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The Pan African Medical Journal 2023in Nigeria, supportive supervision of Supplementary Immunization Activities (SIA) is a quality improvement strategy for providing support to vaccination teams...
Assessment of open data kit mobile technology adoption to enhance reporting of supportive supervision conducted for oral poliovirus vaccine supplementary immunization activities in Nigeria, March 2017-February 2020.
INTRODUCTION
in Nigeria, supportive supervision of Supplementary Immunization Activities (SIA) is a quality improvement strategy for providing support to vaccination teams administering the poliovirus vaccines to children under 5 years of age. Supervision activities were initially reported in paper forms. This had significant limitations, which led to Open Data Kit (ODK) technology being adopted in March 2017. A review was conducted to assess the impact of ODK for supervision reporting in place of paper forms.
METHODS
issues with paper-based reporting and the benefits of ODK were recounted. We determined the average utilization of ODK per polio SIA rounds and assessed the supervision coverage over time based on the proportion of local government areas with ODK geolocation data per round.
RESULTS
a total of 17 problematic issues were identified with paper-based reporting, and ODK addressed all the issues. Open Data Kit-based supervision reports increased from 3,125 in March 2017 to 51,060 in February 2020. Average ODK submissions for national rounds increased from 84 in March 2017 to 459 in February 2020 and for sub-national rounds increased from 533 in July 2017 to 1,596 in October 2019. Supportive supervision coverage improved from 42.5% in March 2017 to 97% in February 2020.
CONCLUSION
the use of digital technologies in public health has comparative advantages over paper forms, and the adoption of ODK for supervision reporting during polio SIAs in Nigeria experienced the advantages. The visibility and coverage of supportive supervision improved, consequentially contributing to the improved quality of polio SIAs.
Topics: Child; Humans; Child, Preschool; Poliovirus Vaccine, Oral; Nigeria; Vaccination; Poliomyelitis; Digital Technology; Immunization Programs; Poliovirus
PubMed: 38370103
DOI: 10.11604/pamj.supp.2023.45.2.38140 -
The Pan African Medical Journal 2023novel oral poliovirus vaccine type 2 (nOPV2), designed to be more genetically stable than Sabin-strain oral poliovirus vaccine type 2 (mOPV2), is a new and key component...
INTRODUCTION
novel oral poliovirus vaccine type 2 (nOPV2), designed to be more genetically stable than Sabin-strain oral poliovirus vaccine type 2 (mOPV2), is a new and key component of the Global Polio Eradication Initiative's strategy to combat outbreaks of circulating vaccine-derived poliovirus type 2 (cVDPV2). The World Health Organization´s (WHO´s) emergency use listing (EUL) requires extensive safety monitoring for Adverse Event of Special Interest (AESI) in its use. We implemented AESI active surveillance to monitor the safety of the nOPV2 in Nigeria.
METHODS
a cross-sectional assessment was conducted in Nigeria during March-June 2021 in 117 local government areas (LGAs) across 6 states and the Federal Capital Area with confirmed cVDPV2 transmission. We conducted active searches for nOPV2 AESI in all health facilities. Suspected events were ascertained, and vaccination and clinical data abstracted. Events were classified using WHO causality assessment algorithm. Data were analyzed using Epi info7.
RESULTS
total of 234 adverse events were reported after 21,997,300 doses of nOPV2 were administered, giving a crude reported incidence of 1 in 94,000 doses of nOPV2. Altogether, 221 of the 234 (94%) adverse events were classified. For 166 AESI ascertained to occur following a dose of nOPV2, the corrected crude incidence rate was 1 in 133,000 doses; 4 of the adverse events, were classified as consistent with casual association with nOPV2 vaccination.
CONCLUSION
we found that nOPV2 had a low incidence of AESI following nOPV2 campaigns and no new or unexpected adverse event was reported. Safety monitoring should be sustained for early detection of signals and uncommon adverse events.
Topics: Humans; Cross-Sectional Studies; Disease Outbreaks; Nigeria; Poliomyelitis; Poliovirus; Poliovirus Vaccine, Oral
PubMed: 38370101
DOI: 10.11604/pamj.supp.2023.45.2.40228 -
The Pan African Medical Journal 2023
Topics: Humans; Nigeria; Poliomyelitis; Global Health; Disease Eradication; Poliovirus Vaccine, Oral; Immunization Programs; Poliovirus
PubMed: 38370100
DOI: 10.11604/pamj.supp.2023.45.2.41049 -
The Pan African Medical Journal 2023in August 2020, the World Health Organization African Region was certified free of wild poliovirus (WPV) when Nigeria became the last African country to interrupt wild...
