Abstract
Ghana was declared polio-free in 2015 after the last polio case in 2008. We determined the poliovirus neutralizing antibody levels among individuals to identify possible immunity gaps. A cross-sectional, hospital-based study was undertaken in Northern, Ashanti and Greater Accra regions of Ghana. Individuals referred for haematology at the teaching hospitals' laboratories were invited to participate in our study. Neutralizing-antibody titers to poliovirus serotypes 1,2 & 3 were assayed by WHO-standards. Antibody titers of ≥8 were considered protective. Bivariate and multivariate analyses were conducted on subject characteristics to assess potential factors for failure to seroconvert. P-values < 0.05 were considered statistically significant. Poliovirus (PV) neutralizing-antibody serotypes 1, 2 and 3 were detected in 86.0% (264/307), 84% (258/307) and 75% (230/307) of samples respectively. 60.1% (185/307) were seropositive for the three poliovirus serotypes. Neutralizing poliovirus antibodies for PV1 and PV2 were higher than for PV3. Seroprevalence of poliovirus-neutralizing antibodies among males (PV1=51.9%, PV2= 51.6% and PV3= 52.6%) were higher than in females. Seroprevalence rates of poliovirus-neutralizing antibodies (PV1, PV2, and PV3) were highest in the Northern region (90%, 81%, and 77%). Poliovirus neutralizing-antibodies (PV1and PV2) decreased with age [p< 0.001]. Low seroprevalence of poliovirus-neutralizing antibodies was significantly associated with low school attendance of mothers (p<0.001). Our study population has some protection from polio. However, immunity appears to be lower with a higher age or low Mother's education. This may suggest the need for young-adult booster-dose to minimize the risk of wild poliovirus infection. WHO Country Office Ghana.
Highlights
Poliomyelitis is a highly infectious viral disease which can have crippling effects
Individuals referred to the laboratory for haematology at the three teaching hospitals partook in the study
Seroprevalence of polio neutralizing antibodies Neutralizing polio antibodies against poliovirus serotypes 1, 2 and 3 were detected in 86.0% (264/307) [95% confidence intervals CI: 82-90%] for poliovirus type1, 84% (258/307) [95% CI 79.4-87.9%] for type 2 and 75% (230/307) [95% CI 70-80%] for poliovirus type 3 of samples
Summary
Poliomyelitis is a highly infectious viral disease which can have crippling effects. The disease is caused by the poliovirus serotypes 1, 2 and 3. It mainly affects children who are less than five years of age if exposed to the virus. According to Robert,[1] in developing countries, one out of 200 polio infections paralytic polio is observed, while fatality is normally observed in 5-10% of paralytic polio cases. Fecal-oral route and in a few instances the respiratory transmission are the primary mode of transmission. Most infections of polio are asymptomatic and less than 1% of the infected individual become paralysed. High population density and lack of immunization are the major risk factors of polio infection
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