The Experts below are selected from a list of 1752 Experts worldwide ranked by ideXlab platform

Derek Ehrhardt - One of the best experts on this subject based on the ideXlab platform.

  • progress toward Poliomyelitis Eradication pakistan january 2019 september 2020
    Morbidity and Mortality Weekly Report, 2020
    Co-Authors: Christopher H Hsu, Hamid Jafari, Muhammad Safdar, Jaume Jorba, Kelley Bullard, Milhia Kader, Muhammad Shafiqur Rehman, Hamish Young, Derek Ehrhardt
    Abstract:

    Pakistan and Afghanistan are the only countries where wild poliovirus type 1 (WPV1) is endemic (1,2). In 2019, Pakistan reported 147 WPV1 cases, approximately 12 times the number reported in 2018. As of September 15, 72 cases had been reported in 2020. Since 2019, WPV1 transmission has also spread from Pakistan's core poliovirus reservoirs (Karachi, Peshawar, and Quetta block) to southern districts of Khyber Pakhtunkhwa (KP), Punjab, and Sindh provinces. Further, an outbreak of circulating vaccine-derived poliovirus type 2 (cVDPV2), first detected in July 2019, has caused 22 paralytic cases in 2019 and 59 as of September 15, 2020, throughout the country. The coronavirus disease 2019 (COVID-19) pandemic has substantially reduced delivery of polio vaccines through essential immunization (formerly routine immunization) and prevented implementation of polio supplementary immunization activities (SIAs)* during March-July 2020. This report describes Pakistan's progress in polio Eradication during January 2019-September 2020 and updates previous reports (1,3,4). The Pakistan polio program has reinitiated SIAs and will need large, intensive, high-quality campaigns with strategic use of available oral poliovirus vaccines (OPVs)† to control the surge and widespread transmission of WPV1 and cVDPV2.

  • progress toward Poliomyelitis Eradication pakistan january 2018 september 2019
    Morbidity and Mortality Weekly Report, 2019
    Co-Authors: Christopher H Hsu, Hamid Jafari, Abdirahman Mahamud, Jaume Jorba, Kelley Bullard, John Agbor, Milhia Kader, Malik Safi, Derek Ehrhardt
    Abstract:

    Afghanistan and Pakistan are the only countries that continue to confirm ongoing wild poliovirus type 1 (WPV1) transmission (1). During January 2018-September 2019 the number of WPV1 cases in Pakistan increased, compared with the number during the previous 4 years. This report updates previous reports on Pakistan's polio Eradication activities, progress, and challenges (2,3). In 2018, Pakistan reported 12 WPV1 cases, a 50% increase from eight cases in 2017, and a 31% increase in the proportion of WPV1-positive sites under environmental surveillance (i.e., sampling of sewage to detect poliovirus). As of November 7, 2019, 80 WPV1 cases had been reported, compared with eight cases by the same time in 2018. An intensive schedule of supplementary immunization activities (SIAs)* implemented by community health workers in the core reservoirs (i.e., Karachi, Peshawar, and Quetta) where WPV1 circulation has never been interrupted, and by mobile teams, has failed to interrupt WPV1 transmission in core reservoirs and prevent WPV1 resurgence in nonreservoir areas. Sewage samples have indicated wide WPV1 transmission in nonreservoir areas in other districts and provinces. Vaccine refusals, chronically missed children, community campaign fatigue, and poor vaccination management and implementation have exacerbated the situation. To overcome challenges to vaccinating children who are chronically missed in SIAs and to attain country and global polio Eradication goals, substantial changes are needed in Pakistan's polio Eradication program, including continuing cross-border coordination with Afghanistan, gaining community trust, conducting high-quality vaccination campaigns, improving oversight of field activities, and improving managerial processes to unify Eradication efforts.

  • progress toward Poliomyelitis Eradication pakistan january 2016 september 2017
    Morbidity and Mortality Weekly Report, 2017
    Co-Authors: Youness Elhamidi, Salmaan Sharif, Christopher H Hsu, Abdirahman Mahamud, Muhammad Safdar, Jaume Jorba, Wasan Al Tamimi, Chukwuma Mbaeyi, Zubair Wadood, Derek Ehrhardt
    Abstract:

    In 1988, the World Health Assembly launched the Global Polio Eradication Initiative. Among the three wild poliovirus serotypes, only wild poliovirus (WPV) type 1 (WPV1) has been detected since 2012. Since 2014, Pakistan, Afghanistan, and Nigeria remain the only countries with continuing endemic WPV1 transmission. This report describes activities conducted and progress made toward the Eradication of poliovirus in Pakistan during January 2016-July 2017 and provides an update to previous reports (1,2). In 2016, Pakistan reported 20 WPV1 cases, a 63% decrease compared with 54 cases in 2015 (3). As of September 25, 2017, five WPV1 cases have been reported in 2017, representing a 69% decline compared with 16 cases reported during the same period in 2016 (Figure 1). During January-September 2017, WPV1 was detected in 72 of 468 (15%) environmental samples collected, compared with 36 of 348 (9%) samples collected during the same period in 2016. WPV1 was detected in environmental samples in areas where no polio cases are being reported, which indicates that WPV1 transmission is continuing in some high-risk areas. Interruption of WPV transmission in Pakistan requires maintaining focus on reaching missed children (particularly among mobile populations), continuing community-based vaccination, implementing the 2017-2018 National Emergency Action Plan (4), and improving routine immunization services.

