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Urinary tract infection (UTI) is the colonization of the urinary tract by pathogenic microorganisms. There is paucity of data on the development of multidrug resistant uropathogenic strains associated with Diabetes Mellitus (DM). In this cross-sectional study we investigated a total of three hundred and thirty (330) known diabetes mellitus (DM) patients, comprising of 06 (1.8%) Type I DM, 296 (89.7%) Type II DM and 28 (8.5%) Gestational Diabetes patients aged 21 to 80 years. The subjects consisted of 150 males (45.5%) and 180 (54.5%) females. Urine culture was carried out on CLED, MacConkey and blood agar and Kirby Bauer disc diffusion for antimicrobial susceptibility testing was carried out to determine the susceptibility of the isolated organisms to commonly used antimicrobials in the study area. The study revealed that one hundred and twenty-two (37%) yielded significant bacterial growth. The percentage distribution of the organisms isolated are as follows; Staphylococci (10.6%), Klebsiella spp. (13.2%), Coliforms spp. (13.9%), Staphylococcus aureus (24.6%) and Escherichia coli has the highest occurrence of (37.7%). Gram negative bacteria isolated were highly susceptible to Ciprofloxacin (10 μg), tarivid (10 μg) and streptomycin (30 μg); and moderately- to poorly sensitive to the other antibiotics used in the study. In conclusion female diabetics were at a higher risk for UTIs that than males (p=0.000) and low educational level/social class was also a risk factor (p=0.04) when compared to subjects of higher educational level/ social class.

Background Hepatitis D virus (HDV) is highly pathogenic, and clinical studies revealed that HDV infection aggravates the natural history of the underlying hepatitis B virus (HBV) infection by progression to cirrhosis that leads to early decompensation of liver function compared with HBV mono-infection. To determine the seroprevalence of HDV among HBsAg-seropositive patients and associated biochemical profiles at Maiduguri, Nigeria, a hospital-based cross-sectional study on 180 sera of patients positive for HBsAg by ELISA were evaluated for anti-HDV, hepatitis B envelop antigen, anti-HBs antibodies and liver enzyme profiles. Results HDV seroprevalence of 3.3% among 180 HBsAg-positive patients. Relatively higher seroprevalence of HDV was observed in males (4.3%) than in females (2.3%). The highest infection rate (20%) was obtained in patients ≥ 56 years. However, no significant association between positive anti-HDV seroprevalence and gender (p > 0.05). Of the 6 (3.3%) anti-HDV-positive patients, only 1 (16.7%) was positive for HBeAg while all were negative for anti-HBs antibodies. The mean level of liver enzyme level of AST and ALT of the anti-HDV-positive patients significantly differ from that of HBsAg mono-infected patients (p ˂ 0.05). However, no significant difference (p p ˃ 0.05) was found. Conclusion This study revealed a relatively low presence of HDV in HBsAg-positive patients. Furthermore, HDV-HBV co-infected patients had somewhat worse liver enzyme upregulation. This underscores the need for rapid HDV testing and treatment in HBV-infected patients.

OBJECTIVE: T-helper cells (Th)-1& -2 cytokines homeostasis control or predict clinical outcome of infected persons, especially those with HIV /AIDS. This case-control study evaluated the leucocytes differentials, TNF-alpha, interleukin (IL)-2 and -10 levels among HIV infected persons with serological evidence of leishmaniasis attending University of Abuja Teaching Hospital, Nigeria MATERIALS AND METHODS: Blood samples from 28 HIV infected persons who had Leishmania donovani rK39 and Immunoglobulin-G (IgG) positive (group 1), 30 age- & -sex matched HIV infected persons without Leishmania antibodies (group 2) and 30 apparently healthy persons without HIV and Leishmania antibodies (group 3). Full blood counts, TNF alpha, IL-2 and -10 levels were analyzed using automated hematology analyzer and ELISA, respectively. Structured questionnaires were used to collate biodata and clinical presentations of participants. RESULTS: Ten (35.7%) participants in group 1 were on ART, 15 (50%) in group 2 were on ART, while group 3 were ART naïve. There were significantly higher values in basophil (4.4±2.5%) and eosinophil counts (12.9±3.8%) in HIV/leishmania coinfected persons (p

