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Abstract Background The declaration of poliomyelitis eradication as a programmatic emergency for global public health by the 65th World Health Assembly in 2012 necessitated innovations and strategies to achieve results. Review of the confirmed polio cases in 2013 showed that most of the cases were from non-compliant households, where parents connived with vaccinators to finger mark the children without actually vaccinating the children with oral polio vaccine or children were absent from home at the time of the visit of vaccinators. Methods We used pre-post design to quantify the outcomes of directly observed vaccination in 90 local government areas from 12 northern Nigeria states at very high risk of polio transmission. The strategy is an intervention, vaccinating children under the direct supervision of an independent supervisor to ensure compliance. Attractive incentives (pluses) were used to make parents willingly submit their children for vaccination or directly attract children to the vaccination teams or post as part of this strategy. Results There was a steady increase in population immunity in all the 90 DOPV implementing LGAs since the introduction of DOPV in 2013. The number of states in which > 90% of children received > 4 OPV doses increased from 7 in 2013 to 11 states by July 2016. Yobe state reported the highest proportional increase from 75 to 99% by July 2016 (22% increase), while Kano state reported 17% increase, from 82 to 99% by July 2016. Conclusion Directly observed polio vaccination strategy improved uptake of polio vaccines and population immunity in high-risk areas for polio transmission.

Abstract Background The Global Commission for the Certification of the Eradication of Poliomyelitis will declare the world free of wild poliovirus transmission when no wild virus has been found in at least 3 consecutive years, and all laboratories possessing wild poliovirus materials have adopted appropriate measures of containment. Nigeria has made progress towards poliomyelitis eradication with the latest reported WPV type 1 on 21 Aug 2016 after 2 years without any case. This milestone achievement was followed by an inventory of biomedical laboratories completed in November 2015 with the destruction of all identified infectious materials. This paper seeks to describe the poliovirus laboratory containment process in Nigeria on which an effective containment system has been built to minimize the risk of virus re-introduction into the population from the laboratories. Methods A national survey of all biomedical facilities, as well as an inventory of laboratories from various sectors, was conducted from June–November 2015. National Task Force (NTF) members and staff working on polio administered an on-site questionnaire in each facility. Laboratory personnel were sensitized with all un-needed materials destroyed by autoclaving and incineration. All stakeholders were also sensitized to continue the destruction of such materials as a requirement for phase one activities. Results A total of 20,638 biomedical facilities were surveyed with 9575 having laboratories. Thirty laboratories were found to contain poliovirus or potentially infectious materials. The 30 laboratories belonged to the ministries of health, education, defence and private organizations. Conclusions This article is amongst the first in Africa that relates poliovirus laboratory containment in the context of the tOPV-bOPV switch in alignment with the Global Action Plan III. All identified infectious materials were destroyed and personnel trained to continue to destroy subsequent materials, a process that needs meticulous monitoring to mitigate the risk of poliovirus re-introduction to the population.

Abstract Background The tremendous progress made by Nigeria towards polio eradication has recently suffered a setback with the isolation of circulating vaccine-derived poliovirus (cVDPV) type 2 from environmental samples and confirmation of four wild poliovirus (WPV) cases from acute flaccid paralysis (AFP) cases, with dates of onset of paralysis in July and August 2016. All these viruses were confirmed from the security-challenged northeastern state of Borno. Polio-compatible cases exist in Nigeria, and they indicate surveillance failure. Surveillance, therefore, has to be strengthened for the country to achieve certification. The objective of this paper is to highlight the epidemiological profile and magnitude of polio-compatible cases in Nigeria during the reporting period, as well as immunization and surveillance response activities conducted to close immunity and surveillance gaps. Methods We conducted a retrospective review of AFP surveillance performance and polio-compatible cases in Nigeria between 2006 and 2016 from the AFP database at the World Health Organization Country Office. We also reviewed and compared key epidemiological features of polio-compatible cases with those of wild poliovirus cases during the reporting period. Results The non-polio AFP rate improved from 6.5 in 2006 to 19.5 in 2016. The corresponding figures for stool adequacy rates were 88 and 98%. The total number of polio-compatible cases reported during the reporting period was 888, with the highest number (194) of cases reported in 2006 and the least (24) in 2016. Clusters of polio-compatible cases were reported every year during the reporting period except in 2015. The highest number (65) of polio-compatible cases in clusters was reported in 2006. The key epidemiological features of polio-compatible and wild poliovirus cases were similar. Conclusion AFP surveillance performance has improved significantly during the reporting period. Surveillance gaps still existed as shown by the presence of orphan viruses and polio-compatible cases, and these gaps need to be identified and closed to achieve certification.