  • progress toward Poliomyelitis Eradication pakistan january 2015 september 2016
    Morbidity and Mortality Weekly Report, 2016
    Co-Authors: Christopher H Hsu, Salmaan Sharif, Rudolph H Tangermann, Abdirahman Mahamud, Jaume Jorba, Jamal A Ahmed, Noha H Farag, Rana Muhammad Safdar, Maureen Martinez, Derek Ehrhardt
    Abstract:

    Pakistan, Afghanistan, and Nigeria remain the only countries where endemic wild poliovirus type 1 (WPV1) transmission continues. This report describes the activities, challenges, and progress toward polio Eradication in Pakistan during January 2015-September 2016 and updates previous reports (1,2). In 2015, a total of 54 WPV1 cases were reported in Pakistan, an 82% decrease from 2014. In 2016, 15 WPV1 cases had been reported as of November 1, representing a 61% decrease compared with the 38 cases reported during the same period in 2015 (Figure 1). Among the 15 WPV1 cases reported in 2016, children aged <36 months accounted for 13 cases; four of those children had received only a single dose of oral poliovirus vaccine (OPV). Seven of the 15 WPV1 cases occurred in the province of Khyber Pakhtunkhwa (KP), five in Sindh, two in the Federally Administered Tribal Areas (FATA), and one in Balochistan (3). During January-September 2016, WPV1 was detected in 9% (36 of 384) of environmental samples collected, compared with 19% (69 of 354) of samples collected during the same period in 2015. Rigorous implementation of the 2015-2016 National Emergency Action Plan (NEAP) (4), coordinated by the National Emergency Operations Center (EOC), has resulted in a substantial decrease in overall WPV1 circulation compared with the previous year. However, detection of WPV1 cases in high-risk areas and the detection of WPV1 in environmental samples from geographic areas where no polio cases are identified highlight the need to continue to improve the quality of supplemental immunization activities (SIAs),* immunization campaigns focused on vaccinating children with OPV outside of routine immunization services, and surveillance for acute flaccid paralysis (AFP). Continuation and refinement of successful program strategies, as outlined in the new 2016-2017 NEAP (5), with particular focus on identifying children missed by vaccination, community-based vaccination, and rapid response to virus identification are needed to stop WPV transmission.

  • progress toward Poliomyelitis Eradication pakistan january 2014 september 2015
    Morbidity and Mortality Weekly Report, 2015
    Co-Authors: Noha H Farag, Rudolph H Tangermann, Mufti Zubair Wadood, Rana Muhammad Safdar, Nabil Ahmed, Sabrine Hamdi, Derek Ehrhardt
    Abstract:

    Since Nigeria reported its last case of wild poliovirus type 1 (WPV1) in July 2014, Pakistan and Afghanistan remain the only two countries where WPV transmission has never been interrupted. This report describes actions taken and progress achieved toward polio Eradication in Pakistan during January 2014-September 2015 and updates previous reports. A total of 38 WPV1 cases were reported in Pakistan during January-September 2015, compared with 243 during the same period in 2014 (an 84% decline). Among WPV1 cases reported in 2015, 32 (84%) occurred in children aged <36 months, nine (32%) of whom had never received oral poliovirus vaccine (OPV). Twenty-six (68%) of the 38 reported cases occurred in the Federally Administered Tribal Areas (FATA) and Khyber Pakhtunkhwa (KPK) Province. During January-September 2015, WPV1 was detected in 20% (64 of 325) of environmental samples collected, compared with 34% (98 of 294) of samples collected during the same period in 2014. The quality and scope of polio Eradication activities improved considerably following the establishment of a national Emergency Operations Center, which coordinated polio Eradication partners' activities. All activities are following a National Polio Eradication Emergency Action Plan that includes a rigorous action plan for the polio low transmission season (January-April). The presence of WPV1 in environmental samples in areas where no polio cases are detected highlights the need to improve surveillance for acute flaccid paralysis (AFP). Focused efforts to close remaining immunity gaps by locating, tracking, and vaccinating continually missed children and improving coverage with OPV through the routine vaccination program are needed to stop WPV transmission in Pakistan.

J M Olive - One of the best experts on this subject based on the ideXlab platform.