Background and Objectives: Human parvovirus B19 (B19V) is a widespread virus with various manifestations depending on the immunologic and hematologic status of the host. Infection with the virus can cause a wide range of complications in fetus of infected pregnant women, especially those with hemoglobinopathies. This study aimed to determine association of hemoglobin electrophoretic patterns and risk of B19V infection in pregnant women. Methods: Blood samples were collected from 200 pregnant women attending University of Abuja Teaching Hospital, Abuja, Nigeria. The samples were screened for anti-B19V IgM and IgG. Hemoglobin patterns were determined using commercial enzyme-linked immunosorbent assay kits and Minicap Flex Piercing Electrophoresis system. Structured questionnaires were used to collate sociodemographic variables and associated risk factors of B19V. Results: Of 200 participants, 12 (6.0%) were positive for B19V IgM, 45 (22.5%) were positive for IgG and two (1.0%) were positive for both antibody, while 145 (72.5%) had no detectable B19V antibody. Twenty-six subjects (28.3%) with HbAA hemoglobin pattern had B19V IgG of whom, nine (12.5%) had HbAS and 11 (30.6%) had HbSS electrophoretic patterns. There was a significant association between prevalence of anti-B19V IgG and hemoglobin electrophoretic pattern of participants (P=0.037). However, no association was found between prevalence of B19V IgM and hemoglobin electrophoretic pattern, age and parity of pregnant women (P>0.05). Conclusion: Our findings revealed a high prevalence of B19V infection among pregnant women in the studied area. In addition, acute B19V seems to be associated with hemoglobin electrophoretic patterns of pregnant women. It is recommended to follow up newborns of anti-B19V IgM positive pregnant women.

The progression of the SARS-CoV-2 pandemic in Africa has so far been heterogeneous and the full impact is not yet well understood. Here, we describe the genomic epidemiology using a dataset of 8746 genomes from 33 African countries and two overseas territories. We show that the epidemics in most countries were initiated by importations, predominantly from Europe, which diminished following the early introduction of international travel restrictions. As the pandemic progressed, ongoing transmission in many countries and increasing mobility led to the emergence and spread within the continent of many variants of concern and interest, such as B.1.351, B.1.525, A.23.1 and C.1.1. Although distorted by low sampling numbers and blind-spots, the findings highlight that Africa must not be left behind in the global pandemic response, otherwise it could become a breeding ground for new variants.

Background: Management and control of the COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus SARS-CoV-2 is critically dependent on quick and reliable identification of the virus in clinical specimens. Detection of viral RNA by a colorimetric reverse transcription loop-mediated isothermal amplification (RT-LAMP) is a simple, reliable and cost-effective assay, deployable in resource-limited settings (RLS). Our objective was to evaluate the intrinsic and extrinsic performances of RT-LAMP in RLS. Methods: This is a multicenter prospective observational study of diagnostic accuracy, conducted from October 2020 to February 2021 in four African Countries: Cameroon, Ethiopia, Kenya and Nigeria; and in Italy. We enroled 1657 individuals who were either COVID-19 suspect cases, or asymptomatic and presented for screening. RNA extracted from pharyngeal swabs was tested in parallel by a colorimetric RT-LAMP and by a standard real time polymerase chain reaction (RT-PCR). Findings: The sensitivity and specificity of index RT LAMP compared to standard RT-PCR on 1657 prospective specimens from infected individuals was determined. For a subset of 1292 specimens, which underwent exactly the same procedures in different countries, we obtained very high specificity (98%) and positive predictive value (PPV = 99%), while the sensitivity was 87%, with a negative predictive value NPV = 70%, Stratification of RT-PCR data showed superior sensitivity achieved with an RT-PCR cycle threshold (Ct) below 35 (97%), which decreased to 60% above 35. Interpretation: In this field trial, RT-LAMP appears to be a reliable assay, comparable to RT-PCR, particularly with medium-high viral loads (Ct