Afghanistan, Nigeria and Pakistan remain endemic for wild poliovirus type 1 (WPV1). (1) Polio eradication activities decreased the number of confirmed WPV cases in Nigeria to 6 by July 2014, [...]

Objective To evaluate a project that integrated essential primary health-care services into the oral polio vaccine programme in hard-to-reach, underserved communities in northern Nigeria. Methods In 2013, Nigeria's polio emergency operation centre adopted a new approach to rapidly raise polio immunity and reduce newborn, child and maternal morbidity and mortality. We identified, trained and equipped eighty-four mobile health teams to provide free vaccination and primary-care services in 3176 hard-to-reach settlements. We conducted cross-sectional surveys of women of childbearing age in households with children younger than 5 years, in 317 randomly selected settlements, pre- and post-intervention (March 2014 and November 2015, respectively). Findings From June 2014 to September 2015 mobile health teams delivered 2 979 408 doses of oral polio vaccine and dewormed 1 562 640 children younger than 5 years old; performed 676 678 antenatal consultations and treated 1 682 671 illnesses in women and children, including pneumonia, diarrhoea and malaria. The baseline survey found that 758 (19.6%) of 3872 children younger than 5 years had routine immunization cards and 690/3872 (17.8%) were fully immunized for their age. The endline survey found 1757/3575 children (49.1%) with routine immunization cards and 1750 (49.0%) fully immunized. Children vaccinated with 3 or more doses of oral polio vaccine increased from 2133 (55.1%) to 2666 (74.6%). Households' use of mobile health services in the previous 6 months increased from 509/1472 (34.6%) to 2060/2426(84.9%). Conclusion Integrating routine primary-care services into polio eradication activities in Nigeria resulted in increased coverage for supplemental oral polio vaccine doses and essential maternal, newborn and child health interventions. [phrase omitted] [phrase omitted] Objectif Evaluer un projet qui integrait des services de soins de sante primaires essentiels au programme d'administration du vaccin antipoliomyelitique oral au sein de communautes difficiles a atteindre et mal desservies au nord du Nigeria. Methodes En 2013, le centre d'intervention d'urgence pour la lutte contre la poliomyelite du Nigeria a adopte une nouvelle approche visant a augmenter rapidement l'immunite contre la poliomyelite et a reduire la morbidite et la mortalite neonatales, infantiles et maternelles. Nous avons selectionne, forme et equipe quatre-vingt-quatre equipes sanitaires mobiles afin d'offrir des services de vaccination et de soins primaires gratuits dans 3176 zones de peuplement difficiles a atteindre. Nous avons mene des enquetes transversales avant et apres l'intervention (en mars 2014 et novembre 2015, respectivement) aupres de femmes en age de procreer dans des familles comptant des enfants Ages de moins de 5 ans, au sein de 317 zones de peuplement selectionnees aleatoirement. Resultats Entre juin 2014 et septembre 2015, les equipes sanitaires mobiles ont fourni 2 979 408 doses de vaccins antipoliomyelitiques oraux et deparasite 1 562 640 enfants Ages de moins de 5 ans; elles ont tenu 676 678 consultations antenatales et soigne 1 682 671 maladies affectant des femmes et des enfants, parmi lesquelles la pneumonie, la diarrhee et le paludisme. Lenquete initiale a revele que sur 3872 enfants Ages de