  • disease Eradication as a public health strategy a case study of Poliomyelitis Eradication
    Bulletin of The World Health Organization, 2000
    Co-Authors: R B Aylward, J M Olive, Stephen L Cochi, Harry F Hull, B Melgaard
    Abstract:

    Disease Eradication as a public health strategy was discussed at international meetings in 1997 and 1998. In this article, the ongoing Poliomyelitis Eradication initiative is examined using the criteria for evaluating candidate diseases for Eradication proposed at these meetings, which covered costs and benefits, biological determinants of eradicability (technical feasibility) and societal and political considerations (operational feasibility). The benefits of Poliomyelitis Eradication are shown to include a substantial investment in health services delivery, the elimination of a major cause of disability, and far-reaching intangible effects, such as establishment of a "culture of prevention". The costs are found to be financial and finite, despite some disturbances to the delivery of other health services. The "technical" feasibility of Poliomyelitis Eradication is seen in the absence of a non-human reservoir and the presence of both an effective intervention and delivery strategy (oral poliovirus vaccine and national immunization days) and a sensitive and specific diagnostic tool (viral culture of specimens from acute flaccid paralysis cases). The certification of Poliomyelitis Eradication in the Americas in 1994 and interruption of endemic transmission in the Western Pacific since March 1997 confirm the operational feasibility of this goal. When the humanitarian, economic and consequent benefits of this initiative are measured against the costs, a strong argument is made for Eradication as a valuable disease control strategy.

  • Eradication of wild poliovirus from the americas acute flaccid paralysis surveillance 1988 1995
    The Journal of Infectious Diseases, 1997
    Co-Authors: Ciro A. De Quadros, Bradley S Hersh, J M Olive, Jon Kim Andrus, C M Da Silveira, Peter Carrasco
    Abstract:

    In May 1985, the Pan American Health Organization proposed the goal of interruption of wild poliovirus transmission in the Western Hemisphere. An important component of the polio Eradication strategy was conducting surveillance for cases of acute flaccid paralysis. Reported cases were thoroughly investigated, including the collection of stool samples for testing for the presence of wild poliovirus. The last patient with Poliomyelitis due to wild poliovirus in the Americas had onset of paralysis on 23 August 1991 in Peru. Since then, >9000 cases of acute flaccid paralysis have been reported and thoroughly investigated; none has been confirmed as paralytic Poliomyelitis due to wild poliovirus. On 29 September 1994, the International Commission for the Certification of Poliomyelitis Eradication declared the Americas to be polio-free.

  • current status of the global Eradication of Poliomyelitis
    World health statistics quarterly. Rapport trimestriel de statistiques sanitaires mondiales, 1997
    Co-Authors: Rudolph H Tangermann, J M Olive, H F Hull, B R Aylward, M Birmingham, R Horner, B Nkowane, A Burton
    Abstract:

    Substantial progress towards the global Eradication of Poliomyelitis by the year 2000 has been achieved since May 1988 when WHO Member States adopted this goal at the Forty-first World Health Assembly. Virtually all polio-endemic countries have begun to implement the WHO-recommended strategies to eradicate polio and it is expected that, by the end of 1997, all endemic countries in the world will have conducted full National Immunization Days (NID), providing supplemental oral polio vaccine (OPV) to nearly two-thirds of all children < 5 years. In contrast, although globally acute flaccid paralysis (AFP) surveillance was being conducted in 126 (86%) of 146 countries where polio is or recently was endemic, surveillance remains incomplete and untimely. A global network of polio laboratories, capable of detecting wild poliovirus when and where it occurs, has been developed. Furthermore, in countries where polio virus circulation has been limited to focal areas, and surveillance is adequate, mopping-up campaigns are being conducted to eliminate the final chains of transmission. The process for certification of polio Eradication has been established in each WHO region as well as at the global level. The impact of the Eradication initiative is evident, with an 88% decrease in the number of reported cases globally since 1988. In order to achieve the goal of Eradication, the rapid development of complete and timely AFP surveillance and the continuation of effective NIDs constitute an urgent priority. This is of particular relevance in the remaining polio-endemic countries, especially in those that are affected by war or politically isolated and are important remaining reservoirs from where wild poliovirus continues to spread into bordering or even distant polio-free countries. External support will continue to be required by those countries and regions where the incidence of polio has reached low levels to ensure that final chains of poliovirus transmission are interrupted and to permit the eventual certification of Eradication. The year 2000 objective for achieving Poliomyelitis Eradication remains a feasible target.