Introduction Poor systematic surveillance for Yellow Fever virus (YFV) is primarily due to lack of affordable diagnostic facilities in resource constrained countries. Objectives This study aimed at providing evidence- based information on immunity against Yellow Fever with a view to assessing the possibility of the recent epidemics persisting in Nigeria. Methods Six hundred patients with febrile illness seeking malaria test in selected hospitals were tested for YFV antibody using three serological assays: IgM, Microneutralization test (MNT90 ) and Plaque reduction neutralization test (PRNT90 ). Results The three assays commonly detected YFV antibody (Ab) in 1.7% patients, MNT: IgM in 8.3%, IgM: PRNT in 7.1% and MNT: PRNT in 3.2%. Immunity against YF was significantly higher in Bauchi and Borno than Adamawa and children aged 0-9 years compared 20-29 years. YFV neutralizing antibody (nAb) strongly correlated with vaccination status of the patients. More unvaccinated patients had nAb compared with the vaccinated. Immunity against YF among treated patients with antibiotic and/or anti-malaria before sample collection inversely correlated with the untreated. YVnAb among unvaccinated indicates natural infections. Conclusion Acute YFV infections were mistaken for malaria and natural infections are ongoing. Individuals aged ≥20 should be targeted during mass vaccination campaigns. With low population immunity, repetitive YF epidemics in Nigeria is not yet over. The current policy on Yellow Fever vaccination in Nigeria still leaves a large unimmunized population at the risk of epidemics. Sufficient mass vaccination in combination with National Programme on Immunization remains key to averting YF epidemics. This article is protected by copyright. All rights reserved.

OBJECTIVES West Nile virus (WNV) is a re-emerging mosquito-borne viral infection. This study investigated the pooled prevalence pattern and risk factors of WNV infection among humans and animals in Nigeria. METHODS A systematic review was conducted of eligible studies published in PubMed, Scopus, Google Scholar, and Web of Science from January 1, 1950 to August 30, 2020. Peer-reviewed cross-sectional studies describing WNV infections in humans and animals were systematically reviewed. Heterogeneity was assessed using the Cochrane Q statistic. RESULTS Eighteen out of 432 available search output were eligible and included for this study. Of which 13 and 5 were WNV studies on humans and animals, respectively. Although 61.5% of the human studies had a low risk of bias, they all had high heterogeneity. The South West geopolitical zone of Nigeria had the highest pooled prevalence of anti-WNV immunoglobulin M (IgM; 7.8% in humans). The pooled seroprevalence of anti-WNV IgM and immunoglobulin G (IgG) was 7.1% (95% confidence interval [CI], 5.9 to 8.3) and 76.5% (95% CI, 74.0 to 78.8), respectively. The WNV RNA prevalence was 1.9% (95% CI, 1.4 to 2.9), while 14.3% (95% CI, 12.9 to 15.8) had WNV-neutralizing antibodies. In animals, the pooled seroprevalence of anti-WNV IgM and IgG was 90.3% (95% CI, 84.3 to 94.6) and 3.5% (95% CI, 1.9 to 5.8), respectively, while 20.0% (95% CI, 12.9 to 21.4) had WNV-neutralizing antibodies. Age (odds ratio [OR], 3.73; 95% CI, 1.87 to 7.45; p

Background:Hepatitis E Virus (HEV) is a major public health problem in developing countries and often fatal among pregnant women in the third trimester.Objectives:The study investigated the sero-prevalence and risk factors of HEV infection among pregnant women attendee of University of Maiduguri Teaching Hospital, Maiduguri, Nigeria.Methods:The cross-sectional study was carried out between 4thJanuary 2016 to 30thMay, 2016. One hundred and eighty blood samples from pregnant women who consented and enrolled for the study were analyzed for anti – HEV IgM using a quality assured commercial Enzyme Linked Immunosorbent Assay (ELISA) kit. Structured questionnaires were used to collate the sociodemographic characteristics and risk factor of study subjects.Results:Out of the 180 pregnant women sampled, the anti-HEV IgM seroprevalence of 13.3% was recorded. The seroprevalence was significantly higher in the age range of 31 – 35 years (26.5%) and least in age range ≤ 20 years (4.9%) (p=0.009). The highest seroprevalence was recorded in the third trimester 14.1% followed by second (p>0.05). After logistic regression, nature of toilet system, and source of water consumption were significant risk factors for active HEV infection (p˂0.05).Conclusion:Based on the 10.8 % pooled national prevalence of HEV infection in Nigeria, this study recorded a significantly high level of anti – HEV IgM seropositivity, an indication of recent and active HEV infection among pregnant women at the study area. Also, these infections are most among the pregnant women in their third trimester. HEV infection was related to personal, water and environmental hygiene.

