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From legacy to integration in the Global Polio Eradication Initiative: looking back to look forward.BMJ Global Health May 2024The Global Polio Eradication Initiative (GPEI) is a global single-disease programme with an extensive infrastructure in some of the world's most underserved areas. It...
INTRODUCTION
The Global Polio Eradication Initiative (GPEI) is a global single-disease programme with an extensive infrastructure in some of the world's most underserved areas. It provides a key example of the opportunities and challenges of transition efforts-the process of shifting from donor-funded, single-disease programmes to programmes with more integrated and sustainable programmatic and funding streams. Our goal is to closely analyse the social and political dynamics of the polio transition in the 2010s to provide insights into today, as well as lessons for other programmes.
METHODS
We conducted semistructured interviews with GPEI officials involved in transition planning across GPEI partner agencies (n=11). We also drew on document review and interviews with national and subnational actors in Nigeria, India, Ethiopia and the Democratic Republic of the Congo. We inductively analysed this material to capture emergent themes in the evolution of transition activities in the GPEI.
RESULTS
Since the mid-2010s, GPEI actors expressed concern that polio's assets should not be lost when polio was eradicated. Planning for polio's legacy, however, proved complicated. The GPEI's commitment to and focus on eradication had taken precedence over strong collaborations outside the polio programme, making building alliances for transition challenging. There were also complex questions around who should be responsible for the transition process, and which agencies would ultimately pay for and deliver polio-funded functions. Current efforts to achieve 'integration' both have great promise and must grapple with these same issues.
DISCUSSION
Within the GPEI, relinquishing control to other programmes and planning for significant, long-term funding for transition will be central to achieving successful integration and eventual transition. Beyond polio, other vertical programmes can benefit from going beyond transition 'planning' to integrate transition into the initial design of vertical programmes.
Topics: Poliomyelitis; Humans; Disease Eradication; Global Health; Immunization Programs
PubMed: 38770815
DOI: 10.1136/bmjgh-2023-014758 -
MMWR. Morbidity and Mortality Weekly... May 2024In 1988, poliomyelitis (polio) was targeted for eradication. Global efforts have led to the eradication of two of the three wild poliovirus (WPV) serotypes (types 2 and...
In 1988, poliomyelitis (polio) was targeted for eradication. Global efforts have led to the eradication of two of the three wild poliovirus (WPV) serotypes (types 2 and 3), with only WPV type 1 (WPV1) remaining endemic, and only in Afghanistan and Pakistan. This report describes global polio immunization, surveillance activities, and poliovirus epidemiology during January 2022-December 2023, using data current as of April 10, 2024. In 2023, Afghanistan and Pakistan identified 12 total WPV1 polio cases, compared with 22 in 2022. WPV1 transmission was detected through systematic testing for poliovirus in sewage samples (environmental surveillance) in 13 provinces in Afghanistan and Pakistan, compared with seven provinces in 2022. The number of polio cases caused by circulating vaccine-derived polioviruses (cVDPVs; circulating vaccine virus strains that have reverted to neurovirulence) decreased from 881 in 2022 to 524 in 2023; cVDPV outbreaks (defined as either a cVDPV case with evidence of circulation or at least two positive environmental surveillance isolates) occurred in 32 countries in 2023, including eight that did not experience a cVDPV outbreak in 2022. Despite reductions in paralytic polio cases from 2022, cVDPV cases and WPV1 cases (in countries with endemic transmission) were more geographically widespread in 2023. Renewed efforts to vaccinate persistently missed children in countries and territories where WPV1 transmission is endemic, strengthen routine immunization programs in countries at high risk for poliovirus transmission, and provide more effective cVDPV outbreak responses are necessary to further progress toward global polio eradication.
Topics: Poliomyelitis; Humans; Disease Eradication; Global Health; Poliovirus; Population Surveillance; Immunization Programs; Disease Outbreaks; Poliovirus Vaccines; Child, Preschool; Infant; Poliovirus Vaccine, Oral
PubMed: 38753550
DOI: 10.15585/mmwr.mm7319a4 -
Healthcare (Basel, Switzerland) May 2024Physical activity (PA) has numerous health benefits for individuals with physical disabilities (IWPD). However, it is common for activity levels to fall below the...
