Spatial analysis of genetic clusters and epidemiologic factors related to wild poliovirus type 1 persistence in Afghanistan and Pakistan

Mendes, Amalia; Whiteman, Ari; Bullard, Kelley; Sharif, Salman; Khurshid, Adnan; Alam, Muhammad Masroor; Salman, Muhammad; Ford, Vanessa; Blair, Taisha; Burns, Cara C.; Ehrhardt, Derek; Jorba, Jaume; Hsu, Christopher H.

doi:10.1371/journal.pgph.0000251

Cited by 2 publications

(1 citation statement)

References 30 publications

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“…Out of 22 countries, 15 had the last few transmission foci in the border areas. The challenge posed by international land borders to disease elimination is not unique to malaria, discussed extensively in eradication of smallpox, polio, guinea worm disease and the elimination of other neglected tropical diseases [ 12 – 15 ]. It is neither limited to countries that only had very low malaria transmission [ 16 ].…”

Section: Is Border Malaria a Real Problem?mentioning

confidence: 99%

Border malaria: defining the problem to address the challenge of malaria elimination

Li,

Snow,

Lindblade

et al. 2023

Malar J

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Border malaria is frequently cited as an obstacle to malaria elimination and sometimes used as a justification for the failure of elimination. Numerous border or cross-border meetings and elimination initiatives have been convened to address this bottleneck to elimination. In this Perspective, border malaria is defined as malaria transmission, or the potential for transmission, across or along shared land borders between countries where at least one of them has ongoing malaria transmission. Border malaria is distinct from malaria importation, which can occur anywhere and in any country. The authors’ analysis shows that the remaining transmission foci of malaria-eliminating countries tend to occur in the vicinity of international land borders that they share with neighbouring endemic countries. The reasons why international land borders often represent the last mile in malaria elimination are complex. The authors argue that the often higher intrinsic transmission potential, the neglect of investment and development, the constant risk of malaria importation due to cross-border movement, the challenges of implementing interventions in complex environments and uncoordinated action in a cross-border shared transmission focus all contribute to the difficulties of malaria elimination in border areas. Border malaria reflects the limitations of the current tools and interventions for malaria elimination and implies the need for social cohesion, basic health services, community economic conditions, and policy dialogue and coordination to achieve the expected impact of malaria interventions. Given the uniqueness of each border and the complex and multifaceted nature of border malaria, a situation analysis to define and characterize the determinants of transmission is essential to inform a problem-solving mindset and develop appropriate strategies to eliminate malaria in these areas.

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Section: Is Border Malaria a Real Problem?mentioning

confidence: 99%

Border malaria: defining the problem to address the challenge of malaria elimination

Li,

Snow,

Lindblade

et al. 2023

Malar J

View full text Add to dashboard Cite

show abstract

Evolution and Transmission Dynamics of Wild Poliovirus in Pakistan and Afghanistan (2012-2023): implications for global polio eradication

Jorgensen,

Pons-Salort,

Salman

et al. 2024

Preprint

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Despite concerted global vaccination efforts, wild poliovirus remains endemic in two countries in 2024, Pakistan and Afghanistan. This study uses phylogeographic analysis of poliovirus genetic and epidemiological data from clinical and wastewater surveillance to identify the causes of poliovirus persistence and routes of spread over the last decade (2012 to 2023). Poliovirus genetic diversity declined post-2020, with the die-out of one of two major genetic clusters and recent detections are now close genetic relatives. We find that high-risk and hard-to-access regions have been key to persistent polio transmission over the past decade, supporting transmission when it had stopped elsewhere. Karachi, one of the most densely populated cities globally, has acted as a major hub for the amplification and spread of poliovirus to other regions, many of which we show to be dead-end for onwards transmission despite frequent virus detection. This information has been used to guide polio vaccination and surveillance.

show abstract

Spatial analysis of genetic clusters and epidemiologic factors related to wild poliovirus type 1 persistence in Afghanistan and Pakistan

Cited by 2 publications

References 30 publications

Border malaria: defining the problem to address the challenge of malaria elimination

Border malaria: defining the problem to address the challenge of malaria elimination

Evolution and Transmission Dynamics of Wild Poliovirus in Pakistan and Afghanistan (2012-2023): implications for global polio eradication

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