Chikungunya (CHIK) is a re-emerging and myo-arthritogenic arboviral infection that has affected significant global population. However, CHIK is a neglected disease in Nigeria. This study aimed to estimate the pooled prevalence pattern of CHIK virus infection in Nigeria. A systematic review of eligible articles was conducted from “PubMed”, “Scopus”, “Google Scholar” and “Web of Science”, between January 1980 to February 2020. Peer-reviewed articles describing CHIKV infection in cross-sectional studies were systematically reviewed. Random-effect model was used to pool the prevalence of CHIKV infection and associated sociodemographic data reported from eligible studies. In total, there were 10 published articles on CHIKV infection. Of these, 7 were cross-sectional studies, which comprised of 1347 pooled participants. The pooled anti-CHIKV IgM and IgG seroprevalence were 26.7% (95% CI: 23.2 – 30.4) and 29.3% (95% CI: 26.2 -32.6), respectively. Of the pooled studies, there were 3.8% (95% CI: 2.0-6.4) CHIKV RNA positive cases and 46.1% prevalence of CHIKV neutralizing antibodies. Of the 6 geopolitical zones in Nigeria, Northeast had the highest serological evidence of CHIKV infection. There was a significance association between the prevalence of anti-CHIKV and geopolitical zones of Nigeria (χ²= 70.04; p˂0.0001). Sex (p ˂0.0001; OR= 1.87 [1.47 – 2.38]) and level of education (p ˂0.0001; OR= 2.74 [1.89 – 3.95]) were significant risk factors for pooled anti-CHIKV IgM seropositivity. However, no significant association was found with other sociodemographic variables (p ˃0.05). Although there was paucity of data on CHIKV research in Nigeria, this meta-analysis revealed a high prevalence of CHIKV infection in the country.

Letter to the Editor

The burden of Arboviral infections is largely underestimated in Africa, particularly in North-Eastern Nigeria. A total of 200 serum samples were collected from patients exhibiting febrile illness who visited the State Specialist Hospital in Maiduguri for medical attention between March and April 2018. Sera were tested for Flavivirus RNA by a pan-flaviviral primer set using hemi-nested RT PCR. Twenty-six samples were positive for flaviviral RNA and sequence analysis indicated a high number of West Nile virus infections and one case of Zika virus. In-house recombinant NS1-based IgM ELISA indicated 47 % of WNV and 22 % of ZIKV infections. These data were also compared to commercially available assays for West Nile and Zika viruses. Finally, NS1 IgG ELISA was conducted for Dengue, Zika, West Nile and Usutu viruses. For serum samples detected by at least one flavivirus, 945% tested positive by NS1 IgG antibodies, while only 5.5 % of the patients were negative for all. To conclude, there is a high prevalence rate of arbovirus infections in the region, including Zika and Usutu viruses that were not previously detected. Interestingly, the analysis was conducted using in–house tools to allow the implementation of a sustainable surveillance protocol locally.

The use of Levamisole hydrochloride as an immunostimulant has been successful in the control of certain diseases such as Derzsy’s disease in chicken as well as in increasing lymphocytes and weight gain in pigs. However, its use as immunostimulant in the prevention of Peste des petits ruminants (PPR) in goats has not been investigated. In this study, the use of Levamisole in enhancing immune response to PPR vaccination including its effects on weight gain was investigated among groups of goats (groups A, B, C and D). Virus neutralization test was used to determine the antibody profile in vaccinated goats while the total and differential leucocyte counts and body mass index (BMI) were determined using standard procedures. Goats in group A (Levamisole primed and PPR vaccinated) seroconverted to more than 3-folds of the initial pre-vaccination geometric mean titre (GMT) of neutralizing antibody beginning from second week post-vaccination and remained high throughout the period of the experiment. Similarly, there was significant increase (p 0.05) in BMI of animals in other groups throughout the period of the experiment. The results of this study further confirm the immunostimulatory effect of Levamisole when used in combination with a vaccine.

