Lessons from integration of mass nutrition screening during combined BOPV/IPV campaign in armed conflict settings, Borno State, Nigeria

Dick Chamla,Naqibullah Safi,Onome Dibosa-Osadolor,Elfriede Kormawa,Abdulkadir Musse,John Agbor,Arjan De Wagt,Ifeanyi Maduanusi,Aminu Usman,Helni Mshelia,Sule Mele,Abimbola Aman Oloniyo,Olusola Oladeji,Bamidele Omotola

doi:10.4314/gjpas.v24i1.9

Abstract

Background: The Boko Haram insurgency has led to severe humanitarian crisis with high levels of malnutrition and polio outbreak in Borno state, Nigeria. In response, outbreak campaigns were conducted that provided an opportunity to integrate nutrition screening during the combined bivalent oral and inactivated polio vaccination (bOPV/IPV) campaign. Methods : This was a cross-sectional study that measured nutrition status of children using a mid-upper arm circumference (MUAC) measurement tape during bOPV/IPV campaign in 4 of the 24 local government areas (LGAs). Data were collected using tally sheets and mobile ODK Collector and bivariate analysis using logistic regression done. Results : Over 1.66 million and 1.47 million children received bOPV and IPV vaccines respectively in 24 LGAs. The coverage of bOPV and IPV in integrated and non-integrated LGAs were above 90% with no statistical difference (OR:0.85; 95%CI: 0.55-1.29; p=0.42). Only 48.5% (351795/725509) of targeted children were screened for malnutrition, of those 3.7% (13050/351795) had severe acute malnutrition (SAM). Less than 47.5% of children with SAM were successfully referred and enrolled in the treatment facilities. Conclusion : Coverage of bOPV and IPV were similar in both integrated and non-integrated LGAs indicating that integrating nutrition screening in polio campaigns is feasible with minimal negative effects. As children with SAM have lower serological protection against polio, provides a strong rationale for inclusion of nutrition interventions in global polio eradication efforts. There are critical lessons that were identified including joint planning, well-defined optimal partnership including military collaborations, and a need for joint monitoring.

Highlights

In the outset of Sustainable Development Goals (SDGs), a Polio-free Africa was a realistic scenario, the occurrence of four cases of wild poliovirus (WPV) in northern state of Borno, has retrogressed Nigeria in the global map of endemic countries (Roberts 2016)
With the exception of Konduga, there were no major differences in coverage of bivalent Oral Polio Vaccines (bOPV) and Inactivated Polio Vaccine (IPV) between integrated and non-integrated local government areas (LGAs) respectively
A total of 351,795 children were screened in the four LGAs of Konduga, Maiduguri, Mafa and Jere that integrated nutrition screening into OPV/IPV campaign

Summary

Introduction

In the outset of Sustainable Development Goals (SDGs), a Polio-free Africa was a realistic scenario, the occurrence of four cases of wild poliovirus (WPV) in northern state of Borno, has retrogressed Nigeria in the global map of endemic countries (Roberts 2016). This new polio outbreak is further amplified by recent reports of a child with vaccine-derived polio virus (cVDPV2) in the Monguno local government area (LGA) of Borno state (Etsano et al 2016). Outbreak campaigns were conducted that provided an opportunity to integrate nutrition screening during the combined bivalent oral and inactivated polio vaccination (bOPV/IPV) campaign

Methods

Results

Discussion

Conclusion