INTRODUCTION
in August 2020, the World Health Organization African Region was certified free of wild poliovirus (WPV) when Nigeria became the last African country to interrupt wild poliovirus transmission. The National Polio Emergency Operations Center instituted in 2012 to coordinate and manage Nigerian polio eradication efforts reviewed the epidemiology of WPV cases during 2000-2020 to document lessons learned.
METHODS
we analyzed reported WPV cases by serotype based on age, oral poliovirus vaccine immunization history, month and year of reported cases, and annual geographic distribution based on incidence rates at the Local Government Area level. The observed trends of cases were related to major events and the poliovirus vaccines used during mass vaccination campaigns within the analysis period.
RESULTS
a total of 3,579 WPV type 1 and 1,548 WPV type 3 laboratory-confirmed cases were reported with onset during 2000-2020. The highest WPV incidence rates per 100,000 population in Local Government Areas were 19.4, 12.0, and 11.3, all in 2006. Wild poliovirus cases were reported each year during 2000-2014; the endemic transmission went undetected throughout 2015 until the last cases in 2016. Ten events/milestones were highlighted, including insurgency in the northeast which led to a setback in 2016 with four cases from children previously trapped in security-compromised areas.
CONCLUSION
Nigeria interrupted WPV transmission despite the challenges faced because of the emergency management approach, implementation of mass vaccination campaigns, the commitment of the government agencies, support from global polio partners, and special strategies deployed to conduct vaccination and surveillance in the security-compromised areas.
Topics: Child; Humans; Poliovirus; Nigeria; Population Surveillance; Poliomyelitis; Poliovirus Vaccines; Poliovirus Vaccine, Oral; Immunization Programs; Disease Eradication
PubMed: 38370099
DOI: 10.11604/pamj.supp.2023.45.2.38079 -
BMJ Global Health Feb 2024To assess the effect of providing BCG and oral polio vaccine (OPV) at an early home visit after delivery. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To assess the effect of providing BCG and oral polio vaccine (OPV) at an early home visit after delivery.
DESIGN
Cluster-randomised trial, randomising 92 geographically defined clusters 1:1 to intervention/control arms.
SETTING
Bandim Health Project Health and Demographic Surveillance System, Guinea-Bissau.
PARTICIPANTS
2226 newborns enrolled between July 2016 and August 2019.
INTERVENTIONS
In both arms, newborns received a home visit within 72 hours after birth. In intervention clusters (n=46), BCG and OPV were provided at the home visit.
MAIN OUTCOME MEASURE
Rates of non-accidental mortality were compared in Cox proportional hazards models from (last of) day 1 or enrolment, until (first of) day 60 or registration of non-trial vaccines.
RESULTS
A total of 35 deaths (intervention: 7, control: 28) were registered during the trial. Providing BCG and OPV reduced non-accidental early infant mortality by 59% (8-82%). The intervention also reduced non-accidental hospital admissions. The intervention had little impact on growth and BCG scarring and tended to increase the risk of consultations.
CONCLUSIONS
The trial was stopped early due to lower-than-expected enrolment and event rates when 33% of the planned number of newborns had been enrolled. Despite the small size of the trial, the results support that early BCG and OPV vaccinations are beneficial and reduce early child mortality and morbidity.
TRIAL REGISTRATION NUMBER
ClinicalTrials.gov Registry (NCT02504203).
Topics: Infant; Child; Humans; Infant, Newborn; BCG Vaccine; Guinea-Bissau; Japan; Infant Mortality; Vaccination; Poliovirus Vaccine, Oral
PubMed: 38350670
DOI: 10.1136/bmjgh-2023-014044 -
Health Science Reports Feb 2024Poliomyelitis is an acute neurologic condition that causes muscle weakness, permanent flaccid paralysis, and even death. The world has seen a drastic fall in the number...