  • Risk of vaccine-associated paralytic Poliomyelitis in Latin America, 1989-91.
    Bulletin of the World Health Organization, 1995
    Co-Authors: Jon Kim Andrus, Peter M. Strebel, C. A. De Quadros, J M Olive
    Abstract:

    A major factor influencing the success of Poliomyelitis Eradication in the Americas was the reliance on mass immunization campaigns with oral poliovirus vaccine (OPV). As global Poliomyelitis Eradication activities accelerate and campaign vaccine delivery strategies are applied elsewhere, it is critical to determine whether the risk of vaccine-associated paralytic Poliomyelitis (VAPP) is altered when routine delivery strategies are supplemented with mass immunization campaigns. We analysed all 6043 cases of acute flaccid paralysis (AFP) reported in Latin America over the period 1989-91 in order to estimate the risk of VAPP. The overall risk was estimated to be one case per 1.5-2.2 million doses of OPV administered, compared with one case per 1.4 million doses administered in England and Wales (1985-91) and with one case per 2.5 million net doses distributed in the USA (1980-89). These data suggest that to eradicate Poliomyelitis globally, strategies that rely on mass immunization campaigns to supplement routine delivery services, as recommended by WHO, do not appear to alter significantly the risk of VAPP.

  • strategies for Poliomyelitis Eradication in developing countries
    Public health reviews, 1993
    Co-Authors: J K Andrus, J M Olive, Peter Carrasco
    Abstract:

    Oral polio vaccine (OPV) delivered only through routine services does not appear to interrupt wild virus transmission in the developing countries. The experience in the Americas, which despite intensive surveillance has not confirmed any cases of paralytic Poliomyelitis due to wild poliovirus since 23 August 1991, has shown the necessity of delivery of additional doses of OPV through mass campaigns targeted at all children under five years of age regardless of their previous immunization status and in special mop-up operations targeted at this same age group in areas categorized as at high risk of virus transmission, such as those that harbored the virus in the recent past. High-risk areas were determined by empirical observations, which were subsequently confirmed by molecular epidemiology which indicated the presence of several "reservoirs" that helped maintain transmission over several years. During mop-ups, OPV is delivered house by house. This paper discusses the rationale for the utilization of these strategies and outlines the phases for their preparation and evaluation, with illustrations from recent experiences with the last cases of paralytic Poliomyelitis in the Americas.

Rudolph H Tangermann - One of the best experts on this subject based on the ideXlab platform.

  • progress toward Poliomyelitis Eradication pakistan january 2015 september 2016
    Morbidity and Mortality Weekly Report, 2016
    Co-Authors: Christopher H Hsu, Salmaan Sharif, Rudolph H Tangermann, Abdirahman Mahamud, Jaume Jorba, Jamal A Ahmed, Noha H Farag, Rana Muhammad Safdar, Maureen Martinez, Derek Ehrhardt
    Abstract:

    Pakistan, Afghanistan, and Nigeria remain the only countries where endemic wild poliovirus type 1 (WPV1) transmission continues. This report describes the activities, challenges, and progress toward polio Eradication in Pakistan during January 2015-September 2016 and updates previous reports (1,2). In 2015, a total of 54 WPV1 cases were reported in Pakistan, an 82% decrease from 2014. In 2016, 15 WPV1 cases had been reported as of November 1, representing a 61% decrease compared with the 38 cases reported during the same period in 2015 (Figure 1). Among the 15 WPV1 cases reported in 2016, children aged <36 months accounted for 13 cases; four of those children had received only a single dose of oral poliovirus vaccine (OPV). Seven of the 15 WPV1 cases occurred in the province of Khyber Pakhtunkhwa (KP), five in Sindh, two in the Federally Administered Tribal Areas (FATA), and one in Balochistan (3). During January-September 2016, WPV1 was detected in 9% (36 of 384) of environmental samples collected, compared with 19% (69 of 354) of samples collected during the same period in 2015. Rigorous implementation of the 2015-2016 National Emergency Action Plan (NEAP) (4), coordinated by the National Emergency Operations Center (EOC), has resulted in a substantial decrease in overall WPV1 circulation compared with the previous year. However, detection of WPV1 cases in high-risk areas and the detection of WPV1 in environmental samples from geographic areas where no polio cases are identified highlight the need to continue to improve the quality of supplemental immunization activities (SIAs),* immunization campaigns focused on vaccinating children with OPV outside of routine immunization services, and surveillance for acute flaccid paralysis (AFP). Continuation and refinement of successful program strategies, as outlined in the new 2016-2017 NEAP (5), with particular focus on identifying children missed by vaccination, community-based vaccination, and rapid response to virus identification are needed to stop WPV transmission.

  • progress toward Poliomyelitis Eradication pakistan january 2014 september 2015
    Morbidity and Mortality Weekly Report, 2015
    Co-Authors: Noha H Farag, Rudolph H Tangermann, Mufti Zubair Wadood, Rana Muhammad Safdar, Nabil Ahmed, Sabrine Hamdi, Derek Ehrhardt
    Abstract:

