Abstract
Recently, the World Health Organization (WHO) declared that the spread of polio is an international public health emergency, and a coordinated international response is sought. Although the importance of such a response is recognized, there are challenges to stopping the spread of polio and achieving a polio free world. The most important issue is directing limited national resources to the specific areas where polio is endemic. In an article published in BMC Medicine, Upfill-Brown and his colleagues recognized this problem and successfully identified the potential risk areas in Nigeria using a validated spatial predictive model of wild poliovirus circulation. They also showed that a lower vaccine-derived population immunity is associated with the probability of a higher number of wild poliovirus cases within a district. Identification of the potential risk areas and understanding the magnitude of risk may help direct limited resources of the endemic countries to areas most at risk to maximize the impact of interventions and motivate the people to participate in the intervention program. These efforts are crucial if these endemic countries hope to eradicate polio.Please see related research article: http://www.biomedcentral.com/1741-7015/12/92.
Highlights
Polio was first traced as a disease of a separate clinical entity by Michael Underwood in 1789 [1]
All children need to receive vaccine, decisions are still needed to know where special efforts are required. To assist with these decisions, Upfill-Brown and colleagues identified the potential risk areas in Nigeria using a spatial modelling technique and the Nigerian Acute Flaccid Paralysis surveillance database maintained by the Nigerian World Health Organization (WHO) [10]
Their results showed that lower vaccine-derived population immunity is associated with the probability of a higher number of wild poliovirus cases within a district
Summary
Polio was first traced as a disease of a separate clinical entity by Michael Underwood in 1789 [1]. All children need to receive vaccine, decisions are still needed to know where special efforts are required To assist with these decisions, Upfill-Brown and colleagues identified the potential risk areas in Nigeria using a spatial modelling technique and the Nigerian Acute Flaccid Paralysis surveillance database maintained by the Nigerian WHO [10]. A substantial amount of residual spatial variation remains in their model due to the paucity of the data on poverty, malnutrition, sanitation and level of health services, all of which influence wild polio virus transmission potential and population vaccine efficacy [11], the predictive accuracy of their model was found to be very high (more than 85%) Such model results are useful for political and religious advocacy as well as public health policy makers to allocate resources to the highest risk areas. Other reasons could include (in some cases) lack of a cold chain resulting in damage to the live virus vaccine; interference by infection with endogenous enteroviruses [16]; or interference via co-administration of OPV and rotavirus vaccines [17]
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