BACKGROUND AND AIMS
Poliomyelitis is an acute neurologic condition that causes muscle weakness, permanent flaccid paralysis, and even death. The world has seen a drastic fall in the number of poliovirus cases owing to effective immunization programs and preventive measures. Pakistan and Afghanistan still remain the two endemic countries for poliovirus, particularly, the WPV1 strain. Global Polio Eradication Initiative (GPEI) has set a target to eradicate all WPV1 cases by the end of 2023. However, the re-emergence of WPV1 cases has posed a serious setback for the achievement of this target. This article aims to discuss the public health challenges that contribute to resurgence of poliovirus cases.
METHODS
A comprehensive literature search was conducted using various databases including Cochrane, Google Scholar, PubMed, Science Direct, MEDLINE. Only articles written in English were considered. All the articles reporting the incidence of poliovirus and WPV1 cases in Pakistan, surveillance data and global context of poliovirus outbreak were evaluated to write this correspondence. In addition, references from the selected articles were also examined to ensure a comprehensive review of the literature.
RESULTS
This article highlights the factors contributing to the re-emergence of WPV1 cases in Pakistan. Low vaccine coverage, attacks on frontline polio health workers, misinformation, and reluctance to vaccine acceptance pose a daunting challenge for polio eradication. Further, gaps in AFP surveillance and sensitivity may underestimate the true extent of the emerging genetic clusters. The Covid-19 pandemic and subsequent flooding in the affected area have further worsened the underdeveloped public health infrastructure.
CONCLUSION
Despite the challenges, the country has observed a significant decline in the number of cases in the past 2 years. It is high time to capitalize on the decrease in WPV1 cases by intensifying the efforts to mitigate and limit the spread of the disease.
PubMed: 38343664
DOI: 10.1002/hsr2.1862 -
Open Forum Infectious Diseases Feb 2024Patients with severe primary immunodeficiency are at risk for complications from live-attenuated vaccines. Here, we report a case of a vaccine-associated paralytic polio...
Patients with severe primary immunodeficiency are at risk for complications from live-attenuated vaccines. Here, we report a case of a vaccine-associated paralytic polio and Bacille Calmette-Guérin disease in a 6-month-old girl with severe combined immunodeficiency resulting from homozygous recombinant activating gene 1 deficiency. The patient was successfully treated with intravenous immunoglobulins and oral pocapavir for poliovirus, and antimycobacterial therapy for regional Bacille Calmette-Guérin disease, allowing stem cell transplant. Following transplantation, poliovirus type 3 with 13 mutations was detected from cerebrospinal fluid but not from stool, indicating ongoing viral evolution in the central nervous system despite pocapavir treatment. Clinical improvement and immune reconstitution allowed the patient to be successfully discharged with no further detection of poliovirus.
PubMed: 38328499
DOI: 10.1093/ofid/ofad678 -
Human Vaccines & Immunotherapeutics Dec 2024DTaP5-HBV-IPV-Hib (Vaxelis®) is a hexavalent combination vaccine (HV) indicated in infants and toddlers for the prevention of diphtheria, tetanus, pertussis, hepatitis...
A phase 4, open-label study to evaluate the safety and immunogenicity of DTaP5-HBV-IPV-Hib in children previously vaccinated with DTaP2-HBV-IPV-Hib or DTaP5-HBV-IPV-Hib (V419-016).
DTaP5-HBV-IPV-Hib (Vaxelis®) is a hexavalent combination vaccine (HV) indicated in infants and toddlers for the prevention of diphtheria, tetanus, pertussis, hepatitis B, poliomyelitis, and invasive disease due to type b. Switching between HVs during the childhood vaccination series is sometimes necessary due to, for example, vaccine availability, health-care provider preference, and/or tender awards. The purpose of this study was to describe the safety, tolerability, and immunogenicity of a booster dose of Vaxelis® in participants who previously received a primary infant series of either DTaP2-HBV-IPV-Hib (Hexyon®) or Vaxelis®. Healthy participants approximately 11-13 months of age who previously received a two-dose primary series of Hexyon® (HHV group) or Vaxelis® (VVV group) all received a Vaxelis® booster dose. Immunogenicity was evaluated by measuring antibody levels to individual vaccine antigens approximately 30 days following booster vaccination. Safety was evaluated as the proportion of participants with adverse events (AEs). The proportions of participants with antibody-specific responses for antigens contained in both Vaxelis® and Hexyon® at 30 days post-toddler-booster vaccination with Vaxelis® were comparable between groups, and higher in the VVV group for Vaxelis® antigens PRN and FIM2/3. The overall proportions of participants with AEs were generally comparable between groups. Following a booster dose of Vaxelis®, immune responses were comparable between groups for all shared antigens, and higher in the VVV group for antigens found only in Vaxelis®. The booster was well tolerated in both groups. These data support the use of Vaxelis® as a booster in mixed HV regimens.