    Since Nigeria reported its last case of wild poliovirus type 1 (WPV1) in July 2014, Pakistan and Afghanistan remain the only two countries where WPV transmission has never been interrupted. This report describes actions taken and progress achieved toward polio Eradication in Pakistan during January 2014-September 2015 and updates previous reports. A total of 38 WPV1 cases were reported in Pakistan during January-September 2015, compared with 243 during the same period in 2014 (an 84% decline). Among WPV1 cases reported in 2015, 32 (84%) occurred in children aged <36 months, nine (32%) of whom had never received oral poliovirus vaccine (OPV). Twenty-six (68%) of the 38 reported cases occurred in the Federally Administered Tribal Areas (FATA) and Khyber Pakhtunkhwa (KPK) Province. During January-September 2015, WPV1 was detected in 20% (64 of 325) of environmental samples collected, compared with 34% (98 of 294) of samples collected during the same period in 2014. The quality and scope of polio Eradication activities improved considerably following the establishment of a national Emergency Operations Center, which coordinated polio Eradication partners' activities. All activities are following a National Polio Eradication Emergency Action Plan that includes a rigorous action plan for the polio low transmission season (January-April). The presence of WPV1 in environmental samples in areas where no polio cases are detected highlights the need to improve surveillance for acute flaccid paralysis (AFP). Focused efforts to close remaining immunity gaps by locating, tracking, and vaccinating continually missed children and improving coverage with OPV through the routine vaccination program are needed to stop WPV transmission in Pakistan.

  • progress toward Poliomyelitis Eradication afghanistan january 2016 june 2017
    Morbidity and Mortality Weekly Report, 2015
    Co-Authors: Maureen Martinez, Rudolph H Tangermann, Joanna Nikulin, Jaume Jorba, Mufti Zubair Wadood, Chukwuma Mbaeyi, Hemant Shukla, Stephen C Hadler, Derek Ehrhardt
    Abstract:

    Despite recent progress toward global polio Eradication, endemic transmission of wild poliovirus (WPV) continues to be reported in Afghanistan and Pakistan. The Afghanistan program must overcome many challenges to remain on track toward achieving the objectives set in the 2013–2018 strategic plan of the Global Polio Eradication Initiative (GPEI). Cross-border transmission of WPV type 1 (WPV1) continues to occur among children traveling to and from Pakistan. The country's routine immunization system remains weak and unable to reach recommended benchmarks in most regions; hence, the national Polio Eradication Initiative (PEI) relies mainly on providing children aged <5 years with oral poliovirus vaccine (OPV), administered during supplementary immunization activities (SIAs). Because of ongoing conflict and insecurity, some children continue to be missed during SIAs in areas not under government control; however, the majority of missed children live in accessible areas and are often unreached because of a failure to plan, implement, and supervise SIAs efficiently. This report describes polio Eradication activities and progress in Afghanistan during January 2014‒August 2015 and updates previous reports. During 2014, a total of 28 WPV1 cases were reported in Afghanistan, compared with 14 cases in 2013; nine cases were reported during January‒August 2015, the same number as during the same period in 2014. To eliminate poliovirus transmission in Afghanistan, emergency operations centers (EOCs) need to be established at the national level and in critical regions without delay to improve overall coordination and oversight of polio Eradication activities. The recently revised National Emergency Action Plan for polio Eradication needs to be fully implemented, including detailed microplanning and enhanced monitoring and supervision of SIAs, as well as improved cross-border coordination with Pakistan.

  • progress toward Poliomyelitis Eradication afghanistan and pakistan january 2013 august 2014
    Morbidity and Mortality Weekly Report, 2014
    Co-Authors: Noha H Farag, Elias Durry, Rudolph H Tangermann, Mufti Zubair Wadood, Stephen C Hadler, James Alexander, Arshad Quddus, Derek Ehrhardt
    Abstract:

    In 2012 the World Health Assembly declared the completion of polio Eradication a programmatic emergency for global public health and called for a comprehensive polio endgame strategy. Afghanistan and Pakistan are two of the three remaining countries (the other is Nigeria) where circulation of indigenous wild poliovirus (WPV) has never been interrupted. This report updates previous reports and describes polio Eradication activities and progress in Afghanistan and Pakistan during January 2013-August 2014. In Afghanistan 14 WPV cases were reported in 2013 compared with 37 cases in 2012; nine cases were reported during January-August 2014 compared with six cases during the same period in 2013. In Pakistan 93 WPV cases were reported in 2013 compared with 58 cases in 2012; 170 cases were reported during January-August 2014 compared with 33 cases during the same period in 2013. All WPV cases reported during January 2013-August 2014 were WPV type 1 (WPV1). Vaccination campaigns have been banned since June 2012 in specific areas in Pakistan where an estimated 300000 children aged <5 years reside and where 69% of WPV cases have occurred in 2014. To accomplish the objectives of the Polio Eradication and Endgame Strategic Plan for 2013-2018 both countries should continue to negotiate access of vaccinators to insecure and temporarily inaccessible areas improve immunization program performance to reach more children in accessible areas and ensure that political and health leaders at all levels are fully committed to the program including being committed to providing financial resources needed to fully implement all the recommendations of external technical advisory groups. Both countries should also continue to strengthen cross-border collaboration to improve surveillance and case detection coordinate outbreak response and maximize vaccination coverage of children moving between the two countries.

