Strategies for Improving Polio Surveillance Performance in the Security-Challenged Nigerian States of Adamawa, Borno, and Yobe During 2009–2014

Abstract

Background. The security-challenged states of Adamawa, Borno, and Yobe bear most of the brunt of the Boko Haram insurgency in Nigeria. The security challenge has led to the killing of health workers, destruction of health facilities, and displacement of huge populations. To identify areas of polio transmission and promptly detect possible cases of importation in these states, polio surveillance must be very sensitive.Methods. We conducted a retrospective review of acute flaccid paralysis surveillance in the security-compromised states between 2009 and 2014, using the acute flaccid paralysis database at the World Health Organization Nigeria Country Office. We also reviewed the reports of surveillance activities conducted in these security-challenged states, to identify strategies that were implemented to improve polio surveillance.Results. Environmental surveillance was implemented in Borno in 2013 and in Yobe in 2014. All disease surveillance and notification officers in the 3 security-challenged states now receive annual training, and the number of community informants in these states has dramatically increased. Media-based messaging (via radio and television) is now used to sensitize the public to the importance of surveillance, and contact samples have been regularly collected in both states since 2014.Conclusions. The strategies implemented in the security-challenged states improved the quality of polio surveillance during the review period.

An epidemiological analysis of Acute Flaccid Paralysis (AFP) surveillance in Kenya, 2016 to 2018

“…Our finding showed that majority of the AFP cases were below the age of 5 years (59 months). This is in agreement with findings from previous studies in Ghana, Iran, Nigeria and India [ 8 , 24 , 31 ]. On the contrary, a study in Italy [ 32 ] highlighted a smaller percentage of AFP cases occurring among under five children.…”

“…In our study, we noted that the NPEC classified 23 AFP cases as polio compatible. The 23 polio compatible cases lent an unprecedented opportunity to cluster investigation of this subgroup of AFP cases by geographical area and time [ 1 ], which was very important towards polio eradication activities [ 31 ]. Cluster investigation and additional passive and active case searches conducted verified that there were no missed polio cases and dismissed the presence of circulation with confidence.…”

Polio eradication efforts in regions of geopolitical strife: the Boko Haram threat to efforts in sub-Saharan Africa

“…The effects of Boko Haram in these zones include violence against polio workers, disruption of immunization campaigns, and reduced access to health care and to immunization 8,9 . Targeted killing of healthcare workers, destruction of healthcare facilities, and displacement of huge populations have been reported 10 . In addition, Northern Nigeria has historically been an area where polio virus vaccination efforts have met with resistance as individuals refuse immunization refusal [11][12][13][14] .…”

On the Epidemiology and Statistical Analysis of HIV/AIDS Patients in the Insurgency Affected States of Nigeria

“…The effect of the ongoing Boko Haram insurgency is a serious health concern for Nigeria [ 5 ]. This has manifested in the child wasting [ 6 ], increasingly psychological trauma [ 7 ], intensifying hunger [ 8 ], under-five malnutrition [ 9 ] and the reemergence of polio cases [ 10 ] [ 11 ] [ 12 ]. Also, the effect has reduced the chances of Nigeria meeting the millennium and sustainable development goals as warned by [ 13 ].…”