Topics: Humans; Infant; Haemophilus influenzae type b; Hepatitis B virus; Diphtheria-Tetanus-Pertussis Vaccine; Vaccines, Combined; Tetanus; Diphtheria; Whooping Cough; Poliovirus Vaccine, Inactivated; Hepatitis B Vaccines; Haemophilus Vaccines; Immunization Schedule; Antibodies, Bacterial
PubMed: 38327239
DOI: 10.1080/21645515.2024.2310900 -
Frontiers in Public Health 2023Over the past two centuries, vaccines have been critical for the prevention of infectious diseases and are considered milestones in the medical and public health... (Review)
Review
Over the past two centuries, vaccines have been critical for the prevention of infectious diseases and are considered milestones in the medical and public health history. The World Health Organization estimates that vaccination currently prevents approximately 3.5-5 million deaths annually, attributed to diseases such as diphtheria, tetanus, pertussis, influenza, and measles. Vaccination has been instrumental in eradicating important pathogens, including the smallpox virus and wild poliovirus types 2 and 3. This narrative review offers a detailed journey through the history and advancements in vaccinology, tailored for healthcare workers. It traces pivotal milestones, beginning with the variolation practices in the early 17th century, the development of the first smallpox vaccine, and the continuous evolution and innovation in vaccine development up to the present day. We also briefly review immunological principles underlying vaccination, as well as the main vaccine types, with a special mention of the recently introduced mRNA vaccine technology. Additionally, we discuss the broad benefits of vaccines, including their role in reducing morbidity and mortality, and in fostering socioeconomic development in communities. Finally, we address the issue of vaccine hesitancy and discuss effective strategies to promote vaccine acceptance. Research, collaboration, and the widespread acceptance and use of vaccines are imperative for the continued success of vaccination programs in controlling and ultimately eradicating infectious diseases.
Topics: Humans; Vaccination; Immunization; Antigens, Viral; Influenza Vaccines; Communicable Diseases
PubMed: 38264254
DOI: 10.3389/fpubh.2023.1326154 -
Frontiers in Public Health 2023The polioviruses (PVs) are mainly transmitted by direct contact with an infected person through the fecal-oral route and respiratory secretions (or more rarely via... (Review)
Review
The polioviruses (PVs) are mainly transmitted by direct contact with an infected person through the fecal-oral route and respiratory secretions (or more rarely via contaminated water or food) and have a primary tropism for the gut. After their replication in the gut, in rare cases (far less than 1% of the infected individuals), PVs can spread to the central nervous system leading to flaccid paralysis, which can result in respiratory paralysis and death. By the middle of the 20th century, every year the wild polioviruses (WPVs) are supposed to have killed or paralyzed over half a million people. The introduction of the oral poliovirus vaccines (OPVs) through mass vaccination campaigns (combined with better application of hygiene measures), was a success story which enabled the World Health Organization (WHO) to set the global eradication of poliomyelitis as an objective. However this strategy of viral eradication has its limits as the majority of poliomyelitis cases today arise in individuals infected with circulating vaccine-derived polioviruses (cVDPVs) which regain pathogenicity following reversion or recombination. In recent years (between January 2018 and May 2023), the WHO recorded 8.8 times more cases of polio which were linked to the attenuated OPV vaccines (3,442 polio cases after reversion or recombination events) than cases linked to a WPV (390 cases). Recent knowledge of the evolution of RNA viruses and the exchange of genetic material among biological entities of the intestinal microbiota, call for a reassessment of the polio eradication vaccine strategies.
Topics: Humans; Poliomyelitis; Central Nervous System; Behavior Therapy; Poliovirus Vaccines; Vaccines
PubMed: 38259741
DOI: 10.3389/fpubh.2023.1284337