Physical activity (PA) has numerous health benefits for individuals with physical disabilities (IWPD). However, it is common for activity levels to fall below the suggested limits. This study aimed to evaluate the prevalence, pattern, and levels of PA among IWPD in Saudi Arabia. It also investigated the effects of individuals' type of disability, mobility assistive devices, and demographic features on PA levels. Data were collected from 238 participants, mostly male (62.2%), aged 39.76 ± 12.19 years. Among them, 19.3% had spinal conditions, 14.7% had progressive muscular dystrophy, 15.1% had multiple sclerosis, 17.6% had cerebral palsy, 16.4% had poliomyelitis, and 16.8% had limb or foot amputations. The participants were assessed using the Arabic version of the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD-AR). The results showed that 62.6% (64.9% of males and 58.9% of females) met the minimum PA guidelines specified by the WHO. The average PASIPD-AR score was 10.33 ± 10.67 MET-hours/day, indicating lower PA levels, and 8.4% of individuals did not participate in any form of PA. Significant discrepancies were detected in disability type and mobility assistive device use after age adjustment. Marital status, education, and occupation greatly affected PA components. Greater attention should be paid to promoting an active lifestyle among IWPD in Saudi Arabia.
PubMed: 38727494
DOI: 10.3390/healthcare12090937 -
Science (New York, N.Y.) May 2024Draft evaluation calls 2016 decision to change oral vaccines a "failure".
Draft evaluation calls 2016 decision to change oral vaccines a "failure".
Topics: Humans; Poliomyelitis; Poliovirus Vaccine, Oral; Global Health; Disease Eradication; World Health Organization
PubMed: 38723076
DOI: 10.1126/science.adq3092 -
Vaccine Jun 2024Vaccine prevention strategies play a crucial role in the management of people living with HIV (PLWH). The aim of this study was to assess vaccination coverage and...
Vaccine prevention strategies play a crucial role in the management of people living with HIV (PLWH). The aim of this study was to assess vaccination coverage and identify barriers to vaccine uptake in PLWH in the Paris region. A cross-sectional survey was conducted in PLWH in 16 hospitals in the Paris region. The vaccination status, characteristics, opinions, and behaviors of participants were collected using a face-to-face questionnaire and from medical records. A total of 338 PLWH were included (response rate 99.7 %). The median age of participants was 51 years (IQR: 41-58). Vaccination coverage was 77.3 % for hepatitis B (95 % CI: 72.3-81.8 %), 62.7 % for hepatitis A (57.3-67.9 %), 61.2 % for pneumococcal vaccines (55.8-66.5 %), 56.5 % for diphtheria/tetanus/poliomyelitis (DTP) (51.0-61.9 %), 44.7 % for seasonal influenza (39.3-50.1 %), 31.4 % for measles/mumps/rubella (26.4-36.6 %) and 38.5 % for meningococcal vaccine (13.9-68.4 %). The main reason for vaccine reluctance was related to the lack of vaccination proposals/reminders. The overall willingness to get vaccinated was 71.0 % (65.9-75.8 %). In the multivariable analysis, several factors were associated with a higher vaccine uptake; for DTP vaccine: higher education level, having vaccination records, being registered with a general practitioner; for seasonal influenza vaccine: age > 60 years, higher education level, being employed. The overall vaccination coverage was suboptimal. Development of strategies reducing missed opportunity to offer vaccines is needed.
Topics: Humans; Middle Aged; Male; Female; Adult; Vaccination Coverage; Paris; Cross-Sectional Studies; Prospective Studies; HIV Infections; Ambulatory Care Facilities; Vaccination Hesitancy; Surveys and Questionnaires; Vaccination; Patient Acceptance of Health Care
PubMed: 38714445
DOI: 10.1016/j.vaccine.2024.04.077 -
Journal of Preventive Medicine and... Mar 2024In the spring of 1964, polio vaccination with the oral vaccine developed by Albert Sabin began in Italy. Polio was feared in the world and in Italy. Thus, between 1957...
In the spring of 1964, polio vaccination with the oral vaccine developed by Albert Sabin began in Italy. Polio was feared in the world and in Italy. Thus, between 1957 and the beginning of 1958, Italian children began receiving the "Salk vaccine", though the results were not particularly convincing. In July 1960, the international scientific community was able to verify the data from the mass testing of the Sabin vaccine. It became clear that the OPV, could prevent the virus from multiplying, thereby providing greater protection and determining the eradication of the disease. In 1960 over 70 million people in the USSR alone had already received the oral vaccine and mass vaccination in the USA would start in March 1961. However, in Italy there was no similar initiative; only later the new vaccine was accepted but was not made compulsory at the beginning. As a result of the commission's report, registration of the "Polioral" vaccine, was authorized in September 1962 but the sale of the vaccine was not authorized until November 1963. At the beginning of 1964, the production of "Polioral" started and the product was marketed and on the 1 st of March 1964, anti-polio vaccination with the "Sabin anti-polio vaccine" also began in Italy. This manuscript focuses on a crucial issue about a historical delay for public health and it points out as the preparation and diffusion of the Sabin polio vaccine demonstrates that decisions regarding health treatments, and specifically vaccination campaigns, must be based exclusively on the results of clinical studies and on independent evaluation by the scientific community. This process ensures trust in vaccines, adequate protection of public health andcitizens' well-being.