  • Poliomyelitis Eradication in the western pacific region
    The Journal of Infectious Diseases, 1997
    Co-Authors: Rudolph H Tangermann, R B Aylward, Julian Bilous, Christopher Maher, Alan Schnur, Yoshikuni Sato, Shigeru Omi
    Abstract:

    Polio Eradication activities in the Western Pacific Region (WPR) have reduced the transmission of wild poliovirus to one remaining focus of endemic transmission in the Mekong Delta area of South Vietnam and Cambodia. There has been a high level of government commitment for national immunization days in all WPR countries in which Poliomyelitis was previously endemic and for continuous improvement in acute flaccid paralysis (AFP) surveillance quality. The total number of reported confirmed Poliomyelitis cases in 1995 (as of June 1996) was 432, only 7% of the total of 5825 cases reported in 1990. In 1995, wild poliovirus was isolated from only 19 of 4800 AFP patients from whom specimens were collected and analyzed. There has been one importation of wild poliovirus type 1 into China from a neighboring country. An international Regional Commission for the Certification of Poliomyelitis Eradication in the WPR has been formed and met for the first time in April 1996.

Jaume Jorba - One of the best experts on this subject based on the ideXlab platform.

  • progress toward Poliomyelitis Eradication pakistan january 2020 july 2021
    Morbidity and Mortality Weekly Report, 2021
    Co-Authors: Chukwuma Mbaeyi, Hamid Jafari, Muhammad Safdar, Jaume Jorba, Hamish Young, Shahzad Baig, Zainul Khan, Millhia Kader, Richard Franka
    Abstract:

    When the Global Polio Eradication Initiative began in 1988, wild poliovirus (WPV) transmission was occurring in 125 countries; currently, only WPV type 1 (WPV1) transmission continues, and as of August 2021, WPV1 transmission persists in only two countries (1,2). This report describes Pakistan's progress toward polio Eradication during January 2020-July 2021 and updates previous reports (3,4). In 2020, Pakistan reported 84 WPV1 cases, a 43% reduction from 2019; as of August 25, 2021, Pakistan has reported one WPV1 case in 2021. Circulating vaccine-derived poliovirus (cVDPV) emerges as a result of attenuated oral poliovirus vaccine (OPV) virus regaining neurovirulence after prolonged circulation in underimmunized populations and can lead to paralysis. In 2019, 22 cases of cVDPV type 2 (cVDPV2) were reported in Pakistan, 135 cases were reported in 2020, and eight cases have been reported as of August 25, 2021. Because of the COVID-19 pandemic, planned supplementary immunization activities (SIAs)* were suspended during mid-March-June 2020 (3,5). Seven SIAs were implemented during July 2020-July 2021 without substantial decreases in SIA quality. Improving the quality of polio SIAs, vaccinating immigrants from Afghanistan, and implementing changes to enhance program accountability and performance would help the Pakistan polio program achieve its goal of interrupting WPV1 transmission by the end of 2022.

  • progress toward Poliomyelitis Eradication pakistan january 2019 september 2020
    Morbidity and Mortality Weekly Report, 2020
    Co-Authors: Christopher H Hsu, Hamid Jafari, Muhammad Safdar, Jaume Jorba, Kelley Bullard, Milhia Kader, Muhammad Shafiqur Rehman, Hamish Young, Derek Ehrhardt
    Abstract:

    Pakistan and Afghanistan are the only countries where wild poliovirus type 1 (WPV1) is endemic (1,2). In 2019, Pakistan reported 147 WPV1 cases, approximately 12 times the number reported in 2018. As of September 15, 72 cases had been reported in 2020. Since 2019, WPV1 transmission has also spread from Pakistan's core poliovirus reservoirs (Karachi, Peshawar, and Quetta block) to southern districts of Khyber Pakhtunkhwa (KP), Punjab, and Sindh provinces. Further, an outbreak of circulating vaccine-derived poliovirus type 2 (cVDPV2), first detected in July 2019, has caused 22 paralytic cases in 2019 and 59 as of September 15, 2020, throughout the country. The coronavirus disease 2019 (COVID-19) pandemic has substantially reduced delivery of polio vaccines through essential immunization (formerly routine immunization) and prevented implementation of polio supplementary immunization activities (SIAs)* during March-July 2020. This report describes Pakistan's progress in polio Eradication during January 2019-September 2020 and updates previous reports (1,3,4). The Pakistan polio program has reinitiated SIAs and will need large, intensive, high-quality campaigns with strategic use of available oral poliovirus vaccines (OPVs)† to control the surge and widespread transmission of WPV1 and cVDPV2.

