Journal of immunological sciences最新文献

Background: There has been civil strife, spanning more than two decades in some countries and recurrent natural disasters in the Horn of Africa (HoA). This has consistently maintained these countries in chronic humanitarian conditions. More important however is the fact that these crises have also denied populations of these countries access to access to lifesaving health services. Children in the difficult terrains and security compromised areas are not given the required immunization services to build their immunity against infectious diseases like the poliovirus. This was the situation in 2013 when the large outbreaks of poliovirus occurred in the HoA. This article reviews the epidemiology, risk, and programme response to what is now famed as the 2013-204 poliovirus outbreaks in the HoA and highlights the challenges that the programme faced in interrupting poliovirus transmission here.

Methods: A case of acute flaccid paralysis (AFP) was defined as a child <15 years of age with sudden onset of fever and paralysis. Polio cases were defined as AFP cases with stool specimens positive for WPV.

Results: Between 2013 and 2016, when transmission was interrupted 20,266 polio viruses were in the Horn of Africa region. In response to the outbreak, several supplementary immunization activities were conducted with oral polio vaccine (OPV) The trivalent OPV was used initially, followed subsequently by bivalent OPV, and targeting various age groups, including children aged <5 years, children aged <10 years, and individuals of any age. Other response activities were undertaken to supplement the immunization in controlling the outbreak. Some of these activities included the use of various communication strategies to create awareness, sensitize and mobilize the populations against poliovirus transmission.

Conclusions: The outbreaks were attributed to the existence of clusters of unvaccinated children due to inaccessibility to them by the health system, caused by poor geographical terrain and conflicts. The key lesson therefore is that the existence of populations with low immunity to infections will necessary constitutes breeding grounds for disease outbreak and of course reservoirs to the vectors. Though brought under reasonable control, the outbreaks indicate that the threat of large polio outbreaks resulting from poliovirus importation will remain constant unless polio transmission is interrupted in the remaining polio-endemic countries of the world.

Background: Poliovirus importations and related outbreaks occurred in the Horn of Africa (HoA) following an initial outbreak, which started in Somalia, spread into Kenya within ten days and later into Ethiopia and gradually to other countries in the region. National preparedness plans for responding to poliovirus introduction were insufficient in many countries of the Region. We describe a series of polio outbreak simulation exercises that were implemented to formally test polio outbreak preparedness plans in the HoA countries, as a step to interrupting further transmission.

Methods: The Polio Outbreak Simulation Exercises (POSEs) were designed and implemented. The results were evaluated and recommendations made. The roles of outbreak simulation exercises in maintaining regional polio-free status were assessed. In addition, we performed a comprehensive review of the national plans of all for seven countries in the HoA Region.

Results: Seven simulation exercises, delivered between 2016 and 2017 revealed that participating countries were generally prepared for poliovirus introduction, but the level of preparedness needed improvement. The areas in particular need of strengthening were national preparedness plans, initial response, plans for securing vaccine supply, and communications.

Conclusions: Polio outbreak simulation exercises can be valuable tools to help maintain polio-free status and should be extended to other high-risk countries and subnational areas in the HoA Region and elsewhere. There is also need to standardize the process and methods for conducting POSE for comparability.

Background: Globally, tremendous improvement has been made in Polio eradication since its inception in 1988. For the third time in a decade, Kenya has experienced a Polio outbreak along the border with Somalia. The affected areas were in Garissa County, replete with previous occurrences in 2006 and 2012. This article, give an account of series of events and activities that were used to stop the transmission within 13 weeks, an interval between the first and the last case of the 2013 outbreak.

Methods: In an attempt to stop further transmission and time bound closure of the outbreak, many activities were brought to fore: the known traditional methods, innovative approaches, improved finances and surge capacity. These assisted in case detection, implementation, and coordination of activities. The external outbreak assessments and the six-monthly technical advisory group recommendations were also employed.

Result: There were increased case detections of >=2/100,000, stool adequacy >=80%, due to enhanced surveillance, timely feedbacks from laboratory investigation and diagnosis. Sustained coverage in supplemental immunisation of > 90%, ensured that immune profile of >=3 polio vaccine doses was quickly attained to protect the targeted population, prevent further polio infection and eventual reduction of cases coming up with paralysis.

Conclusion: Overall, the outbreak was stopped within the 120 days of the first case using 14 rounds of supplemental immunisation activities.