moins de 5 ans, 758 (19,6%) avaient des fiches de vaccination systematique et 690 (17,8%) avaient recu toutes les vaccinations correspondant a leur Age. Lenquete finale a revele que 1757 enfants sur 3575 (49,1%) avaient des fiches de vaccination systematique et que 1750 (49,0%) avaient recu toutes les vaccinations correspondant a leur Age. Le nombre d'enfants ayant recu 3 doses ou plus de vaccins antipoliomyelitiques oraux est passe de 2133 (55,1%) a 2666 (74,6%). Le nombre d'utilisations par les familles des services de sante mobiles au cours des 6 mois precedents est passe de 509 sur 1472 (34,6%) a 2060 sur 2426 (84,9%). Conclusion Lintegration des services de soins primaires systematiques dans les activites d'eradication de la poliomyelite au Nigeria a entraine une augmentation du nombre de beneficiaires de doses supplementaires de vaccins antipoliomyelitiques oraux et des interventions essentielles en sante maternelle, neonatale et infantile. [phrase omitted] Objetivo Evaluar un proyecto que integro los servicios esenciales de atencion primaria en el programa de vacunacion oral contra la polio en comunidades de dificil acceso y desatendidas del norte de Nigeria. Metodos En 2013, el centro de operaciones de emergencia contra la polio de Nigeria adopto un nuevo enfoque para aumentar rapidamente la inmunidad a la enfermedad y reducir la morbilidad y la mortalidad de recien nacidos, ninos y madres. Se identificaron, formaron y equiparon ochenta y cuatro equipos sanitarios moviles para proporcionar servicios gratuitos de vacunacion y atencion primaria en 3176 asentamientos de dificil acceso. Se realizaron encuestas transversales de mujeres en edad fertil en hogares con ninos menores de 5 anos, en 317 asentamientos seleccionados al azar, antes y despues de la intervencion (marzo de 2014 y noviembre de 2015, respectivamente). Resultados Entre junio de 2014 y septiembre de 2015, los equipos sanitarios moviles administraron 2 979 408 dosis de la vacuna oral contra la polio y desparasitaron a 1 562 640 ninos menores de 5 anos, realizaron 676 678 consultas prenatales y trataron 1 682 671 enfermedades de mujeres y ninos, incluidas la neumonia, la diarrea y el paludismo. La encuesta de referencia concluyo que 758 (19,6 %) de 3872 ninos menores de 5 anos tenian tarjetas de vacunacion de rutina y 690/3872 (17,8 %) estaban totalmente inmunizados para su edad. La encuesta final revelo 1757/3575 ninos (49,1 %) con tarjetas de vacunacion de rutina y 1750 (49,0 %) totalmente inmunizados. Los ninos vacunados con tres o mas dosis de la vacuna oral contra la polio aumentaron de 2133 (55,1 %) a 2666 (74,6 %). El uso de los servicios sanitarios moviles por parte de los hogares en los seis meses anteriores aumento de 509/1472 (34,6 %) a 2060/2426 (84,9 %). Conclusion La integracion de los servicios de atencion primaria de rutina en las actividades de erradicacion de la polio en Nigeria dio lugar a un aumento de la cobertura de las dosis suplementarias de la vacuna oral contra la polio y de las intervenciones esenciales de salud materna, neonatal e infantil., Abstracts in [phrase omitted], Francais, [phrase omitted] and Espanol at the end of each article. Introduction The World Health Organization (WHO) has called for universal health coverage (UHC) to be [...]

Nearly 3 decades after the World Health Assembly launched the Global Polio Eradication Initiative in 1988, 4 of the 6 WHO regions have been certified polio-free. (1) Nigeria is one [...]