Deep sequencing of untreated sewage provides an opportunity to monitor enteric infections in large populations and for high-throughput viral discovery. A metagenomics analysis of purified viral particles in untreated sewage from the United States (San Francisco, CA), Nigeria (Maiduguri), Thailand (Bangkok), and Nepal (Kathmandu) revealed sequences related to 29 eukaryotic viral families infecting vertebrates, invertebrates, and plants (BLASTx E score, −4 ), including known pathogens (>90% protein identities) in numerous viral families infecting humans ( Adenoviridae , Astroviridae , Caliciviridae , Hepeviridae , Parvoviridae , Picornaviridae , Picobirnaviridae , and Reoviridae ), plants ( Alphaflexiviridae , Betaflexiviridae , Partitiviridae , Sobemovirus , Secoviridae , Tombusviridae , Tymoviridae , Virgaviridae ), and insects ( Dicistroviridae , Nodaviridae , and Parvoviridae ). The full and partial genomes of a novel kobuvirus, salivirus, and sapovirus are described. A novel astrovirus (casa astrovirus) basal to those infecting mammals and birds, potentially representing a third astrovirus genus, was partially characterized. Potential new genera and families of viruses distantly related to members of the single-stranded RNA picorna-like virus superfamily were genetically characterized and named Picalivirus , Secalivirus , Hepelivirus , Nedicistrovirus , Cadicistrovirus , and Niflavirus . Phylogenetic analysis placed these highly divergent genomes near the root of the picorna-like virus superfamily, with possible vertebrate, plant, or arthropod hosts inferred from nucleotide composition analysis. Circular DNA genomes distantly related to the plant-infecting Geminiviridae family were named Baminivirus , Nimivirus , and Niminivirus . These results highlight the utility of analyzing sewage to monitor shedding of viral pathogens and the high viral diversity found in this common pollutant and provide genetic information to facilitate future studies of these newly characterized viruses.

The milestone in polio eradication program is to protect effectively children aged 0–5 years against the three serotypes of poliovirus. It became necessary to measure the level of neutralizing antibodies to the three poliovirus types in an endemic State in Nigeria. Neutralizing antibodies to the poliovirus types among children aged 0–5 years was estimated using micro neutralization assay. Of 129 children, 99 (76.8%), 95 (73.6%), and 95 (73.6%) had neutralizing antibodies with the geometric mean titer of 42.7, 31.3, and 33.2 for the poliovirus type 1, 2, and 3, respectively. Fifty-three percent of the children were protected against the three types of poliovirus. Combination of poliovirus types 1 and 2, 1 and 3, and 2 and 3 were neutralized by 62.8, 58.9, and 61.2% of the children studied, respectively. Only poliovirus type 1 induced antibody titres ≥1:1,024. The number of children with neutralizing antibodies after receiving three doses was significantly higher than those who received one or two doses of oral polio vaccine (P ≤ 0.05). However, those who received more than three doses of oral polio vaccine showed no significant difference in their antibody response. The existence of immunity gap poses a risk of re-emergence of the paralytic poliovirus. The existence of unimmunized and unprotected children along with high birth rate could impede the success of polio vaccination in Nigeria. Elimination of non-compliance to polio vaccine, promotion of health education and documented evidence of vaccination of each child with the parents may facilitate the success of polio eradication program in Nigeria. J. Med. Virol. 84:691–696, 2012. © 2011 Wiley Periodicals, Inc.

Introduction: Clinical symptoms of malaria and typhoid infections are virtually indistinguishable from those initially seen in many arbovirus infections. Here we describe arbovirus co-infection detected in 310 sera samples collected from febrile, clinically suspected malaria/typhoid patients in Borno State, Nigeria. Methodology: Tested initially for Plasmodium falciparum by microscopy and for Salmonella Typhi by Widal test, samples were subsequently tested for chikungunya (CHIKV), yellow fever (YFV), dengue (DENV) and West Nile viruses (WNV) by plaque reduction neutralization test. Results: While 92% of patients tested positive for malaria, typhoid, an arbovirus infection, or a combination of one or more of these types of infections, less than 1% of the patients tested positive for malaria alone and only 3.9% tested positive for typhoid alone. Approximately half of the patients tested positive for infection with a single arbovirus (48%) regardless of the presence or absence of malaria or typhoid. Of those who showed 90% to 95% virus neutralization, 67.7% had neutralizing antibodies against DENV, 50% against CHIKV, 25% against WNV and 8.7% against YFV. Eight per cent tested negative against all six pathogens, suggesting that other arboviruses not tested for in this study may also be circulating in Nigeria. Conclusions: The results suggest that misdiagnosis of arbovirus co-infections as malaria infections, combined with a lack of virus surveillance and underreporting of arbovirus infections, increases the potential for undetected and uncontrolled spread of important vector-borne arboviruses becoming serious underlying public health concerns in Nigeria.

