed in a separate analysis (Kalkowska & Thompson, 2020). Consistent with the available epidemiology and virology evidence, the modeling results strongly suggests die out of indigenous WPV1 and WPV3 transmission in Borno and Yobe prior to 2020.…”

Section: Discussionmentioning

confidence: 99%

Modeling Poliovirus Transmission in Borno and Yobe, Northeast Nigeria

Kalkowska¹,

Franka

Higgins

et al. 2020

Risk Analysis

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Beginning in 2013, multiple local government areas (LGAs) in Borno and Yobe in northeast Nigeria and other parts of the Lake Chad basin experienced a violent insurgency that resulted in substantial numbers of isolated and displaced people. Northeast Nigeria represents the last known reservoir country of wild poliovirus (WPV) transmission in Africa, with detection of paralytic cases caused by serotype 1 WPV in 2016 in Borno and serotype 3 WPV in late 2012. Parts of Borno and Yobe are also problematic areas for transmission of serotype 2 circulating vaccine‐derived polioviruses, and they continue to face challenges associated with conflict and inadequate health services in security‐compromised areas that limit both immunization and surveillance activities. We model poliovirus transmission of all three serotypes for Borno and Yobe using a deterministic differential equation‐based model that includes four subpopulations to account for limitations in access to immunization services and dynamic restrictions in population mixing. We find that accessibility issues and insufficient immunization allow for prolonged poliovirus transmission and potential undetected paralytic cases, although as of the end of 2019, including responsive program activities in the modeling suggest die out of indigenous serotypes 1 and 3 WPVs prior to 2020. Specifically, recent and current efforts to access isolated populations and provide oral poliovirus vaccine continue to reduce the risks of sustained and undetected transmission, although some uncertainty remains. Continued improvement in immunization and surveillance in the isolated subpopulations should minimize these risks. Stochastic modeling can build on this analysis to characterize the implications for undetected transmission and confidence about no circulation.

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Modeling Undetected Live Poliovirus Circulation After Apparent Interruption of Transmission: Borno and Yobe in Northeast Nigeria

Cited by 8 publications

References 14 publications

Review of poliovirus modeling performed from 2000 to 2019 to support global polio eradication

Review of poliovirus modeling performed from 2000 to 2019 to support global polio eradication

Expected Implications of Globally Coordinated Cessation of Serotype 3 Oral Poliovirus Vaccine (OPV) Before Serotype 1 OPV

Modeling Poliovirus Transmission in Borno and Yobe, Northeast Nigeria

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