Topics: Italy; Humans; Poliomyelitis; Poliovirus Vaccine, Oral; History, 20th Century; Vaccination; Disease Eradication
PubMed: 38706758
DOI: 10.15167/2421-4248/jpmh2024.65.1.3242 -
The American Journal of Case Reports May 2024BACKGROUND Hoffa fractures are an uncommon form of coronal fracture that impact the femoral condyle. As a result, they are not very prevalent. It is necessary to perform... (Review)
Review
BACKGROUND Hoffa fractures are an uncommon form of coronal fracture that impact the femoral condyle. As a result, they are not very prevalent. It is necessary to perform anatomical reduction and rigorous fixation on these fractures; however, there is no consensus among medical professionals on the surgical procedure and implant that would be the most successful in treating these fractures. CASE REPORT A 50-year-old woman who had poliomyelitis in her right lower limb presented with a displaced medial Hoffa fracture of her left knee. She had fallen and was suffering from poliomyelitis. The trauma that caused this fracture had a modest energy level. Open reduction and internal fixation with 2 retrograde cannulated screws were included in her surgical procedure. An approach known as the medial parapatellar route was used for this treatment. As part of her postoperative rehabilitation, she participated in physiotherapy, exercises that did not require weight bearing, exercises that used passive and active assistance, activities that involved partial and full weight bearing, and exercises that involved complete weight bearing. At the 2-year follow-up, the patient's left knee continued to be painless and stable, and it had unrestricted range of motion across the whole extremity. It was determined via radiographs that the fracture had healed without any problems or arthritic changes developing. She was able to walk without help and carry out her daily tasks since she was able to walk with the use of a cane. CONCLUSIONS Retrograde cannulated screws can be a reliable and successful choice for treatment of medial Hoffa fractures, with positive results according to both clinical and radiographic characteristics. Further research is needed to analyze the outcomes over a longer period of time and make comparisons between this technique and others.
Topics: Humans; Female; Middle Aged; Fracture Fixation, Internal; Femoral Fractures; Bone Screws; Open Fracture Reduction; Poliomyelitis; Hoffa Fracture
PubMed: 38706183
DOI: 10.12659/AJCR.943136 -
Biologicals : Journal of the... May 2024
Topics: Poliomyelitis; Humans; Disease Eradication; Poliovirus
PubMed: 38703474
DOI: 10.1016/j.biologicals.2024.101766 -
Fitoterapia Jul 2024Anogeissus leiocarpus (DC.) Guill. & Perr. belongs to the family Combretaceae and is used both by African traditional medical practitioners and livestock rearers to... (Review)
Review
Anogeissus leiocarpus (DC.) Guill. & Perr. belongs to the family Combretaceae and is used both by African traditional medical practitioners and livestock rearers to treat diseases such as African trypanosomiasis, animal diarrhoea, asthma, cancer, cough, diabetes, dysentery, erectile dysfunction, fever, giardiasis, helminthiases, meningitis, menstrual disorders, monkeypox, oral infections, poliomyelitis, sickle cell anaemia, snake bites, toothache, urinary schistosomiasis, and yellow fever. Some of these activities have been associated with the presence of polyphenols in the plant which include ellagic acid derivatives, flavonoids, stilbenes, tannins, and triterpenes. Several bioactive molecules have been identified from A. leiocarpus. These include the main active constituents, ellagitannins, ellagic acid derivates, flavonoids and triterpenes. Pharmacological studies have confirmed its antibacterial, antifungal, antihyperglycemic, antihypertensive, antimalarial, antioxidative, antiparasitic, antitumour and anti-ulcer effects. The stem bark has been investigated mainly for biological activities and phytochemistry, and it is the most mentioned plant part highlighted by the traditional users in ethnomedicinal surveys. In vitro and in vivo models, which revealed a wide range of pharmacological actions against parasites causing helminthiasis, leishmaniasis, malaria and trypanosomiasis, have been used to study compounds from A. leiocarpus. Because of its uses in African traditional medicine and veterinary practices, A. leiocarpus has received considerable attention from researchers. The current review provides a comprehensive overview and critical appraisal of scientific reports on A. leiocarpus, covering its traditional uses, pharmacological activities and phytochemistry.
Topics: Phytochemicals; Medicine, African Traditional; Combretaceae; Humans; Plant Extracts; Animals; Plant Bark
PubMed: 38692415
DOI: 10.1016/j.fitote.2024.105979 -
Neurological Sciences : Official... Apr 2024
PubMed: 38684544
DOI: 10.1007/s10072-024-07557-x