International audience; A new species of parvovirus, tentatively named human bocavirus 4 (HBoV4), was genetically characterized. Among 641 feces samples obtained from children and adults, the most commonly detected bocavirus species were, in descending order, HBoV2, HBoV3, HBoV4, and HBoV1, with an HBoV2 prevalence of 21% and 26% in Nigerian and Tunisian children, respectively. HBoV3 or HBoV4 species were found in 12 of 192 patients with non-polio acute flaccid paralysis in Tunisia and Nigeria and 0 of 96 healthy Tunisian contacts (P = .01). Evidence of extensive recombination at the NP1 and VP1 gene boundary between and within bocavirus species was found. The high degree of genetic diversity seen among the human bocaviruses found in feces specimens, relative to the highly homogeneous HBoV1, suggest that this worldwide-distributed respiratory pathogen may have recently evolved from an enteric bocavirus after acquiring an expanded tropism favoring the respiratory tract. Elucidating the possible role of the newly identified enteric bocaviruses in human diseases, including acute flaccid paralysis and diarrhea, will require further epidemiological studies.

A novel picornavirus genome was sequenced, showing 42.6%, 35.2%, and 44.6% of deduced amino acid identities corresponding to the P1, P2, and P3 regions, respectively, of the Aichi virus. Divergent strains of this new virus, which we named salivirus, were detected in 18 stool samples from Nigeria, Tunisia, Nepal, and the United States. A statistical association was seen between virus shedding and unexplained cases of gastroenteritis in Nepal ( P = 0.0056). Viruses with approximately 90% nucleotide similarity, named klassevirus, were also recently reported in three cases of unexplained diarrhea from the United States and Australia and in sewage from Spain, reflecting a global distribution and supporting a pathogenic role for this new group of picornaviruses.

In spite of several serological evidences for the presence of West Nile (WN) virus in Nigeria, the host range of the virus is not fully understood. In this study, the prevalence of the WN virus antibody was determined among horse, donkey and camel populations in Borno state, Nigeria. Two hundred and fifty serum samples comprising of 96 sera from each of horses and camels and 58 from donkeys were tested for presence of WN virus neutralizing antibody. An overall prevalence of WN virus neutralizing antibody of 13.2% was noted in the population of animals tested. Significant difference (P≤0.05) in prevalence was observed between the animals tested. Highest prevalence (17.7%) was noted in camels followed by horses (11.5%) and donkeys (8.6%). The results of this study confirmed the prevalence of WV virus antibody in camels in Nigeria and represented the first serosurvey for WN virus activities among horses and donkeys in this part of the country. There is considerable activity of the virus in the study area and provided evidence for the potential roles this group of animals could play in the epidemiology of WN virus infection in Nigeria.

Despite significant success of the Global Polio Eradication Initiative (GPEI) in Nigeria, Afghanistan, India, Pakistan, wild poliovirus still occurs due to persistently high proportions of under and unimmunized children. The study aimed at determining the type of poliovirus often excreted into the environment. Four hundred nine fecal samples collected from apparently healthy school children aged 5–16 years in Borno and Adamawa States, northeastern Nigeria, were tested for poliovirus by tissue culture technique. The isolates were characterized further by intratypic differentiation testing and genetic sequencing. Three wild poliovirus type, 11 Sabin type, combination of Sabin-types 1 + 2 and 2 + 3 poliovirus, and 22 non-polio enteroviruses were obtained. The continued excretion of wild-type poliovirus among children above 5 years old vaccinated with oral polio vaccine contributes to the persistent circulation of these viruses in the environment and may limit the population immunity. However, the excreted Sabin poliovirus is capable of immunizing the unvaccinated children and promotes herd immunity. Similarly, the excretion of combination of two polio serotypes indicates the child susceptibility to the missing serotype (s) and therefore indicates an immunity gap. The common unhygienic practices in the environment could aid the spread of these viruses through oral–fecal route. Asymptomatic transmission of wild poliovirus among older oral polio vaccine-vaccinated children poses a serious threat to polio eradication program in Nigeria and therefore, environmental and serological surveillance with larger sample size are important for monitoring poliovirus circulation in Nigeria. J. Med. Virol. 84:358–364, 2012. © 2011 Wiley Periodicals, Inc.