  • progress toward Poliomyelitis Eradication pakistan january 2018 september 2019
    Morbidity and Mortality Weekly Report, 2019
    Co-Authors: Christopher H Hsu, Hamid Jafari, Abdirahman Mahamud, Jaume Jorba, Kelley Bullard, John Agbor, Milhia Kader, Malik Safi, Derek Ehrhardt
    Abstract:

    Afghanistan and Pakistan are the only countries that continue to confirm ongoing wild poliovirus type 1 (WPV1) transmission (1). During January 2018-September 2019 the number of WPV1 cases in Pakistan increased, compared with the number during the previous 4 years. This report updates previous reports on Pakistan's polio Eradication activities, progress, and challenges (2,3). In 2018, Pakistan reported 12 WPV1 cases, a 50% increase from eight cases in 2017, and a 31% increase in the proportion of WPV1-positive sites under environmental surveillance (i.e., sampling of sewage to detect poliovirus). As of November 7, 2019, 80 WPV1 cases had been reported, compared with eight cases by the same time in 2018. An intensive schedule of supplementary immunization activities (SIAs)* implemented by community health workers in the core reservoirs (i.e., Karachi, Peshawar, and Quetta) where WPV1 circulation has never been interrupted, and by mobile teams, has failed to interrupt WPV1 transmission in core reservoirs and prevent WPV1 resurgence in nonreservoir areas. Sewage samples have indicated wide WPV1 transmission in nonreservoir areas in other districts and provinces. Vaccine refusals, chronically missed children, community campaign fatigue, and poor vaccination management and implementation have exacerbated the situation. To overcome challenges to vaccinating children who are chronically missed in SIAs and to attain country and global polio Eradication goals, substantial changes are needed in Pakistan's polio Eradication program, including continuing cross-border coordination with Afghanistan, gaining community trust, conducting high-quality vaccination campaigns, improving oversight of field activities, and improving managerial processes to unify Eradication efforts.

  • progress toward Poliomyelitis Eradication pakistan january 2017 september 2018
    Morbidity and Mortality Weekly Report, 2018
    Co-Authors: Christopher H Hsu, Salmaan Sharif, Abdirahman Mahamud, Muhammad Safdar, Joanna Nikulin, Jaume Jorba, Kelley Bullard, John Agbor, Milhia Kader, Jamal A Ahmed
    Abstract:

    Among the three wild poliovirus (WPV) serotypes, only WPV type 1 (WPV1) has been reported in polio cases or detected from environmental surveillance globally since 2012. Pakistan remains one of only three countries worldwide (the others are Afghanistan and Nigeria) that has never had interrupted WPV1 transmission. This report documents Pakistan's activities and progress toward polio Eradication during January 2017-September 2018 and updates previous reports (1,2). In 2017, Pakistan reported eight WPV1 cases, a 60% decrease from 20 cases in 2016. As of September 18, 2018, four cases had been reported, compared with five cases at that time in 2017. Nonetheless, in 2018, WPV1 continues to be isolated regularly from environmental surveillance sites, primarily in the core reservoir areas of Karachi, Quetta, and Peshawar, signifying persistent transmission. Strategies to increase childhood immunity have included an intense schedule of supplemental immunization activities (SIAs), expanding and refining deployment of community-based vaccination implemented by community health workers recruited from the local community in reservoir areas, and strategic placement of permanent transit points where vaccination is provided to mobile populations. Interruption of WPV1 transmission will require further programmatic improvements throughout the country with a focus on specific underperforming subdistricts in reservoir areas.

  • progress toward Poliomyelitis Eradication pakistan january 2016 september 2017
    Morbidity and Mortality Weekly Report, 2017
    Co-Authors: Youness Elhamidi, Salmaan Sharif, Christopher H Hsu, Abdirahman Mahamud, Muhammad Safdar, Jaume Jorba, Wasan Al Tamimi, Chukwuma Mbaeyi, Zubair Wadood, Derek Ehrhardt
    Abstract:

    In 1988, the World Health Assembly launched the Global Polio Eradication Initiative. Among the three wild poliovirus serotypes, only wild poliovirus (WPV) type 1 (WPV1) has been detected since 2012. Since 2014, Pakistan, Afghanistan, and Nigeria remain the only countries with continuing endemic WPV1 transmission. This report describes activities conducted and progress made toward the Eradication of poliovirus in Pakistan during January 2016-July 2017 and provides an update to previous reports (1,2). In 2016, Pakistan reported 20 WPV1 cases, a 63% decrease compared with 54 cases in 2015 (3). As of September 25, 2017, five WPV1 cases have been reported in 2017, representing a 69% decline compared with 16 cases reported during the same period in 2016 (Figure 1). During January-September 2017, WPV1 was detected in 72 of 468 (15%) environmental samples collected, compared with 36 of 348 (9%) samples collected during the same period in 2016. WPV1 was detected in environmental samples in areas where no polio cases are being reported, which indicates that WPV1 transmission is continuing in some high-risk areas. Interruption of WPV transmission in Pakistan requires maintaining focus on reaching missed children (particularly among mobile populations), continuing community-based vaccination, implementing the 2017-2018 National Emergency Action Plan (4), and improving routine immunization services.

