Polio Outbreak Response in Ethiopia

Abstract

Background: ethiopia had been polio-free for almost four years until December 2004. however, between December 2004 and February 2006, 24 children were paralysed as a result of infection with wild poliovirus imported from the neighbouring country of sudan. in response, the country has attempted to document the impact of various response measures on the containment of wild poliovirus transmission. Objectives: this study aims at systematic and epidemiological assessment of the extent of the outbreak, its determinants, and the lessons learned as well as the implications for future control strategies to interrupt wild poliovirus transmission. Design: a cross-sectional study design with qualitative and quantitative data collection approaches was used to conduct the epidemiologic assessment. Subjects: All confirmed wild poliovirus cases, and reported acute flaccid paralysis cases in close proximity to the confirmed polio cases were the study subjects. Child caretakers and health service providers were interviewed as part of the investigation. Results: between December 2004 and February 2006, eight children from tigray regional state, nine children from amhara regional state and seven children from oromia regional state were paralysed as a result of infection with wild poliovirus type 1. Genetic sequencing demonstrated two separate importations to ethiopia. risk factors that may have facilitated spread of the outbreak within the country included gaps in vaccination coverage and interruption of the cold chain system, gaps in acute flaccid paralysis surveillance performance, high population mobility, poor environmental sanitation, crowded living conditions and unsafe drinking water. in response to the outbreak, Ethiopia conducted detailed outbreak investigations within two days of confirmation of the index cases. large-scale, house-to-house vaccination campaigns were also implemented. as a result, the three regions interrupted the wild poliovirus transmission within the regions within one year of confirmation of the index case. Conclusion: outbreak response activities were successful in interrupting the imported wild poliovirus transmission in tigray, amhara and oromia regional states of ethiopia within a oneyear period of time. In Ethiopia, programme strategies should be intensified to contain further spread and prevent future importation of wild poliovirus. large-scale immunisation campaigns should reach every child, including those isolated by geography, poverty and security.

Analysis of acute flaccid paralysis surveillance in Ethiopia, 2005-2015: progress and challenges

“…Since 1996, Ethiopia has been implementing polio eradication initiative activities using standard World Health Organization(WHO) recommended strategies [ 4 ], with significant success recorded, resulting in interruption of transmission of indigenous wild poliovirus (WPV) in December 2001, just five years after launching the “Kick polio Out of Africa” campaign [ 5 ]. However, the country has experienced numerous separate WPV importations from neighboring countries, including the 2013 polio outbreak, which was genetically linked to the virus circulating in neighboring countries, Somalia and Kenya, and related to the virus circulating in West Africa [ 6 – 8 ]. Ethiopia has been conducting case-based surveillance for Acute Flaccid Paralysis(AFP) countrywide since 1997 [ 9 ], and it is mandatory for all surveillance sites in the country to notify any suspected cases of AFP that fulfill the national case definitions including weekly zero case reporting.…”

Epidemiological Characteristics of Poliomyelitis during the 21st century (2000-2013)

“…In year 2005, Yemen identified 478 poliovirus cases in the country, 185 cases were reported from Somalia [83] and Sudan reported 24 confirmed wild poliovirus cases. There were 22 cases reported in various districts of Ethiopia in 2005 [86]. Indonesia had not reported any case of polio since 1995.…”

Trust, Communication, and Community Networks: How the CORE Group Polio Project Community Volunteers Led the Fight against Polio in Ethiopia’s Most At-Risk Areas

“…Children in these regions were highly susceptible to polio because of suboptimal routine immunization coverage levels in these remote areas. 5,6 Children living in major cities were much more likely to have enough protection from OPV. However, children living in rural areas and pastoralist populations were and still are vulnerable.…”