R B Aylward - One of the best experts on this subject based on the ideXlab platform.

  • disease Eradication as a public health strategy a case study of Poliomyelitis Eradication
    Bulletin of The World Health Organization, 2000
    Co-Authors: R B Aylward, J M Olive, Stephen L Cochi, Harry F Hull, B Melgaard
    Abstract:

    Disease Eradication as a public health strategy was discussed at international meetings in 1997 and 1998. In this article, the ongoing Poliomyelitis Eradication initiative is examined using the criteria for evaluating candidate diseases for Eradication proposed at these meetings, which covered costs and benefits, biological determinants of eradicability (technical feasibility) and societal and political considerations (operational feasibility). The benefits of Poliomyelitis Eradication are shown to include a substantial investment in health services delivery, the elimination of a major cause of disability, and far-reaching intangible effects, such as establishment of a "culture of prevention". The costs are found to be financial and finite, despite some disturbances to the delivery of other health services. The "technical" feasibility of Poliomyelitis Eradication is seen in the absence of a non-human reservoir and the presence of both an effective intervention and delivery strategy (oral poliovirus vaccine and national immunization days) and a sensitive and specific diagnostic tool (viral culture of specimens from acute flaccid paralysis cases). The certification of Poliomyelitis Eradication in the Americas in 1994 and interruption of endemic transmission in the Western Pacific since March 1997 confirm the operational feasibility of this goal. When the humanitarian, economic and consequent benefits of this initiative are measured against the costs, a strong argument is made for Eradication as a valuable disease control strategy.

  • perspectives from the global Poliomyelitis Eradication initiative
    Bulletin of The World Health Organization, 1998
    Co-Authors: Harry F Hull, Jon Kim Andrus, Julian Bilous, De Quadros C, G Oblapenko, R Aslanian, Hamid Jafari, J M Bele, R B Aylward
    Abstract:

    Ten years after the year 2000 target was set by the World Health Assembly, the global Poliomyelitis Eradication effort has made significant progress towards that goal. The success of the initiative is built on political commitment within the endemic countries. A partnership of international organizations and donor countries works to support the work of the countries. Interagency coordinating committees are used to ensure that all country needs are met and to avoid duplication of donor effort. Private sector support has greatly expanded the resources available at both the national and international level. At the programmatic level, rapid implementation of surveillance is the key to success, but the difficulty of building effective surveillance programmes is often underestimated. Mass immunization campaigns must be carefully planned with resources mobilized well in advance. Programme strategies should be simple, clear and concise. While improvements in strategy and technology should be continuously sought, changes should be introduced only after careful consideration. Careful consideration should be given in the planning phases of a disease control initiative on how the initiative can be used to support other health initiatives.

  • Poliomyelitis Eradication in the western pacific region
    The Journal of Infectious Diseases, 1997
    Co-Authors: Rudolph H Tangermann, R B Aylward, Julian Bilous, Christopher Maher, Alan Schnur, Yoshikuni Sato, Shigeru Omi
    Abstract:

    Polio Eradication activities in the Western Pacific Region (WPR) have reduced the transmission of wild poliovirus to one remaining focus of endemic transmission in the Mekong Delta area of South Vietnam and Cambodia. There has been a high level of government commitment for national immunization days in all WPR countries in which Poliomyelitis was previously endemic and for continuous improvement in acute flaccid paralysis (AFP) surveillance quality. The total number of reported confirmed Poliomyelitis cases in 1995 (as of June 1996) was 432, only 7% of the total of 5825 cases reported in 1990. In 1995, wild poliovirus was isolated from only 19 of 4800 AFP patients from whom specimens were collected and analyzed. There has been one importation of wild poliovirus type 1 into China from a neighboring country. An international Regional Commission for the Certification of Poliomyelitis Eradication in the WPR has been formed and met for the first time in April 1996.

  • unimmunized gypsy populations and implications for the Eradication of Poliomyelitis in europe
    The Journal of Infectious Diseases, 1997
    Co-Authors: R B Aylward, Daniela Porta, L Fiore, B Ridolfi, P Chierchini, F Forastiere
    Abstract:

    The certification of Poliomyelitis Eradication in Europe will eventually require that countries demonstrate there is a minimal risk of wild poliovirus reintroduction and sustained transmission through unimmunized subpopulations such as ethnic minorities. A serologic survey among a Gypsy community in Italy found that despite only 26% documented immunization coverage, serum neutralizing antibodies to poliovirus types 1, 2, and 3 were detected in 81%, 94%, and 63% of the 86 persons studied. While the high level of immunity found in this community may have been due to secondary spread of vaccine virus, the possibility of unrecognized circulation of wild polioviruses cannot be excluded. Targeted immunization of such groups may be the most efficient means of eliminating the risk of importation-associated outbreaks.